[Three-dimensional Quantitative Evaluation Method in ¹²³I-MIBG Myocardial SPECT-CT]

Area of Science:

• Nuclear medicine
• Medical imaging
• Cardiology

Context:

• Distinguishing neurodegenerative diseases requires accurate assessment of cardiac autonomic function.
• 123I-metaiodobenzylguanidine (MIBG) scintigraphy is a key imaging modality for evaluating cardiac sympathetic denervation.
• Quantitative analysis of MIBG uptake in the myocardium can improve diagnostic accuracy.

Purpose:

• To develop and validate a method for quantifying myocardial standardized uptake value (SUV) from SPECT-CT images.
• To assess the accuracy and repeatability of the proposed myocardial SUV measurement.
• To compare the quantitative performance of myocardial SUV with the conventional heart-to-mediastinal (H/M) ratio.

Summary:

• Optimal reconstruction parameters (10 iterations, 10 subsets, 4-pixel FWHM Gaussian filter) were determined using a phantom study.
• The proposed method demonstrated good repeatability for maximum SUVmax (MaxSUVmax) and average SUVmax (AveSUVmax) with %CVs of 4.99% and 4.84%, respectively.
• Myocardial SUVs in normal cases (average MaxSUVmax=8.27, AveSUVmax=7.58) showed values closer to theoretical expectations than the H/M ratio.

Impact:

• This quantitative method enables more accurate and repeatable assessment of myocardial MIBG uptake.
• Improved quantification may enhance the ability to distinguish neurodegenerative diseases based on cardiac autonomic function.
• The findings support the clinical utility of myocardial SUV as a superior quantitative metric compared to the H/M ratio.