Characterization of Japanese standards for myocardial sympathetic and metabolic imaging in comparison with perfusion imaging

Matsuo, Shinro; Nakajima, Kénichi; Yamashina, Shohei; Sakata, Kazuki; Momose, Mitsuru; Hashimoto, Jun; Kumita, Shin‐ichiro; Kawano, Masaya; Okuda, Koichi

doi:10.1007/s12149-009-0269-x

Cited by 30 publications

(26 citation statements)

References 19 publications

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“…The JSNM working group for standardization of myocardial SPECT has accumulated MIBG normal databases of early and late anterior images and SPECT [15,16]. The selection criteria of the normal databases involved patients who had none of the following conditions: electrocardiographic evidence of myocardial ischemia, baseline cardiac diseases (including coronary artery disease, valvular heart disease and severe arrhythmia), history of heart failure, severe liver dysfunction, renal dysfunction, history of heart failure, hypertension with medication, diabetes with medication and dyslipidemia with medication.…”

Section: Jsnm Working Group Databasementioning

confidence: 99%

Standardization of metaiodobenzylguanidine heart to mediastinum ratio using a calibration phantom: effects of correction on normal databases and a multicentre study

Nakajima

Okuda

Matsuo

et al. 2011

Eur J Nucl Med Mol Imaging

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Purpose. This study was performed to demonstrate that the results obtained with a calibration phantom could be used as a tool for standardizing measurement of heart-tomediastinum (H/M) ratio in cardiac metaiodobenzylguanidine (MIBG) imaging.Method. Images of the phantom containing 123 I-MIBG were acquired on the cameras in 10 hospitals (11 camera types) to determine the relationship between H/M ratios using different collimators: low energy (LE) and medium-energy (ME)/low-medium-energy (LME) collimators. The effect of standardization to the ME-comparable H/M ratio was examined in two settings: a Japanese standard MIBG database (n=62) and multi-center studies (n=49). In a multi-center study, probable Alzheimer disease (AD, n=18) and probable dementia with Lewy bodies (DLB, n=31) were studied and standardized by the calibration phantom method.Results. Linear regression equations between LE and ME collimators were obtained for the phantom study in all institutions. When the H/M ratio with a LE collimator was corrected based upon the calibration phantom, the corrected values were comparable to those obtained using ME collimators. The standard database also exhibited a normal distribution after standardization as determined by skewness and goodness-of-fit test. A mixture of the 2 populations by LE and ME collimators showed significant separation of AD and DLB groups (F ratio=24.9 for the late H/M), but the corrected values resulted in higher F ratios for both early and late H/M (F ratio= 34.9 for the late H/M). Conclusion.Standardization of H/M ratios by the heart-chest calibration phantom method is feasible among different collimator types. This method could be practically used for multicenter comparison of H/M ratios.Key Words: 123 I-metaiodobenzylguanidine; heart-to-mediastinum ratio; calibration phantom; Lewy-body disease; standardization Introduction123 I-metaiodobenzylguanidine (MIBG) has been used extensively in fields of cardiology and neurology as a unique imaging method to evaluate sympathetic nerve activity and its integrity [1][2][3][4][5][6][7]. Inter-institutional differences in MIBG quantification using the heart-tomediastinum ratio (H/M) have hampered multi-center comparison of the H/M ratio, and single-center results could not easily be extrapolated to other hospitals [8]. Since the difference in collimator type has been investigated and found to be one of the major confounders of the results, a practical standardization method for quantification has been sought [9][10][11][12].In neurological studies, patients with Parkinson disease and dementia with Lewy bodies (DLB), which is categorized as Lewy-body disease demonstrated significantly lower H/ M ratios both in early and late imaging [4][5][6][7]. Since the patients with Lewy-body disease showed lower H/M values compared with those of normal populations, we used this patient group for a pilot study of the procedure for correction of H/M ratios. In addition, since a multi-center study including DLB and MIBG imaging has started in Japan, an a...

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Section: Jsnm Working Group Databasementioning

confidence: 99%

Standardization of metaiodobenzylguanidine heart to mediastinum ratio using a calibration phantom: effects of correction on normal databases and a multicentre study

Nakajima

Okuda

Matsuo

et al. 2011

Eur J Nucl Med Mol Imaging

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“…The severity of the attenuation artifact can be influenced by the energy of the incident photon [19]. Therefore attenuation of 201 Tl is more marked than for 99m Tc [8,20]. Experienced nuclear cardiologists can recognize the artifacts of the inferior wall with information of regional wall motion, differentiating attenuation artifact from myocardial scarring.…”

Section: Iq-spect/ct Systemmentioning

confidence: 99%

Nuclear myocardial perfusion imaging using thallium-201 with a novel multifocal collimator SPECT/CT: IQ-SPECT versus conventional protocols in normal subjects

et al. 2015

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Objective: A novel multifocal collimator, IQ-SPECT (Siemens) consists of cardio-centric and 3D iterative SPECT reconstruction and makes it possible to perform MPI scans in a short time. The aims are to delineate the normal uptake in thallium-201 ( 201 Tl) SPECT in each acquisition method and to compare the distribution between new and conventional protocol, especially in patients with normal imaging.Methods: Forty patients (eight women, mean age of seventy-five years) who underwent myocardial perfusion imaging were included in the study. All patients underwent one-day protocol perfusion scan after an adenosine-stress test and at rest after administrating 201 Tl and showed normal results. Acquisition was performed on a Symbia T6 equipped with a conventional dual-headed gamma camera system (Siemens ECAM) and with a multifocal collimator called IQ-SPECT. Imaging was performed with a conventional system followed by IQ-SPECT/computed tomography (CT).Reconstruction was performed with or without X-ray CT-derived attenuation correction (AC). Two nuclear physicians blinded to clinical information interpreted all MPI studies.A semi-quantitative myocardial perfusion was analyzed by a 17-segment model with a 5-point visual scoring. The uptake of each segment was measured and left ventricular functions were analyzed by QPS software.Results: IQ-SPECT provided good or excellent image quality. IQ-SPECT images without AC were similar to those of conventional LEHR study. Mid-inferior defect score (0.3±0.5) in conventional LEHR study was increased significantly in IQ-SPECT with AC (0±0). IQ-SPECT (AC) improved the mid-inferior decreased perfusion shown in conventional images. The apex in IQ-SPECT (AC) was decreased compared to that in LEHR (0.1±0.3 vs. 0.5±0.7, p<0.05). The left ventricular ejection fraction from IQ-SPECT was significantly higher than that from the LEHR collimator (p=0.0009). Conclusion:The images of IQ-SPECT acquired in a short time are equivalent with that of conventional LEHR. The results indicated that the IQ-SPECT system with attenuation correction is capable of correcting inferior artifacts with high image quality.(Ann Nucl Med)

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“…The databases used in this study were based on Tc-99m MIBI and tetrofosmin with 360° (n=80) and 180° (n=56). Their ages, height, weight, heart rate and blood pressure at rest and exercise, ejection fraction, left ventricular volumes and regional distribution of the tracers were precisely described elsewhere [4][5][6]. The common database was not modified in each institution thereafter.…”

Section: Jsnm 2007 Databasementioning

confidence: 99%

“…In the preceding studies, although visual evaluation of extent and severity of ischemia was essential, quantitative analysis aided or enhanced a diagnostic accuracy [1][2][3]. Since appropriate normal databases matching those of the acquisition parameters, genders and types of tracers were considered indispensable, we accumulated normal databases from multiple institutions as the working group activity of the Japanese Society of Nuclear Medicine (JSNM) [4][5][6]. Our aim was to use one common standard database for multiple centers with nuclear medicine facilities.…”

Section: Introductionmentioning

confidence: 99%

The validity of multi-center common normal database for identifying myocardial ischemia: Japanese Society of Nuclear Medicine working group database

et al. 2009

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Purpose. The Japanese Society of Nuclear Medicine (JSNM) working group has created a myocardial perfusion imaging database applicable to standard acquisition protocol. The aim of this study is to validate the diagnostic accuracy of the common normal database compared with the expert interpretation of each institute. Methods. Five institutions participated in this study and used different acquisition settings which included 360°/180° rotation, camera configuration and camera orbits. The software and its version used in each institution also varied. The working group database was applied to detect the culprit coronary territory from a total of 166 patients with coronary artery disease (CAD) and 145 patients with low-likelihood of CAD. Results. When summed stress score ≥4 was defined as significant abnormality, overall sensitivity, specificity and accuracy of patient-based analysis were 77%, 72% and 75%, respectively, based on quantitative analysis using the common database, whereas those by institutional visual expert reading were 72%, 79% and 75%, respectively. Conclusion. The common database, which was created by a multi-center working group and separated between male/female with 180/360° acquisitions, demonstrated comparable diagnostic accuracy to expert interpretation by each institute, and it may be applicable to multi-center studies.

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Characterization of Japanese standards for myocardial sympathetic and metabolic imaging in comparison with perfusion imaging

Abstract: Myocardial sympathetic nerve and metabolic scintigraphy data that were specific for the Japanese population were generated and found to be different from that of perfusion tracers. The normal database can serve as a standard for nuclear cardiology work conducted in Japan.

Cited by 30 publications

References 19 publications

Standardization of metaiodobenzylguanidine heart to mediastinum ratio using a calibration phantom: effects of correction on normal databases and a multicentre study

Standardization of metaiodobenzylguanidine heart to mediastinum ratio using a calibration phantom: effects of correction on normal databases and a multicentre study

Nuclear myocardial perfusion imaging using thallium-201 with a novel multifocal collimator SPECT/CT: IQ-SPECT versus conventional protocols in normal subjects

The validity of multi-center common normal database for identifying myocardial ischemia: Japanese Society of Nuclear Medicine working group database

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