123I-MIBG Imaging: Patient Preparation and Technologist's Role

The radiopharmaceutical (123)I-metaiodobenzylguanidine (MIBG) was approved by the Food and Drug Administration in March 2013 for the assessment of myocardial sympathetic innervation in the evaluation of patients with heart failure and an ejection fraction of no more than 35%. Almost any well-equipped nuclear medicine or nuclear cardiology laboratory can perform this test, although there is a need for special attention to patient preparation, dose calibration, and proper timing of the image acquisition. This article reviews the role of the nuclear medicine technologist and some practical aspects of cardiac sympathetic (123)I-MIBG imaging of which the laboratory team needs to be mindful.