High-speed scanning of planar images showing  123 I-MIBG uptake using a whole-body CZT camera: a phantom and clinical study

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Abstract

Background

The heart-to-mediastinum ratio (HMR) obtained in myocardial sympathetic innervation imaging using ¹²³I-metaiodobenzylguanidine (MIBG) is used for heart failure or Lewy body diseases (LBD). Discovery NM/CT 670 CZT, a novel whole-body scanner, enables direct HMR measurements in planar images, in contrast to cardiac-dedicated CZT-based cameras which require specific post-processing reconstruction. We sought to investigate the clinical utility of the Discovery NM/CT 670 CZT for myocardial innervation imaging and the potential time reduction.

Results

Following preliminary phantom examinations, ¹²³I-MIBG planar imaging was performed in 36 patients with suspected or known LBD to measure HMRs with a collection time of 300 s. Images for different collection times were subsequently reframed using already acquired data, and changes in HMRs were evaluated.

The HMRs for patients with versus without clinically diagnosed LBD were 1.63 ± 0.08 versus 2.21 ± 0.08 at early phase ( p < 0.001) and 1.54 ± 0.09 versus 2.08 ± 0.09 at delayed phase ( p < 0.001). The difference of HMRs (300 s − other collection time) became greater as the collection time became shorter. There was good consistency in HMRs between the 300-s images (reference) and the 200-s (intra-class correlation (ICC) coefficients > 0.99), 100-s (ICC coefficients > 0.97), and 50-s (ICC coefficients > 0.89) images.

Conclusions

In planar images with a whole-body CZT-based camera, the HMRs of patients with LBD were significantly lower than those without. HMRs with the collection time of 50 s and longer showed good consistency with those of 300 s in the ICC analysis. These findings indicate a clinical utility of this novel scanner for HMR measurements and potential time reductions.

Electronic supplementary material

The online version of this article (10.1186/s13550-019-0491-z) contains supplementary material, which is available to authorized users.

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Most cited references 22

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Proposal for standardization of 123I-metaiodobenzylguanidine (MIBG) cardiac sympathetic imaging by the EANM Cardiovascular Committee and the European Council of Nuclear Cardiology.

Ignasi Carrió, , … (2010)

This proposal for standardization of (123)I-metaiodobenzylguanidine (iobenguane, MIBG) cardiac sympathetic imaging includes recommendations for patient information and preparation, radiopharmaceutical, injected activities and dosimetry, image acquisition, quality control, reconstruction methods, attenuation, scatter and collimator response compensation, data analysis and interpretation, reports, and image display. The recommendations are based on evidence coming from original or scientific studies whenever possible and as far as possible reflect the current state-of-the-art in cardiac MIBG imaging. The recommendations are designed to assist in the practice of performing, interpreting and reporting cardiac sympathetic imaging. The proposed standardization does not include clinical indications, benefits or drawbacks of cardiac sympathetic imaging, and does not address cost benefits or cost effectiveness; however, clinical settings of potential utility are mentioned. Standardization of MIBG cardiac sympathetic imaging should contribute to increasing its clinical applicability and integration into current nuclear cardiology practice.

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A novel high-sensitivity rapid-acquisition single-photon cardiac imaging camera.

Michael Nagler, Brian Hutton, T Sharir … (2009)

This study described and validated a new solid-state single-photon gamma-camera and compared it with a conventional-SPECT Anger camera. The compact new camera uses a unique method for localizing gamma-photon information with a bank of 9 solid-state detector columns with tungsten collimators that rotate independently. Several phantom studies were performed comparing the new technology with conventional-SPECT technology. These included measurements of line sources and single- and dual-radionuclide studies of a torso phantom. Simulations were also performed using a cardiothoracic phantom. Furthermore, 18 patients were scanned with both the new camera and a conventional-SPECT camera. The new camera had a count sensitivity that was 10 times higher than that of the conventional camera and a compensated spatial resolution that was moderately better. Dual-radionuclide studies using a phantom show the further potential of the new camera for a 2-tracer simultaneous acquisition. Two-minute clinical studies with the new camera and 11-min studies with the conventional camera qualitatively showed good-to-excellent image quality and improved myocardial edge definition for the new camera. These initial performance characteristics of a new solid-state single-photon gamma-camera offer great promise for clinical dynamic SPECT protocols, with important implications for applications in nuclear cardiology and molecular imaging.

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Multicenter cross-calibration of I-123 metaiodobenzylguanidine heart-to-mediastinum ratios to overcome camera-collimator variations

Kenichi Nakajima, Koichi Okuda, Mana Yoshimura … (2014)

Background The heart-to-mediastinum ratio (HMR) of 123I-metaiodobenzylguanidine (MIBG) showed variations among institutions and needs to be standardized among various scinticamera-collimator combinations. Methods A total of 225 phantom experiments were performed in 84 institutions to calculate cross-calibration coefficients of HMR. Based on phantom studies, a conversion coefficient for each camera-collimator system was created, including low-energy (LE, n = 125) and a medium-energy (ME, n = 100) collimators. An average conversion coefficient from the most common ME group was used to calculate the standard HMR. In clinical MIBG studies (n = 52) from three institutions, HMRs were standardized from both LE- and ME-type collimators and classified into risk groups of <1.60, 1.60-2.19, and ≥2.20. Results The average conversion coefficients from the individual camera-collimator condition to the mathematically calculated reference HMR ranged from 0.55 to 0.75 for LE groups and from 0.83 to 0.95 for ME groups. The conversion coefficient of 0.88 was used to unify HMRs from all acquisition conditions. Using the standardized HMR, clinical studies (n = 52) showed good agreement between LE and ME types regarding three risk groups (κ = 0.83, P < .0001, complete agreement in 90%, 42% of the patients reclassified into the same risk group). Conclusion By using the reference HMR and conversion coefficients for the system, HMRs with various conditions can be converted to the standard HMRs in a range of normal to low HMRs.

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Author and article information

Contributors

Nanami Okano:

ORCID: http://orcid.org/0000-0001-5116-6893

+81-49-276-1302 , nanami@saitama-med.ac.jp

Iichiro Osawa: oyabun@saitama-med.ac.jp

Saki Tsuchihashi: t_saki@saitama-med.ac.jp

Masafumi Takahashi: mt043ch@saitama-med.ac.jp

Mamoru Niitsu: niitsu@saitama-med.ac.jp

Ichiro Matsunari: m_ichiro@saitama-med.ac.jp

Journal

Journal ID (nlm-ta): EJNMMI Res

Journal ID (iso-abbrev): EJNMMI Res

Title: EJNMMI Research

Publisher: Springer Berlin Heidelberg (Berlin/Heidelberg )

ISSN (Electronic): 2191-219X

Publication date (Electronic): 26 February 2019

Publication date PMC-release: 26 February 2019

Publication date Collection: 2019

Volume: 9

Electronic Location Identifier: 22

Affiliations

[1 ]ISNI 0000 0004 0640 5017, GRID grid.430047.4, Department of Radiology, , Saitama Medical University Hospital, ; 38 Morohongo, Moroyama, Iruma, Saitama, 350-0495 Japan

[2 ]ISNI 0000 0004 0640 5017, GRID grid.430047.4, Department of Central Radiological Technology, , Saitama Medical University Hospital, ; Saitama, Japan

[3 ]ISNI 0000 0004 0640 5017, GRID grid.430047.4, Division of Nuclear Medicine, Department of Radiology, , Saitama Medical University Hospital, ; Saitama, Japan

Author information

Nanami Okano http://orcid.org/0000-0001-5116-6893

Article

Publisher ID: 491

DOI: 10.1186/s13550-019-0491-z

PMC ID: 6391509

PubMed ID: 30806836

SO-VID: 0af2d37c-85b7-4c32-9135-f2479aee1040

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

History

Date received : 15 December 2018

Date accepted : 11 February 2019

Custom metadata

ScienceOpen disciplines: Radiology & Imaging

Keywords: czt,hmr,mibg,planar images,lbd

Data availability:

ScienceOpen disciplines: Radiology & Imaging

Keywords: czt, hmr, mibg, planar images, lbd

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