¹²³I-MIBG SPECT for Evaluation of Patients with Heart Failure

Abstract

Heart failure (HF) is characterized by activation of the sympathetic cardiac nerves. The condition of cardiac sympathetic nerves can be evaluated by 123 I-metaiodobenzylguanidine ( 123 I-MIBG) imaging. Most cardiac 123 I-MIBG studies have relied on measurements from anterior planar images of the chest. However, it has become progressively more common to include SPECT imaging in clinical and research protocols. This review examines recent trends in 123 I-MIBG SPECT imaging and evidence that provides the basis for the increased use of the procedure in the clinical management of patients with HF. 123 I-MIBG SPECT has been shown to be complementary to planar imaging in patients with HF in studies of coronary artery disease after an acute myocardial infarction. Moreover, 123 I-MIBG SPECT has been used in numerous studies to document regional denervation for arrhythmic event risk assessment. For better quantification of the size and severity of innervation abnormalities in 123 I-MIBG SPECT, programs and protocols specifically for 123 I have been developed. Also, the introduction of new solid-state cameras has created the potential for more rapid SPECT acquisitions or a reduction in radiopharmaceutical activity. Although PET imaging has superior quantitative capabilities, 123 I-MIBG SPECT is, for the foreseeable future, the only widely available nuclear imaging method for assessing regional myocardial sympathetic innervation.

Intra-image referencing for simplified assessment of HER2-expression in breast cancer metastases using the Affibody molecule ABY-025 with PET and SPECT

“…Examples for SPECT include heart-to-mediastinal ratio (H/R) in [ 123 I]-MIBG neurocardiac imaging [30] and the Krenning scale (tumour-to-liver ratio) for [ 111 In]-octreoscan scintigraphy [31]. …”

Quantitative Analysis of Dynamic 123I-mIBG SPECT Imaging Data in Healthy Humans with a Population-Based Metabolite Correction Method

“…However, 2D planar imaging is not fully quantitative, because of the superposition of background structures with the 2D heart region of interest and lack of corrections for attenuation and scatter. Three-dimensional (3D) SPECT 123 I-mIBG imaging has been proposed to overcome this limitation and enable evaluation of regional myocardial tracer uptake (6)(7)(8)(9)(10)(11). However, the HMR and WOR values change with the timing for early and delayed imaging in both 2D planar and 3D SPECT, which are only surrogates of tracer retention and kinetics.…”

Sleep-disordered breathing, impaired cardiac adrenergic innervation and prognosis in heart failure

“…However, the use of SPECT would increase the injected dose and the duration of the study with no proven benefit 32. In addition, in the present study, we used planar images according to the ADMIRE-HF trial protocol22 that represents the largest multicentre study on the prognostic role of MIBG in patients with HF.…”