Standardization of the heart-to-mediastinum ratio of 123I-labelled-metaiodobenzylguanidine uptake using the dual energy window method: feasibility of correction with different camera–collimator combinations

Matsuo, Shinro; Nakajima, Kénichi; Okuda, Koichi; Kawano, Masaya; Ishikawa, Takehiro; Hosoya, Tetsuo; Taki, Junichi; Kinuya, Seigo

doi:10.1007/s00259-008-0971-2

Cited by 29 publications

(21 citation statements)

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“…130,131 Although most clinical literature is based on use of a LEHR, in fact the reported HMRs are severely underestimated in relation to the true value. 132 Several methods have been explored attempting to overcome this problem when an LEHR is used, including mathematical deconvolution of septal penetration (DSP), 130 image acquisition using 123 I-dual window acquisition (IDW), 133 decreasing the 159-kEV energy window to 15%. 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.…”

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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“…The calibration phantom for 123 I-MIBG was used as previously described [11,13]. Briefly, the phantom was made for a planar-image acquisition and consisted of multiple slices of heart, lung, mediastinum and liver parts.…”

Section: Phantom Designmentioning

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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“…However, estimates of the H/M ratio are substantially affected by the acquisition protocol and data processing method and vary largely among institutions (4,5). This large variation disturbs the widespread use of cardiac 123 I-MIBG imaging, and standardization is being pursued (6)(7)(8)(9).…”

mentioning

confidence: 99%

Acquisition Protocols and Correction Methods for Estimation of the Heart-to-Mediastinum Ratio in ¹²³I-Metaiodobenzylguanidine Cardiac Sympathetic Imaging

et al. 2013

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Septal penetration of high-energy photons affects quantitative results in imaging of 123 I-labeled tracers. We investigated acquisition protocols (collimator choice and energy window setting) and correction methods for estimating the heart-to-mediastinum (H/M) ratio in cardiac 123 I-metaiodobenzylguanidine (MIBG) imaging. Methods: Four hours after 123 I-MIBG injection, 40 patients successively underwent planar anterior chest imaging with the medium-energy (ME) (ME method) and low-energy high-resolution (LEHR) (LEHR method) collimators. A 20% energy window was used for both collimators. Another 40 patients were imaged successively with the ME collimator and a 20% window (ME method), the low-medium-energy (LME) collimator and a 20% window (LME20 method), and the LME collimator and a 15% window (LME15 method). The H/M ratios obtained by the LEHR, LME20, and LME15 methods were corrected using their correlations with the H/M ratio obtained by the ME method (empiric correction). The 123 I-dual-window (IDW) correction was also applied to remove the influence of high-energy photons. Results: Without correction, severe underestimation of the H/M ratio was shown for the LEHR method using the ME method as a standard, and this underestimation increased with increasing H/M ratios. Underestimation substantially decreased using the LME20 method and further using the LME15 method. Empiric correction reduced the error in the H/M ratio by the LEHR method, but the error was still evident. After empiric correction, the H/M ratios with the LME collimator were comparable to those with the ME collimator. The IDW correction only partially reduced underestimation by the LEHR method and caused a small overestimation for the LME15 method. Conclusion: The use of an LME collimator appears to be acceptable for cardiac 123 I-MIBG imaging as an alternative to an ME collimator, and the application of a 15% energy window is recommended when an LME collimator is used. Empiric correction is also expected to improve exchangeability between H/M ratios calculated with ME and LME collimators. Neither the use of an LEHR collimator nor the use of IDW correction is recommended.

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Standardization of the heart-to-mediastinum ratio of 123I-labelled-metaiodobenzylguanidine uptake using the dual energy window method: feasibility of correction with different camera–collimator combinations

Abstract: Background. Although heart-to-mediastinum (H/M) ratio in a planner image has been

Cited by 29 publications

References 20 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

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

Acquisition Protocols and Correction Methods for Estimation of the Heart-to-Mediastinum Ratio in ¹²³I-Metaiodobenzylguanidine Cardiac Sympathetic Imaging

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Standardization of the heart-to-mediastinum ratio of 123I-labelled-metaiodobenzylguanidine uptake using the dual energy window method: feasibility of correction with different camera–collimator combinations

Abstract: Background. Although heart-to-mediastinum (H/M) ratio in a planner image has been

Cited by 29 publications

References 20 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

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

Acquisition Protocols and Correction Methods for Estimation of the Heart-to-Mediastinum Ratio in 123I-Metaiodobenzylguanidine Cardiac Sympathetic Imaging

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Acquisition Protocols and Correction Methods for Estimation of the Heart-to-Mediastinum Ratio in ¹²³I-Metaiodobenzylguanidine Cardiac Sympathetic Imaging