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Published in: Current Cardiology Reports 2/2011

01-04-2011

Variation of Heart-to-Mediastinal Ratio in 123I-mIBG Cardiac Sympathetic Imaging: Its Affecting Factors and Potential Corrections

Authors: Wengen Chen, Qi Cao, Vasken Dilsizian

Published in: Current Cardiology Reports | Issue 2/2011

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Abstract

Studies have repeatedly shown the utility of 123I-mIBG cardiac sympathetic imaging for identifying symptomatic heart failure patients most likely to experience adverse cardiac events. Delayed heart-to-mediastinal ratio (H/M) and washout rate derived from meta-iodobenzylguanidine (mIBG) scintigraphy have been used to monitor response to medical treatment. However, there is great variation of H/M ratio among publications from various institutions. The current article systemically reviews factors that can potentially affect H/M ratio, particularly the acquisition parameters, and proposes new approaches and/or procedures to standardize the imaging procedure and minimize the variation of H/M among institutions.
Literature
1.
go back to reference Nakajo M, Shimabukuro K, Yoshimura H, et al.: Iodine-131 metaiodobenzylguanidine intra- and extravesicular accumulation in the rat heart. J Nucl Med 1986, 27:84-89.PubMed Nakajo M, Shimabukuro K, Yoshimura H, et al.: Iodine-131 metaiodobenzylguanidine intra- and extravesicular accumulation in the rat heart. J Nucl Med 1986, 27:84-89.PubMed
2.
go back to reference Wieland DM, Brown LE, Rogers WL, et al.: Myocardial imaging with a radioiodinated norepinephrine storage analog. J Nucl Med 1981, 22:22-31.PubMed Wieland DM, Brown LE, Rogers WL, et al.: Myocardial imaging with a radioiodinated norepinephrine storage analog. J Nucl Med 1981, 22:22-31.PubMed
3.
go back to reference Kline RC, Swanson DP, Wieland DM, et al.: Myocardial imaging in man with I-123 meta-iodobenzylguanidine. J Nucl Med 1981, 22:129-132.PubMed Kline RC, Swanson DP, Wieland DM, et al.: Myocardial imaging in man with I-123 meta-iodobenzylguanidine. J Nucl Med 1981, 22:129-132.PubMed
4.
go back to reference Dilsizian V, Chandrashekhar Y, Narula J: Introduction of New Tests: Low are the mountains, high the expectations. JACC Cardiovasc Imaging 2010, 3:117-119.CrossRefPubMed Dilsizian V, Chandrashekhar Y, Narula J: Introduction of New Tests: Low are the mountains, high the expectations. JACC Cardiovasc Imaging 2010, 3:117-119.CrossRefPubMed
5.
6.
go back to reference Carrio I, Cowie MR, Yamazaki J et al.: Cardiac sympathetic imaging with mBIG in hear failure. JACC Cardiovasc Imaging 2010, 3:92-100.CrossRefPubMed Carrio I, Cowie MR, Yamazaki J et al.: Cardiac sympathetic imaging with mBIG in hear failure. JACC Cardiovasc Imaging 2010, 3:92-100.CrossRefPubMed
7.
go back to reference Gerson MC, Craft LL, McGuire N, et al.: Carvedilol improves left ventricular function in heart failure patients with idiopathic dilated cardiomyopathy and a wide range of sympathetic nervous system function as measured by iodine 123 metaiodobenzylguanidine. J Nucl Cardiol 2002, 9:608-615.CrossRefPubMed Gerson MC, Craft LL, McGuire N, et al.: Carvedilol improves left ventricular function in heart failure patients with idiopathic dilated cardiomyopathy and a wide range of sympathetic nervous system function as measured by iodine 123 metaiodobenzylguanidine. J Nucl Cardiol 2002, 9:608-615.CrossRefPubMed
8.
go back to reference Verberne HJ, Brewster LM, Somsen GA, et al.: Prognostic value of myocardial 123I-metaiodobenzylguanidine (MIBG) parameters in patients with heart failure: a systematic review. Eur Heart J 2008, 29:1147-1159.CrossRefPubMed Verberne HJ, Brewster LM, Somsen GA, et al.: Prognostic value of myocardial 123I-metaiodobenzylguanidine (MIBG) parameters in patients with heart failure: a systematic review. Eur Heart J 2008, 29:1147-1159.CrossRefPubMed
9.
go back to reference • Verberne HJ, Habraken JB, van Eck-Smit BL, et al.: Variations in 123I-metaiodobenzylguanidine (MIBG) late heart mediastinal ratios in chronic heart failure: a need for standardisation and validation. Eur J Nucl Med Mol Imaging 2008, 35:547-553. This retrospective multicenter study in 290 heart failure patients from six sites of five European countries showed a large variation in acquisition parameters, which contributes to the variation of H/M in patients. CrossRefPubMed • Verberne HJ, Habraken JB, van Eck-Smit BL, et al.: Variations in 123I-metaiodobenzylguanidine (MIBG) late heart mediastinal ratios in chronic heart failure: a need for standardisation and validation. Eur J Nucl Med Mol Imaging 2008, 35:547-553. This retrospective multicenter study in 290 heart failure patients from six sites of five European countries showed a large variation in acquisition parameters, which contributes to the variation of H/M in patients. CrossRefPubMed
10.
go back to reference • Agostini D, Verberne HJ, Burchert W, et al.: I-123-mIBG myocardial imaging for assessment of risk for a major cardiac event in heart failure patients: insights from a retrospective European multicenter study. Eur J Nucl Med Mol Imaging 2008, 35:535-546. The paper re-analyzed pooled data on 290 heart failure patients from six sites in five European countries, which confirmed the prognostic value of H/M in heart failure patients. CrossRefPubMed • Agostini D, Verberne HJ, Burchert W, et al.: I-123-mIBG myocardial imaging for assessment of risk for a major cardiac event in heart failure patients: insights from a retrospective European multicenter study. Eur J Nucl Med Mol Imaging 2008, 35:535-546. The paper re-analyzed pooled data on 290 heart failure patients from six sites in five European countries, which confirmed the prognostic value of H/M in heart failure patients. CrossRefPubMed
11.
go back to reference • Jacobson AF, Senior R, Cerqueira MD, et al.: Myocardial iodine-123 meta-iodobenzylguanidine imaging and cardiac events in heart failure. Results of the prospective ADMIRE-HF (AdreView Myocardial Imaging for Risk Evaluation in Heart Failure) study. J Am Coll Cardiol 2010, 55:2212-2221. This multicenter, prospective study on 961 heart failure patients from 96 sites provided validation of the independent prognostic value of H/M in assessing heart failure patients.CrossRefPubMed • Jacobson AF, Senior R, Cerqueira MD, et al.: Myocardial iodine-123 meta-iodobenzylguanidine imaging and cardiac events in heart failure. Results of the prospective ADMIRE-HF (AdreView Myocardial Imaging for Risk Evaluation in Heart Failure) study. J Am Coll Cardiol 2010, 55:2212-2221. This multicenter, prospective study on 961 heart failure patients from 96 sites provided validation of the independent prognostic value of H/M in assessing heart failure patients.CrossRefPubMed
12.
go back to reference Inoue Y, Suzuki A, Shirouzu I, et al.: Effect of collimator choice on quantitative assessment of cardiac iodine 123 MIBG uptake. J Nucl Cardiol 2003, 10:623-632.CrossRefPubMed Inoue Y, Suzuki A, Shirouzu I, et al.: Effect of collimator choice on quantitative assessment of cardiac iodine 123 MIBG uptake. J Nucl Cardiol 2003, 10:623-632.CrossRefPubMed
13.
go back to reference Fletcher AM, Motherwell DW, Small AD, et al.: I-123 MIBG cardiac uptake measurements: limitations of collimator choice and scatter correction in the clinical context. Nucl Med Commun 2010, 31:629-636.PubMed Fletcher AM, Motherwell DW, Small AD, et al.: I-123 MIBG cardiac uptake measurements: limitations of collimator choice and scatter correction in the clinical context. Nucl Med Commun 2010, 31:629-636.PubMed
14.
go back to reference Farahati J, Bier D, Scheubeck M, et al.: Effect of specific activity on cardiac uptake of iodine-123-MIBG. J Nucl Med 1997, 38:447-451.PubMed Farahati J, Bier D, Scheubeck M, et al.: Effect of specific activity on cardiac uptake of iodine-123-MIBG. J Nucl Med 1997, 38:447-451.PubMed
15.
go back to reference Ogita H, Shimonagata T, Fukunami M, et al.: Prognostic significance of cardiac (123)I metaiodobenzylguanidine imaging for mortality and morbidity in patients with chronic heart failure: a prospective study. Heart 2001, 86:656-660.CrossRefPubMed Ogita H, Shimonagata T, Fukunami M, et al.: Prognostic significance of cardiac (123)I metaiodobenzylguanidine imaging for mortality and morbidity in patients with chronic heart failure: a prospective study. Heart 2001, 86:656-660.CrossRefPubMed
16.
go back to reference Kioka H, Yamada T, Mine T, et al.: Prediction of sudden death in patients with mild-to-moderate chronic heart failure by using cardiac iodine-123 metaiodobenzylguanidine imaging. Heart 2007, 93:1213-1218.CrossRefPubMed Kioka H, Yamada T, Mine T, et al.: Prediction of sudden death in patients with mild-to-moderate chronic heart failure by using cardiac iodine-123 metaiodobenzylguanidine imaging. Heart 2007, 93:1213-1218.CrossRefPubMed
17.
go back to reference Henderson EB, Kahn JK, Corbett JR, et al.: Abnormal I-123 metaiodobenzylguanidine myocardial washout and distribution may reflect myocardial adrenergic derangement in patients with congestive cardiomyopathy. Circulation 1988, 78:1192-1199.PubMed Henderson EB, Kahn JK, Corbett JR, et al.: Abnormal I-123 metaiodobenzylguanidine myocardial washout and distribution may reflect myocardial adrenergic derangement in patients with congestive cardiomyopathy. Circulation 1988, 78:1192-1199.PubMed
18.
go back to reference Nagamachi S, Fujita S, Nishii R, et al.: Prognostic value of cardiac I-123 metaiodobenzylguanidine imaging in patients with non-insulin-dependent diabetes mellitus. J Nucl Cardiol 2006, 13:34-42.CrossRefPubMed Nagamachi S, Fujita S, Nishii R, et al.: Prognostic value of cardiac I-123 metaiodobenzylguanidine imaging in patients with non-insulin-dependent diabetes mellitus. J Nucl Cardiol 2006, 13:34-42.CrossRefPubMed
19.
go back to reference Dae MW, De Marco T, Botvinick EH, et al.: Scintigraphic assessment of MIBG uptake in globally denervated human and canine hearts--implications for clinical studies. J Nucl Med 1992, 33:1444-1450.PubMed Dae MW, De Marco T, Botvinick EH, et al.: Scintigraphic assessment of MIBG uptake in globally denervated human and canine hearts--implications for clinical studies. J Nucl Med 1992, 33:1444-1450.PubMed
20.
go back to reference Sisson JC, Wieland DM, Sherman P, et al.: Metaiodobenzylguanidine as an index of the adrenergic nervous system integrity and function. J Nucl Med 1987, 28:1620-1624.PubMed Sisson JC, Wieland DM, Sherman P, et al.: Metaiodobenzylguanidine as an index of the adrenergic nervous system integrity and function. J Nucl Med 1987, 28:1620-1624.PubMed
21.
go back to reference Taki J, Nakajima K, Hwang EH, et al.: Peripheral sympathetic dysfunction in patients with Parkinson's disease without autonomic failure is heart selective and disease specific. Eur J Nucl Med Mol Imaging 2000, 27:566-573.CrossRef Taki J, Nakajima K, Hwang EH, et al.: Peripheral sympathetic dysfunction in patients with Parkinson's disease without autonomic failure is heart selective and disease specific. Eur J Nucl Med Mol Imaging 2000, 27:566-573.CrossRef
22.
go back to reference • Haider N, Baliga RR, Chandrashekhar Y, et al.: Adrenergic excess, hNET1 down-regulation, and compromised mIBG uptake in heart failure poverty in the presence of plenty. JACC Cardiovas Imaging 2010, 3:71-75. This is an excellent editorial viewpoint regarding cardiac mIBG imaging, which also presented data of hNET1 expression in heart failure patients.CrossRef • Haider N, Baliga RR, Chandrashekhar Y, et al.: Adrenergic excess, hNET1 down-regulation, and compromised mIBG uptake in heart failure poverty in the presence of plenty. JACC Cardiovas Imaging 2010, 3:71-75. This is an excellent editorial viewpoint regarding cardiac mIBG imaging, which also presented data of hNET1 expression in heart failure patients.CrossRef
23.
go back to reference Backs J, Haunstetter A, Gerber SH, et al.: The neuronal norepinephrine transporter in experimental heart failure: evidence for a posttranscriptional downregulation. J Mol Cell Cardiol 2001, 33:461-472.CrossRefPubMed Backs J, Haunstetter A, Gerber SH, et al.: The neuronal norepinephrine transporter in experimental heart failure: evidence for a posttranscriptional downregulation. J Mol Cell Cardiol 2001, 33:461-472.CrossRefPubMed
24.
go back to reference Himura Y, Felten SY, Kashiki M, et al.: Cardiac noradrenergic nerve terminal abnormalities in dogs with experimental congestive heart failure. Circulation 1993, 88:1299-1309.PubMed Himura Y, Felten SY, Kashiki M, et al.: Cardiac noradrenergic nerve terminal abnormalities in dogs with experimental congestive heart failure. Circulation 1993, 88:1299-1309.PubMed
25.
go back to reference Bohm M, La Rosee K, Schwinger RH, et al.: Evidence for reduction of norepinephrine uptake sites in the failing human heart. J Am Coll Cardiol 1995, 25:146-153.CrossRefPubMed Bohm M, La Rosee K, Schwinger RH, et al.: Evidence for reduction of norepinephrine uptake sites in the failing human heart. J Am Coll Cardiol 1995, 25:146-153.CrossRefPubMed
Metadata
Title
Variation of Heart-to-Mediastinal Ratio in 123I-mIBG Cardiac Sympathetic Imaging: Its Affecting Factors and Potential Corrections
Authors
Wengen Chen
Qi Cao
Vasken Dilsizian
Publication date
01-04-2011
Publisher
Current Science Inc.
Published in
Current Cardiology Reports / Issue 2/2011
Print ISSN: 1523-3782
Electronic ISSN: 1534-3170
DOI
https://doi.org/10.1007/s11886-010-0157-y

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