Localized reduction in 123I-MIBG accumulation in the lung

A patient with old myocardial infarction underwent 123I-MIBG scintigraphy to evaluate the adrenergic nerve system in the heart following the treatment of pneumonia. Decreased accumulation of MIBG was observed in the right lower lung field, corresponding to the area affected by pneumonia, as well as in the left ventricle with myocardial infarction. 99mTc-MAA lung perfusion scan demonstrated hypoperfusion in the region of reduced MIBG uptake. Regional decrease in MIBG uptake in the lung is considered to suggest lung pathology, and lung perfusion scan is recommended to discriminate selective endothelial damage from loss of vascular bed.