Determination of the Heart-to-Mediastinum Ratio of ¹²³I-MIBG Uptake Using Dual-Isotope (¹²³I-MIBG/^99mTc-Tetrofosmin) Multipinhole Cadmium-Zinc-Telluride SPECT in Patients with Heart Failure

Abstract

The aim of this retrospective study was to compare the heart-to-mediastinum ratio (HMR) of I-metaiodobenzylguanidine (I-MIBG) uptake obtained using a multipinhole cadmium-zinc-telluride (CZT) camera with that obtained using conventional planar imaging. Forty consecutive heart failure patients underwent planar acquisition 4 h afterI-MIBG injection (191 ± 41 [mean ± SD] MBq). To localize the heart using the CZT camera, Tc-tetrofosmin (358 ± 177 MBq) was administered and dual-isotope acquisition was performed. The HMRs were calculated with conventional planar imaging (HMR), with anterior reprojection images using the CZT camera (HMR), and with transaxial reconstructed images using the CZT camera (HMR). In a phantom study, we estimated a linear model fitting the CZT camera data to the planar data, and we applied it to provide corrected CZT camera-determined HMRs in patients (cHMR and cHMR). Thirty-four men and 6 women (71 ± 9 y old) with ischemic (22 patients) and nonischemic (18 patients) heart failure completed the study. For 22 of the 40 patients (55%), the New York Heart Association classification was class II and the ejection fraction was 35% ± 9%. HMR (1.12 ± 0.19) and HMR (1.35 ± 0.34) were lower than HMR (1.44 ± 0.14) ( < 0.0001 and < 0.01, respectively). cHMR (1.54 ± 0.09) and cHMR (1.45 ± 0.14) were significantly different ( < 0.0001). Lin concordance correlation and Bland-Altman analysis demonstrated an almost perfect concordance and a high agreement between HMR and cHMR ( was not significant) but not between HMR and cHMR ( < 0.0001). This study demonstrated that determination of the late HMR of cardiacI-MIBG uptake using dual-isotope (I and Tc) acquisition on a multipinhole CZT camera was feasible in patients with heart failure. However, this determination should be performed using transaxial reconstructed images and linear correction based on phantom data acquisitions.

Co-Registered Solid-State 123i-Mibg Spect And Ct Imaging For The Assessment Of Sympathetic Cardiac Innervation In Healthy Individuals And Variation Over Time

“…However, there are only a small number of studies evaluating cardiac sympathetic innervation imaging with these new generation detectors [21][22][23] and only a few studies have compared H/M ratio determined using CZT acquisition versus that determined using A-SPECT [13,14]. Bellevre et al demonstrated that determination of the late H/M ratio of 123 I-MIBG uptake using a parallel-collimator CZT camera (D-SPECT, Spectrum Dynamics Medical, Caesarea, Israel) was feasible, reliable and equivalent to H/M ratio using A-SPECT in patients with heart failure [13].…”

“…In contrast, Blaire et al using a multi-pinhole CZT camera (Discovery NM 530c, GE Healthcare) found almost perfect concordance between H/M ratio derived from transaxial SPECT images and H/M ratio from planar ones however concordance between H/M ratio from re-projected images and planar ones was only moderate. Blaire et al considered that was related to the multi-pinhole collimation, which is responsible for a truncation artifact that interferes with the mean counts of the myocardial ROI [14].…”

Phase dyssynchrony and 123I-meta-iodobenzylguanidine innervation imaging towards standardization

“…4 However, the recent development of a calibration phantom-based standardization method provides optimal conversion coefficients for most of the Anger-type camera-collimator combinations. 5,6 The standardization method could be applied to cadmium-zinc-telluride (CZT) cameras, either by empirical conversion equation between two systems with a phantom study 7,8 or calibration phantom experiments as described for Anger cameras. 9 On the other hand, the assessment of regional 123 ImIBG uptake with SPECT has not been standardized so rigorously yet.…”

Quantification of myocardial 99mTc-labeled bisphosphonate uptake with cadmium zinc telluride camera in patients with transthyretin-related cardiac amyloidosis

“…In the context of a new era for medical therapy of ATTR cardiac amyloidosis, there is a need for quantitative approaches that would be useful for diagnosis, assessment of patient prognosis, and also therapeutic response. With the widespread use of cadmium zinc telluride (CZT)-based single-photon emission computed tomography (SPECT) camera, it is now feasible to propose a semi quantitative assessment of a cardiac tracer uptake using either 3D reconstructed acquisition or reprojected planar images [16,17].…”