Multicenter cross-calibration of I-123 metaiodobenzylguanidine heart-to-mediastinum ratios to overcome camera-collimator variations

Nakajima, Kénichi; Okuda, Koichi; Yoshimura, Mana; Matsuo, Shinro; Wakabayashi, Hiroshi; Imanishi, Yasuhiro; Kinuya, Seigo

doi:10.1007/s12350-014-9916-2

Cited by 121 publications

(123 citation statements)

References 17 publications

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“…132 Although it has been suggested that a medium-energy collimator may be preferred, 129 use of a calibration phantom to derive a conversion coefficient for each camera-collimation system may be a better approach. 134,135 There have been recent reports on the 123 I-mIBG imaging with solid-state cameras. While data from these are encouraging, given the aforementioned discussion, one must consider the image that derived quantitative parameters from these camera(s) may differ from those reported in the literature upon which clinical use is recommended.…”

Section: Imaging Techniquesmentioning

confidence: 99%

ASNC imaging guidelines for SPECT nuclear cardiology procedures: Stress, protocols, and tracers

Henzlova

Duvall

Einstein

et al. 2016

Journal of Nuclear Cardiology

529

386

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Section: Imaging Techniquesmentioning

confidence: 99%

ASNC imaging guidelines for SPECT nuclear cardiology procedures: Stress, protocols, and tracers

Henzlova

Duvall

Einstein

et al. 2016

Journal of Nuclear Cardiology

529

386

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“…We proposed a calibration phantom method to cross-calibrate HMRs among institutions (31,32). Because HMRs from 2 camera acquisition conditions have an approximately linear relationship, a conversion formula for 2 systems can be determined with the cross-calibration phantom designed for planar imaging.…”

Section: Standardization Of Hmr For Prognostic Evaluationmentioning

confidence: 99%

Cardiac ¹²³I-MIBG Imaging for Clinical Decision Making: 22-Year Experience in Japan

Nakajima

Nakata

2015

J Nucl Med

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Cardiac neuroimaging with 123 I-metaiodobenzylguanidine ( 123 I-MIBG) has been officially used in clinical practice in Japan since 1992. The nuclear cardiology guidelines of the Japanese Circulation Society, revised in 2010, recommended cardiac 123 I-MIBG imaging for the management of heart failure (HF) patients, particularly for the assessment of HF severity and prognosis of HF patients. Consensus in North American and European countries regarding incorporation into clinical practice, however, has not been established yet. This article summarizes 22 y of clinical applications in Japan of 123 I-MIBG imaging in the field of cardiology; these applications are reflected in cardiology guidelines, including recent methodologic advances. A standardized cardiac 123 I-MIBG parameter, the heartto-mediastinum ratio (HMR), is the basis for clinical decision making and enables common use of parameters beyond differences in institutions and studies. Several clinical studies unanimously demonstrated its potent independent roles in prognosis evaluation and risk stratification irrespective of HF etiologies. An HMR of less than 1.6−1.8 and an accelerated washout rate are recognized as high-risk indicators of pump failure death, sudden cardiac death, and fatal arrhythmias and have independent and incremental prognostic values together with known clinical variables, such as left ventricular ejection fraction and brain natriuretic peptide. Another possible use of this imaging technique is the selection of therapeutic strategy, such as pharmacologic treatment and nonpharmacologic treatment with an implantable cardioverter-defibrillator or cardiac resynchronization device; however, this possibility remains to be investigated. Recent multiple-cohort database analyses definitively demonstrated that patients who were at low risk for lethal events and who were defined by an HMR of greater than 2.0 on 123 I-MIBG studies had a good long-term prognosis. Future investigations of cardiac 123 I-MIBG imaging will contribute to better risk stratification of low-risk and high-risk populations, to the establishment of costeffective use of this imaging technique for the management of HF patients, and to worldwide acceptance of this imaging technique in clinical cardiology practice.

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“…Since the average CC of ME general-purpose collimators is 0.88 (16) general-purpose (ELEGP) with two types depending on camera, LME, MEGP and ME low penetration (MELP) collimators, respectively (16). However, the CC of the same LEHR collimator that was commonly used in the multicenter ADMIRE-HF study might have significantly varied depending on septal thickness, the size and length of the hole, as well as the camera crystals (17).…”

Section: Calibration Phantom To Overcome Camera-collimator Differencesmentioning

confidence: 99%

<sup>123</sup>I-Meta-Iodobenzylguanidine Imaging

Nakajima

2016

Annals of Nuclear Cardiology

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Abstract123 I-meta-iodobenzylguanidine (MIBG) is a potent prognostic marker of chronic heart failure (CHF). However, inter-institutional variations due to methodological variations required minimization before 123 I-MIBG findings could be universally applied to the diagnosis, treatment and prognosis of CHF. Therefore, protocols including data acquisition, setting regions of interest for calculating heart-to-mediastinum ratios (HMR) and crosscalibration of HMR among institutions required standardization. A cross-calibration phantom was introduced to overcome institutional differences, and a large amount of experimental data were collected, which enabled multicenter comparisons and the creation of large-scale prognostic databases. Thereafter, cardiac mortality risk models to estimate short-and long-term (two and five years, respectively) mortality were created based on a standardized 123 I-MIBG HMR. The ability of these models to accurately determine prognosis is currently Kenichi Nakajima Department of Nuclear Medicine, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, Japan 920-8641 E-mail: nakajima@med.kanazawa-u.ac.jp ME general-purpose (MEGP) collimators, but low-energy high-resolution (LEHR), low-energy general-purpose (LEGP), and low-medium-energy (LME) collimators are also popular in Japan. Single-photon emission computed tomography (SPECT) imaging also allows 360º or 180º rotation and it can score defects similar to perfusion defects (7,8). The Japanese Society Nuclear Medicine working group created normal early / late, 180º / 360º and gender-specific databases (9) that work with any software and are applicable to clinical and research purposes. Administration of 123 I-MIBG and data acquisition Heart-to-mediastinum ratio: ROI setting and stabilityThe most popular index of cardiac MIBG uptake is early and late HMR. Although the HMR is a simple average count ratio between the heart and mediastinum, the location, size and (10) and the semiautomatic smartMIBG software used in Japan (5). This software needs only to point towards the center of the heart, and then a circular ROI on the heart and a rectangular ROI on the upper mediastinum are automatically determined. The mediastinal ROI was set at 10% of the body width and 30% of the height from the center of the heart to the upper border of the mediastinum. The optimal mediastinal region was automatically searched vertically to determine the minimal count on the mediastinum. The HMR remains relatively stable for three or four hours, when late images can be acquired (11,12). A washout rate (WR) can also be calculated using the formula:WR (%) = (early heart count-late heart count) / early heart count×100.The mediastinal count in this formula is usually subtracted from the heart count as the background, and a 123 I (half-life, 13 h) decay is corrected using a decay factor at three to four hours after the initial image acquisition (correction factor of ×1.17and ×1.24, respectively). Although ROI settings are generally considered reproducible (13), the sem...

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Multicenter cross-calibration of I-123 metaiodobenzylguanidine heart-to-mediastinum ratios to overcome camera-collimator variations

Cited by 121 publications

References 17 publications

ASNC imaging guidelines for SPECT nuclear cardiology procedures: Stress, protocols, and tracers

ASNC imaging guidelines for SPECT nuclear cardiology procedures: Stress, protocols, and tracers

Cardiac ¹²³I-MIBG Imaging for Clinical Decision Making: 22-Year Experience in Japan

<sup>123</sup>I-Meta-Iodobenzylguanidine Imaging

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Multicenter cross-calibration of I-123 metaiodobenzylguanidine heart-to-mediastinum ratios to overcome camera-collimator variations

Cited by 121 publications

References 17 publications

ASNC imaging guidelines for SPECT nuclear cardiology procedures: Stress, protocols, and tracers

ASNC imaging guidelines for SPECT nuclear cardiology procedures: Stress, protocols, and tracers

Cardiac 123I-MIBG Imaging for Clinical Decision Making: 22-Year Experience in Japan

<sup>123</sup>I-Meta-Iodobenzylguanidine Imaging

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Product

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Cardiac ¹²³I-MIBG Imaging for Clinical Decision Making: 22-Year Experience in Japan