The prognostic value of 123I-mIBG SPECT cardiac imaging in heart failure patients: a systematic review

Pontico, Mariano; Brunotti, Gabriele; Conte, Miriam; Corica, Ferdinando; Cosma, Laura; Angelis, Cristina de; Feo, Maria Silvia De; Lazri, Julia; Matto, Antonio; Montebello, Melissa; Rocco, Arianna Di; Frantellizzi, Viviana; Farcomeni, Alessio; Vincentis, Giuseppe De

doi:10.1007/s12350-020-02501-w

Cited by 17 publications

(9 citation statements)

References 48 publications

(80 reference statements)

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“…The H/M ratio on the anterior planar image has been widely used as the semiquantitative myocardial [ 123 I]-MIBG uptake parameter [17,18]. A prior study reported that the semiquantitative analysis of [ 123 I]-MIBG cardiac SPECT is useful for evaluating regional sympathetic activity [6,19]. However, the disadvantage of semiquantitative analysis of [ 123 I]-MIBG ).…”

Section: Discussionmentioning

confidence: 99%

“…The LVEF, LAVI, E/A, septal e′, and septal E/e′ ratio were 80.0%, 40.6 mL/mm 2 , 0.72, 4.0 cm/s, and 14.2, respectively. These echocardiographic findings indicate the presence of LV diastolic dysfunction cardiac SPECT is its poor reproducibility [6,19]. Recently, a semiquantitative parameter has introduced SUV derived from SPECT/CT imaging.…”

Section: Discussionmentioning

confidence: 99%

“…Several reports stated that semiquantitative analysis of [ 123 I]-MIBG cardiac planar or single-photon emission computed tomography (SPECT) can predict the prognoses of patients with chronic heart failure [3][4][5][6]. However, estimating the uptake of local tracer using SPECT images can be technically complex, and inter-or intraobserver variability might not be negligible [6].…”

Section: Introductionmentioning

confidence: 99%

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Application of 123I-MIBG myocardial maximum standardized uptake value to characterize cardiac function in patients with pheochromocytoma: comparison with echocardiography

et al. 2022

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Purpose This study examined the usefulness of the maximum standardized uptake value (SUVmax) of myocardial [123I]-metaiodobenzylguanidine ([123I]-MIBG) to characterize myocardial function by comparing it with echocardiographic parameters in patients with pheochromocytoma. Materials and methods This study included 18 patients with pheochromocytoma who underwent both planar and [123I]-MIBG single-photon emission computed tomography/computed tomography scans and echocardiography before surgery. Myocardial [123I]-MIBG visibility and SUVmax were compared with echocardiographic parameters related to systolic and diastolic functions. The Mann–Whitney U test, Fisher exact test, or Spearman rank correlation assessed differences or relationships between two quantitative variables. Results On visual analysis, 6 patients showed normal myocardial [123I]-MIBG uptake, whereas 12 patients showed decreased myocardial [123I]-MIBG uptake. No patients showed systolic dysfunction. A significant difference was observed in the incidence of diastolic dysfunction between the groups with normal and decreased uptake (p = 0.009), and left ventricular (LV) diastolic dysfunction was observed in 9 (75%) of 12 patients with decreased myocardial uptake. The myocardial SUVmax was significantly lower in 9 patients with LV diastolic dysfunction than in 9 patients with normal cardiac function (1.67 ± 0.37 vs. 3.03 ± 1.38, p = 0.047). Myocardial SUVmax was positively correlated with septal e′ (early diastolic velocity of septal mitral annulus) (ρ = 0.51, p = 0.031) and negatively correlated with the septal E/e′ ratio (early mitral E-velocity to early diastolic velocity of septal mitral annulus; ρ = − 0.64, p = 0.004), respectively. Conclusions LV diastolic dysfunction was inversely related to myocardial [123I]-MIBG uptake. Myocardial [123I]-MIBG SUVmax may be useful for characterizing cardiac function in patients with pheochromocytoma. Second abstract. The semiquantitative analysis using the myocardial SUVmax in 123I-MIBG SPECT/CT was found to be potentially useful for characterizing cardiac function in patients with pheochromocytoma.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Application of 123I-MIBG myocardial maximum standardized uptake value to characterize cardiac function in patients with pheochromocytoma: comparison with echocardiography

et al. 2022

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“…The norepinephrine transporter (NET), which controls neurotransmission by regulating the reuptake of the neurotransmitter norepinephrine (NE) in the synaptic cleft [ 1 ], is an important theranostic target in multiple areas, including the diagnosis of cardiac diseases by monitoring the function of the sympathetic nervous system (SNS), the diagnosis and treatment of neuroendocrine tumors, and the early detection of Parkinson’s disease (PD) [ 2 , 3 , 4 ]. Radionuclide-labeled tracers targeting the NET are NE analogs that mimic NE turnover via NET-mediated uptake and NE storage within the neuronal terminals; these compounds are exemplified by meta -iodobenzylguanidine (MIBG), which has been in use for over 30 years as a single-photon emission computed tomography (SPECT) diagnostic tracer and has recently been approved by the US Food and Drug Administration (FDA) as a therapeutic agent [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Rationalizing the Binding Modes of PET Radiotracers Targeting the Norepinephrine Transporter

et al. 2023

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Purpose: A new PET radiotracer 18F-AF78 showing great potential for clinical application has been reported recently. It belongs to a new generation of phenethylguanidine-based norepinephrine transporter (NET)-targeting radiotracers. Although many efforts have been made to develop NET inhibitors as antidepressants, systemic investigations of the structure–activity relationships (SARs) of NET-targeting radiotracers have rarely been performed. Methods: Without changing the phenethylguanidine pharmacophore and 3-fluoropropyl moiety that is crucial for easy labeling, six new analogs of 18F-AF78 with different meta-substituents on the benzene-ring were synthesized and evaluated in a competitive cellular uptake assay and in in vivo animal experiments in rats. Computational modeling of these tracers was established to quantitatively rationalize the interaction between the radiotracers and NET. Results: Using non-radiolabeled reference compounds, a competitive cellular uptake assay showed a decrease in NET-transporting affinity from meta-fluorine to iodine (0.42 and 6.51 µM, respectively), with meta-OH being the least active (22.67 µM). Furthermore, in vivo animal studies with radioisotopes showed that heart-to-blood ratios agreed with the cellular experiments, with AF78(F) exhibiting the highest cardiac uptake. This result correlates positively with the electronegativity rather than the atomic radius of the meta-substituent. Computational modeling studies revealed a crucial influence of halogen substituents on the radiotracer–NET interaction, whereby a T-shaped π–π stacking interaction between the benzene-ring of the tracer and the amino acid residues surrounding the NET binding site made major contributions to the different affinities, in accordance with the pharmacological data. Conclusion: The SARs were characterized by in vitro and in vivo evaluation, and computational modeling quantitatively rationalized the interaction between radiotracers and the NET binding site. These findings pave the way for further evaluation in different species and underline the potential of AF78(F) for clinical application, e.g., cardiac innervation imaging or molecular imaging of neuroendocrine tumors.

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“…summed scores or total perfusion de cit (TPD)) (3,4) provide high sensitivity diagnosis of the extent and severity of ischemia. Beyond perfusion, 123 I-metaiodobensylguanidine ( 123 I-mIBG) SPECT was also effectively introduced for the molecular level diagnosis of innervation disorders related to cardiomyopathies (5)(6)(7)(8) as well as accurate prognosis (9) and clinical decision making (10) in case of patients with chronic heart failure (HF). While these clinically proven applications are widely used, the image quality of conventional dual-head SPECT with parallel hole collimators remained limited due to the relatively low tomographic sensitivity and spatial resolution of this technique.…”

mentioning

confidence: 99%

Performance Evaluation of a Novel Multi-PinHole Collimator on Triple-detector SPECT/CT for dedicated myocardial imaging

Krizsán¹,

Kukuts²,

Al-Muhanna³

et al. 2022

Preprint

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BackgroundIn this study we evaluated the imaging capabilities of a novel Multi-pinhole collimator (MPH-Cardiac) specially designed for nuclear cardiology imaging on a triple head NaI(Tl) detector based SPECT/CT system.Methods99mTc point source measurements covering the field-of-view (FOV) were used to determine tomographic sensitivity (TSpointsource) and spatial resolution. Organ-size tomographic sensitivity (TSorgan) was measured with a left ventricle (LV) phantom filled with typical myocardial activity of a patient scan. Reconstructed image uniformity was measured with a 140 mm diameter uniform cylinder phantom. Using the LV phantom once filled with 99mTc and after with 123I, a polar map analysis was performed determining Spill-Over-Ratio in water (SORwater) and image noise. Results were compared with that of a dual-head parallel-hole low energy high resolution (LEHR) collimator system. A patient with suspected coronary artery disease (CAD) was scanned on the LEHR system using local protocol of 16 minutes total acquisition time, followed by a 4-minute MPH-Cardiac scan. ResultsPeak TSpointsource was found to be 1013 cps/MBq in the axial center of the FOV while it was decreasing towards the radial edges. TSorgan in the CFOV was found to be 134 cps/MBq and 700 cps/MBq for the LEHR and MPH-Cardiac respectively. Average spatial resolution throughout the FOV was 4.38 mm FWHM for the MPH-Cardiac collimator. Reconstructed image uniformity values were found to be 0.504 % versus 0.392 % for the LEHR and MPH-Cardiac measurements respectively. SORwater values were found to be 28.83% and 21.1 % for the 99mTc measurements, and 31.44 % and 24.33 % for the 123I measurements for LEHR and MPH-Cardiac respectively. Pixel noise of the 99mTc polar maps resulted in values of 0.38 % and 0.24 % and of the 123I polar maps 0.62 % and 0.21 % for LEHR and MPH-Cardiac respectively. Visually interpreting the patient scan images, MPH-Cardiac resulted in better image contrast compared to the LEHR technique with four times shorter scan duration.ConclusionsThe significant image quality improvement achieved with dedicated MPH-Cardiac collimator on triple head SPECT/CT system paves the way for short acquisition and low-dose cardiovascular SPECT applications.

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The prognostic value of 123I-mIBG SPECT cardiac imaging in heart failure patients: a systematic review

Cited by 17 publications

References 48 publications

Application of 123I-MIBG myocardial maximum standardized uptake value to characterize cardiac function in patients with pheochromocytoma: comparison with echocardiography

Application of 123I-MIBG myocardial maximum standardized uptake value to characterize cardiac function in patients with pheochromocytoma: comparison with echocardiography

Rationalizing the Binding Modes of PET Radiotracers Targeting the Norepinephrine Transporter

Performance Evaluation of a Novel Multi-PinHole Collimator on Triple-detector SPECT/CT for dedicated myocardial imaging

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