Standardization of 123I-meta-iodobenzylguanidine myocardial sympathetic activity imaging: phantom calibration and clinical applications

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Abstract

Purpose

Myocardial sympathetic imaging with ¹²³I- meta-iodobenzylguanidine ( ¹²³I- mIBG) has gained clinical momentum. Although the need for standardization of ¹²³I- mIBG myocardial uptake has been recognized, the availability of practical clinical standardization approaches is limited. The need for standardization includes the heart-to-mediastinum ratio (HMR) and washout rate with planar imaging, and myocardial defect scoring with single-photon emission computed tomography (SPECT).

Methods

The planar HMR shows considerable variation due to differences in collimator design. These camera–collimator differences can be overcome by cross-calibration phantom experiments. The principles of these cross-calibration phantom experiments are summarized in this article. ¹²³I- mIBG SPECT databases were compiled by Japanese Society of Nuclear Medicine working group. Literature was searched based on the words “ ¹²³I- mIBG quantification method”, “standardization”, “heart-to-mediastinum ratio”, and its application to “risk model”.

Results

Calibration phantom experiments have been successfully performed in Japan and Europe. The benefit of these cross-calibration phantom experiments is that variation in the HMR between institutions is minimized including low-energy, low–medium-energy and medium-energy collimators. The use of myocardial ¹²³I- mIBG SPECT can be standardized using ¹²³I- mIBG normal databases as a basis for quantitative evaluation. This standardization method can be applied in cardiac event prediction models.

Conclusion

Standardization of myocardial ¹²³I- mIBG outcome parameters may facilitate a universal implementation of myocardial ¹²³I- mIBG scintigraphy.

Related collections

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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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Author and article information

Contributors

Kenichi Nakajima: +81-762652333 , nakajima@med.kanazawa-u.ac.jp

Journal

Journal ID (nlm-ta): Clin Transl Imaging

Journal ID (iso-abbrev): Clin Transl Imaging

Title: Clinical and Translational Imaging

Publisher: Springer Milan (Milan )

ISSN (Print): 2281-5872

ISSN (Electronic): 2281-7565

Publication date (Electronic): 4 May 2017

Publication date PMC-release: 4 May 2017

Publication date (Print): 2017

Volume: 5

Issue: 3

Pages: 255-263

Affiliations

[1 ]ISNI 0000 0001 2308 3329, GRID grid.9707.9, Department of Nuclear Medicine, , Kanazawa University, ; 13-1 Takara-machi, Kanazawa, 920-8641 Japan

[2 ]ISNI 0000000084992262, GRID grid.7177.6, Department of Nuclear Medicine, Academic Medical Center, , University of Amsterdam, ; Amsterdam, The Netherlands

[3 ]Department of Cardiology, Zaans Medical Center, Zaandam, The Netherlands

[4 ]ISNI 0000 0001 0265 5359, GRID grid.411998.c, Department of Physics, , Kanazawa Medical University, ; Uchinada, Kahoku, Japan

Article

Publisher ID: 230

DOI: 10.1007/s40336-017-0230-2

PMC ID: 5437131

PubMed ID: 28596948

SO-VID: f916dc31-ed52-43a3-b5f6-a851576b6aef

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 : 10 March 2017

Date accepted : 19 April 2017

Custom metadata

Keywords: quantification,heart-to-mediastinum ratio,calibration phantom,conversion coefficient,collimator

Data availability:

Keywords: quantification, heart-to-mediastinum ratio, calibration phantom, conversion coefficient, collimator