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01-10-2014 | Original Article

Prone-position acquisition of myocardial ¹²³I-metaiodobenzylguanidine (MIBG) SPECT reveals regional uptake similar to that found using ¹¹C-hydroxyephedrine PET/CT

Authors: Keiichiro Yoshinaga, Yuuki Tomiyama, Osamu Manabe, Katsuhiko Kasai, Chietsugu Katoh, Kenichi Magota, Eriko Suzuki, Ken-ichi Nishijima, Yuji Kuge, Yoichi M. Ito, Nagara Tamaki

Published in: Annals of Nuclear Medicine | Issue 8/2014

Abstract

Objectives

¹²³I-metaiodobenzylguanidine (MIBG) has been used to estimate cardiac sympathetic nervous innervation. Heterogeneous MIBG distribution is mainly associated with high physiological MIBG uptakes in the liver. We postulate that prone position acquisition might be especially effective for MIBG, providing for separation from high liver uptake similar to that provided by perfusion single-photon emission computed tomography (SPECT). We investigated whether prone-position acquisition improved MIBG image quality by comparing our results to those acquired using supine MIBG and high-quality ¹¹C-hydroxyephedrine (HED) positron emission tomography/computed tomography PET/CT.

Methods

Ten male volunteers (body mass index (BMI) 22.7 ± 3.4) underwent prone and supine MIBG and HED PET. Relative regional tracer uptake was estimated in early MIBG and HED. Acquired images were divided into 17 segments and were grouped into 4 regions: anterior, inferior, septum, and lateral. For each patient, the inferior/anterior ratio was calculated.

Results

The quality of images acquired using prone MIBG was better than that using supine MIBG (p < 0.05). Inferior and septum relative MIBG uptake was reduced in comparison with anterior or lateral MIBG uptake in the supine position (inferior vs. anterior: 69.0 ± 5.6 vs. 82.3 ± 4.6 %, p < 0.01; septum vs. lateral: 66.2 ± 5.1 vs. 81.9 ± 5.4 %, p < 0.01). Prone MIBG showed a significantly higher inferior/anterior uptake ratio in comparison with supine MIBG (n = 24, seg: 92.2 ± 7.2 vs. 83.6 ± 5.7 %, p < 0.05). However, intergroup differences in uptake ratio were demonstrated among prone and supine MIBG and HED. HED PET/CT still showed a higher uptake ratio in comparison with prone MIBG SPECT (103.9 ± 8.0 vs. 92.2 ± 7.2 %, p < 0.05).

Conclusion

Even in normal male subjects, standard supine MIBG imaging showed reduced inferior and septum uptake. Uptake with prone MIBG imaging showed a significant improvement over that with supine imaging and was closer to uptake for HED PET/CT. This improvement may be the result of preventing intense uptake by the liver. Prone data acquisition may be a viable alternative in evaluating regional abnormalities using MIBG SPECT in men.

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Title: Prone-position acquisition of myocardial 123I-metaiodobenzylguanidine (MIBG) SPECT reveals regional uptake similar to that found using 11C-hydroxyephedrine PET/CT
Authors: Keiichiro Yoshinaga
Yuuki Tomiyama
Osamu Manabe
Katsuhiko Kasai
Chietsugu Katoh
Kenichi Magota
Eriko Suzuki
Ken-ichi Nishijima
Yuji Kuge
Yoichi M. Ito
Nagara Tamaki
Publication date: 01-10-2014
Publisher: Springer Japan
Published in: Annals of Nuclear Medicine / Issue 8/2014
Print ISSN: 0914-7187
Electronic ISSN: 1864-6433
DOI: https://doi.org/10.1007/s12149-014-0868-z

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Springer Medicine

Prone-position acquisition of myocardial ¹²³I-metaiodobenzylguanidine (MIBG) SPECT reveals regional uptake similar to that found using ¹¹C-hydroxyephedrine PET/CT

Abstract

Objectives

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

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