Cardiac sympathetic nervous system imaging with 123I-meta-iodobenzylguanidine: Perspectives from Japan and Europe

Abstract

Cardiac sympathetic nervous system dysfunction is closely associated with risk of serious cardiac events in patients with heart failure (HF), including HF progression, pump-failure death, and sudden cardiac death by lethal ventricular arrhythmia. For cardiac sympathetic nervous system imaging, I-meta-iodobenzylguanidine (I-MIBG) was approved by the Japanese Ministry of Health, Labour and Welfare in 1992 and has therefore been widely used since in clinical settings. I-MIBG was also later approved by the Food and Drug Administration (FDA) in the United States of America (USA) and it was expected to achieve broad acceptance. In Europe,I-MIBG is currently used only for clinical research. This review article is based on a joint symposium of the Japanese Society of Nuclear Cardiology (JSNC) and the American Society of Nuclear Cardiology (ASNC), which was held in the annual meeting of JSNC in July 2016. JSNC members and a member of ASNC discussed the standardization of I-MIBG parameters, and clinical aspects ofI-MIBG with a view to further promoting I-MIBG imaging in Asia, the USA, Europe, and the rest of the world.

What does diagnostic threshold mean? Deterministic and probabilistic considerations

“…17 Phantom experiments are ongoing in Japan and Europe to overcome camera and collimator differences among 123 I-mIBG studies. 6,18 Procedural guidelines, normal databases, and normal values created by academic medical societies are also convenient for clinical practice. 12,19 DETERMINISTIC AND PROBABILISTIC APPROACHES…”

123I-meta-Iodobenzylguanidine Imaging in Patients with Cardiac Resynchronization Therapy: Results are Intriguing, but Unknowns Remain

“…9 Despite the current level of evidence, clinical use of 123 I-mIBG scintigraphy has remained limited, potentially because 123 I-mIBG activity can be affected by imaging and processing conditions, raising the need for protocol standardization. 10,11 With the advent of cadmium-zinc-telluride cameras, data have demonstrated that despite a good agreement between transaxial and planar HMR, the absolute HMR values obtained using a multi-pinhole cadmium-zinc-telluride camera were lower than those using conventional planar imaging. 12 However, Bateman et al have shown that HMR of 123 I-mIBG is highly reproducible when subjects are imaged on the same camera.…”

Impact of Novel Antidepressants on Cardiac 123I-Metaiodobenzylguanidine Uptake: Experimental Studies on SK-N-SH Cells and Healthy Rabbits

“…These preliminary results warrant further confirmatory clinical trials regarding the reliability of cardiac 123 I-MIBG imaging, in particular, if the patient's neuropsychiatric status would not tolerate withdrawal of a potentially norepinephrine-interfering antidepressant. Pr oviding a semiquantitative score for mortality risk stratification in heart failure, the guanethidine analog 123 I-metaiodobenzylguanidine ( 123 I-MIBG) has recently been Food and Drug Administration-approved after extensive early-phase use (1)(2)(3). Sharing similar pathways with norepinephrine, including entering adrenergic cells through the uptake-1 pathway and being stored in presynaptic vesicles, the pharmacokinetics of 123 I-MIBG depend mainly on norepinephrine-recycling tissues (4,5).…”