Heart failure & cardiomyopathiesDiagnostic or prognostic study
Pathology-Based Validation of Quantitative Single-photon Emission CT (SPECT)/Computed Tomography (CT) in Patients With Suspected Transthyretin Amyloid Cardiomyopathy
- Pathology-based validation of quantitative SPECT/CT
- consecutive patients
- single centre (Mayo Clinic)
Authors' conclusion
In patients with suspected ATTR-CM undergoing 99m Tc-pyrophosphate SPECT/CT, the Mayo 3D Score demonstrated superior diagnostic performance compared with planar metrics and comparable to SPECT Perugini, while correlating with myocardial ATTR burden and deposition patterns on pathology. These findings support its integration as a quantitative adjunct within clinical diagnostic ATTR-CM workflows.
Study context
- Population
- Patients who underwent 99m Tc-pyrophosphate SPECT/CT for suspected ATTR-CM between June 2017 and January 2025 with archived myocardial tissue107 (47%) had ATTR-CM, of whom 9 had hereditary ATTR-CM
- Participants
- 230 patients
- Comparison
- Mayo 3D Score against myocardial pathology, compared with planar Perugini, heart-to-contralateral lung ratio and SPECT Perugini
Performance
As reported in the abstract
Mayo 3D Score
0.92
AUC · CI 0.88–0.96
planar Perugini
0.87
AUC · CI 0.83–0.92
heart-to-contralateral lung ratio
0.86
AUC · CI 0.81–0.91
SPECT Perugini
0.90
AUC · CI 0.86–0.94
Mayo 3D Score vs planar Perugini: P = 0.006 · Mayo 3D Score vs heart-to-contralateral lung ratio: P = 0.004 · Mayo 3D Score vs SPECT Perugini: P = 0.12
Further findings
- Mayo 3D Score cutoff ≥1.0 diagnostic performance
- 86.0% · sensitivity · specificity 92.7% · positive predictive value 91.1% · negative predictive value 88.4%
Mayo 3D Score vs pathology among ATTR-positive cases
- Correlation with semiquantitative amyloid burden (Spearman ρ)
- 0.69
- Higher in pericellular than nodular deposition patterns
- P < 0.001
- Not associated with vascular involvement
- P = 0.42
Original publication
Summarised from the published abstract; every number is checked against it