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Dynamic SPET parameters of 123I-MIBG cardiac imaging
A S Arbab1, K Koizumi, K Toyama
1Department of Radiology, Yamanashi Medical University, Yamanashi-ken, Japan. saali@res.yamanashi-med.ac.jp
Insights
This study shows that Iodine-123 meta-iodobenzylguanidine (123I-MIBG) SPECT imaging can differentiate cardiac disorders. Precise uptake and clearance measurements help distinguish conditions like cardiomyopathy and myocardial infarction.
Area of Science:
- Nuclear Medicine
- Cardiology
- Medical Imaging
Background:
- Cardiac sympathetic denervation is a hallmark of various heart diseases.
- 123I-MIBG SPECT imaging is a valuable tool for assessing cardiac sympathetic nerve function.
Purpose of the Study:
- To investigate the utility of early dynamic and late static 123I-MIBG SPECT parameters in differentiating cardiac pathologies.
- To analyze uptake ratios and clearance rates in patients with and without heart disease.
Main Methods:
- 46 individuals (34 non-diabetic, 12 diabetic) underwent early dynamic and late static 123I-MIBG SPECT.
- Regions of interest were defined on cardiac walls to calculate uptake ratios and clearance rates.
- Parameters including HU3, HU11, HU19, DUP, Kse, Ke, and Kd were analyzed.
Main Results:
- Significant differences in delayed 123I-MIBG uptake were observed among cardiac pathologies.
- Cardiomyopathy patients exhibited the lowest delayed uptake.
- Infarcted segments showed significantly lower 123I-MIBG uptake compared to normal segments at all time points.
- Clearance rate Kd was the lowest, while Kse and Ke were significantly higher in cardiomyopathy patients than in normal individuals.
Conclusions:
- 123I-MIBG SPECT imaging, with precise uptake and clearance measurements, can effectively distinguish between different cardiac disorders.
- The study confirms findings consistent with existing literature, highlighting the diagnostic potential of quantitative SPECT analysis.
Abstract:
Early dynamic and late 123I-MIBG SPET studies were performed to investigate several parameters used to distinguish the characteristics of various cardiac disorders. Forty-six individuals (34 non-diabetic, 12 diabetic) with or without heart disease were included in the study. Early dynamic and late static SPET images were acquired using a triple-headed gamma camera. After selecting mid-sections from vertical (VLA) and horizontal (HLA) long-axis images, regions of interest were created over the apex, whole heart and anterior, inferior, septal and lateral walls of the heart. Various uptake ratios at 3, 11 and 19 min and 4 h after injection (HU3, HU11, HU19, DUP) and clearances (Kse: between HU3 and HU11; Ke: between HU11 and HU19; Kd: between HU19 and DUP) were calculated. There were significant differences among various cardiac pathologies on the delayed images. Cardiomyopathy patients showed the lowest uptake on the delayed images. When all segments in normal patients and all involved segments in myocardial infarcted patients were compared, there was significantly lower uptake of MIBG in infarcted segments at all time points. Kd showed the lowest value compared with Kse and Ke. In cardiomyopathy patients, Kse, Ke and Kd were significantly different from each other. Both Kse and Ke were significantly higher in cardiomyopathy patients than in normal patients. In conclusion, the results of this study are in line with published data and precise measurement of uptake and clearance was possible when excluding background and blood pool activity.