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Pontico M, Brunotti G, Conte M, Corica F, Cosma L, De Angelis C, De Feo MS, Lazri J, Matto A, Montebello M, Di Rocco A, Frantellizzi V, Farcomeni A, De Vincentis G. The prognostic value of 123I-mIBG SPECT cardiac imaging in heart failure patients: a systematic review. J Nucl Cardiol 2022; 29:1799-1809. [PMID: 33442819 PMCID: PMC9345809 DOI: 10.1007/s12350-020-02501-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 12/15/2020] [Indexed: 12/31/2022]
Abstract
This systematic review aimed to evaluate the prognostic value of Iodine123 Metaiodobenzylguanidine (123I-mIBG) SPECT myocardial imaging in patients with heart failure (HF) and to assess whether semi-quantitative SPECT scores can be useful for accurate risk stratification concerning arrhythmic event (AE) and sudden cardiac death (SCD) in this cohort. A systematic literature search of studies published until November 2020 regarding the application of 123I-mIBG SPECT in HF patients was performed, in Pubmed, Scopus, Medline, Central (Cochrane Library) and Web Of Science databases, including the words "MIBG", "metaiodobenzylguanidine", "heart", "spect", and "tomographic". The included studies had to correlate 123I-mIBG SPECT scores with endpoints such as overall survival and prevention of AE and SCD in HF patients. According to the sixteen studies included, the analysis showed that 123I-mIBG SPECT scores, such as summed defect score (SDS), regional wash-out (rWO), and regional myocardial tracer uptake, could have a reliable prognostic value in patients with HF. An increased SDS or rWO, as well as a reduced 123I-mIBG myocardial uptake, have proven to be effective in predicting AE- and SCD-specific risk in HF patients. Despite achieved results being promising, a more reproducible standardized method for semi-quantitative analysis and further studies with larger cohort are needed for 123I-mIBG SPECT myocardial imaging to be as reliable and, thus, accepted as the conventional 123I-mIBG planar myocardial imaging.
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Affiliation(s)
- Mariano Pontico
- Department of Radiological Sciences, Oncology and Anatomical Pathology, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Gabriele Brunotti
- Department of Radiological Sciences, Oncology and Anatomical Pathology, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Miriam Conte
- Department of Radiological Sciences, Oncology and Anatomical Pathology, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Ferdinando Corica
- Department of Radiological Sciences, Oncology and Anatomical Pathology, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Laura Cosma
- Department of Radiological Sciences, Oncology and Anatomical Pathology, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Cristina De Angelis
- Department of Radiological Sciences, Oncology and Anatomical Pathology, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Maria Silvia De Feo
- Department of Radiological Sciences, Oncology and Anatomical Pathology, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Julia Lazri
- Department of Radiological Sciences, Oncology and Anatomical Pathology, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Antonio Matto
- Department of Radiological Sciences, Oncology and Anatomical Pathology, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Melissa Montebello
- Department of Radiological Sciences, Oncology and Anatomical Pathology, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Arianna Di Rocco
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy
| | - Viviana Frantellizzi
- Department of Radiological Sciences, Oncology and Anatomical Pathology, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
| | - Alessio Farcomeni
- Department of Economics & Finance, University of Rome "Tor Vergata", Rome, Italy
| | - Giuseppe De Vincentis
- Department of Radiological Sciences, Oncology and Anatomical Pathology, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
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Tamaki S, Yamada T, Watanabe T, Morita T, Kawasaki M, Kikuchi A, Kawai T, Seo M, Nakamura J, Kayama K, Sakamoto D, Ueda K, Kogame T, Tamura Y, Fujita T, Nishigaki K, Fukuda Y, Kokubu Y, Fukunami M. Usefulness of the 2-year iodine-123 metaiodobenzylguanidine-based risk model for post-discharge risk stratification of patients with acute decompensated heart failure. Eur J Nucl Med Mol Imaging 2022; 49:1906-1917. [PMID: 34997293 DOI: 10.1007/s00259-021-05663-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 12/15/2021] [Indexed: 01/02/2023]
Abstract
PURPOSE A four-parameter risk model that included cardiac iodine-123 metaiodobenzylguanidine (MIBG) imaging and readily available clinical parameters was recently developed for prediction of 2-year cardiac mortality risk in patients with chronic heart failure. We sought to validate the ability of this risk model to predict post-discharge clinical outcomes in patients with acute decompensated heart failure (ADHF) and to compare its prognostic value with that of the Acute Decompensated Heart Failure National Registry (ADHERE) and Get With The Guidelines-Heart Failure (GWTG-HF) risk scores. METHODS We studied 407 consecutive patients who were admitted for ADHF and survived to discharge, with definitive 2-year outcomes (death or survival). Cardiac MIBG imaging was performed just before discharge. The 2-year cardiac mortality risk was calculated using four parameters, namely age, left ventricular ejection fraction, New York Heart Association functional class, and cardiac MIBG heart-to-mediastinum ratio on delayed images. Patients were stratified into three groups based on the 2-year cardiac mortality risk: low- (< 4%), intermediate- (4-12%), and high-risk (> 12%) groups. The ADHERE and GWTG-HF risk scores were also calculated. RESULTS There was a significant difference in the incidence of cardiac death among the three groups stratified using the 2-year cardiac mortality risk model (p < 0.0001). The 2-year cardiac mortality risk model had a higher C-statistic (0.732) for the prediction of cardiac mortality than the ADHERE and GWTG-HF risk scores. CONCLUSION The 2-year MIBG-based cardiac mortality risk model is useful for predicting post-discharge clinical outcomes in patients with ADHF. TRIAL REGISTRATION NUMBER UMIN000015246, 25 September 2014.
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Affiliation(s)
- Shunsuke Tamaki
- Division of Cardiology, Osaka General Medical Centre, 3-1-56, Mandai-Higashi, Sumiyoshi-ku, Osaka, 558-8558, Japan.
| | - Takahisa Yamada
- Division of Cardiology, Osaka General Medical Centre, 3-1-56, Mandai-Higashi, Sumiyoshi-ku, Osaka, 558-8558, Japan
| | - Tetsuya Watanabe
- Division of Cardiology, Osaka General Medical Centre, 3-1-56, Mandai-Higashi, Sumiyoshi-ku, Osaka, 558-8558, Japan
| | - Takashi Morita
- Division of Cardiology, Osaka General Medical Centre, 3-1-56, Mandai-Higashi, Sumiyoshi-ku, Osaka, 558-8558, Japan
| | - Masato Kawasaki
- Division of Cardiology, Osaka General Medical Centre, 3-1-56, Mandai-Higashi, Sumiyoshi-ku, Osaka, 558-8558, Japan
| | - Atsushi Kikuchi
- Division of Cardiology, Osaka General Medical Centre, 3-1-56, Mandai-Higashi, Sumiyoshi-ku, Osaka, 558-8558, Japan
| | - Tsutomu Kawai
- Division of Cardiology, Osaka General Medical Centre, 3-1-56, Mandai-Higashi, Sumiyoshi-ku, Osaka, 558-8558, Japan
| | - Masahiro Seo
- Division of Cardiology, Osaka General Medical Centre, 3-1-56, Mandai-Higashi, Sumiyoshi-ku, Osaka, 558-8558, Japan
| | - Jun Nakamura
- Division of Cardiology, Osaka General Medical Centre, 3-1-56, Mandai-Higashi, Sumiyoshi-ku, Osaka, 558-8558, Japan
| | - Kiyomi Kayama
- Division of Cardiology, Osaka General Medical Centre, 3-1-56, Mandai-Higashi, Sumiyoshi-ku, Osaka, 558-8558, Japan
| | - Daisuke Sakamoto
- Division of Cardiology, Osaka General Medical Centre, 3-1-56, Mandai-Higashi, Sumiyoshi-ku, Osaka, 558-8558, Japan
| | - Kumpei Ueda
- Division of Cardiology, Osaka General Medical Centre, 3-1-56, Mandai-Higashi, Sumiyoshi-ku, Osaka, 558-8558, Japan
| | - Takehiro Kogame
- Division of Cardiology, Osaka General Medical Centre, 3-1-56, Mandai-Higashi, Sumiyoshi-ku, Osaka, 558-8558, Japan
| | - Yuto Tamura
- Division of Cardiology, Osaka General Medical Centre, 3-1-56, Mandai-Higashi, Sumiyoshi-ku, Osaka, 558-8558, Japan
| | - Takeshi Fujita
- Division of Cardiology, Osaka General Medical Centre, 3-1-56, Mandai-Higashi, Sumiyoshi-ku, Osaka, 558-8558, Japan
| | - Keisuke Nishigaki
- Division of Cardiology, Osaka General Medical Centre, 3-1-56, Mandai-Higashi, Sumiyoshi-ku, Osaka, 558-8558, Japan
| | - Yuto Fukuda
- Division of Cardiology, Osaka General Medical Centre, 3-1-56, Mandai-Higashi, Sumiyoshi-ku, Osaka, 558-8558, Japan
| | - Yuki Kokubu
- Division of Cardiology, Osaka General Medical Centre, 3-1-56, Mandai-Higashi, Sumiyoshi-ku, Osaka, 558-8558, Japan
| | - Masatake Fukunami
- Division of Cardiology, Osaka General Medical Centre, 3-1-56, Mandai-Higashi, Sumiyoshi-ku, Osaka, 558-8558, Japan
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Boccalini C, Carli G, Vanoli EG, Cocco A, Albanese A, Garibotto V, Perani D. Manual and semi-automated approaches to MIBG myocardial scintigraphy in patients with Parkinson's disease. Front Med (Lausanne) 2022; 9:1073720. [PMID: 36530915 PMCID: PMC9755341 DOI: 10.3389/fmed.2022.1073720] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 11/17/2022] [Indexed: 12/04/2022] Open
Abstract
Objective This study investigates the effects of manual and semi-automatic methods for assessing MIBG semi-quantitative indices in a clinical setting. Materials and methods We included 123I-MIBG scans obtained in 35 patients with idiopathic Parkinson's Disease. Early and late heart-to-mediastinum (H/M) ratios were calculated from 123I-MIBG images using regions of interest (ROIs) placed over the heart and the mediastinum. The ROIs were derived using two approaches: (i) manually drawn and (ii) semi-automatic fixed-size ROIs using anatomical landmarks. Expert, moderate-expert, and not expert raters applied the ROIs procedures and interpreted the 123I-MIBG images. We evaluated the inter and intra-rater agreements in assessing 123I-MIBG H/M ratios. Results A moderate agreement in the raters' classification of pathological and non-pathological scores emerged regarding early and late H/M ratio values (κ = 0.45 and 0.69 respectively), applying the manual method, while the early and late H/M ratios obtained with the semi-automatic method reached a good agreement among observers (κ = 0.78). Cohen-Kappa values revealed that the semi-automatic method improved the agreement between expert and inexpert raters: the agreement improved from a minimum of 0.29 (fair, for early H/M) and 0.69 (substantial, in late H/M) with the manual method, to 0.90 (perfect, in early H/M) and 0.87 (perfect, in late H/M) with the semi-automatic method. Conclusion The use of the semi-automatic method improves the agreement among raters in classifying' H/M ratios as pathological or non-pathological, namely for inexpert readers. These results have important implications for semi-quantitative assessment of 123I-MIBG images in clinical routine.
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Affiliation(s)
- Cecilia Boccalini
- School of Psychology, Vita-Salute San Raffaele University, Milan, Italy.,In vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) San Raffaele Scientific Institute, Milan, Italy.,Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTlab), Geneva University Neurocenter and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Giulia Carli
- In vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) San Raffaele Scientific Institute, Milan, Italy.,Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | | | - Antoniangela Cocco
- Department of Neurology, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Humanitas Research Hospital, Milan, Italy
| | - Alberto Albanese
- Department of Neurology, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Humanitas Research Hospital, Milan, Italy.,Department of Neuroscience, Catholic University, Milan, Italy
| | - Valentina Garibotto
- Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTlab), Geneva University Neurocenter and Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospitals, Geneva, Switzerland.,Center for Biomedical Imaging, Geneva, Switzerland
| | - Daniela Perani
- School of Psychology, Vita-Salute San Raffaele University, Milan, Italy.,In vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) San Raffaele Scientific Institute, Milan, Italy.,Nuclear Medicine Unit, San Raffaele Hospital, Milan, Italy
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Teresińska A, Woźniak O, Maciąg A, Wnuk J, Jezierski J, Fronczak A, Biernacka EK. Quality and utility of [ 123I]I-metaiodobenzylguanidine cardiac SPECT imaging in nondiabetic postinfarction heart failure patients qualified for implantable cardioverter defibrillator. Ann Nucl Med 2021; 35:916-926. [PMID: 34023989 PMCID: PMC8285320 DOI: 10.1007/s12149-021-01628-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 05/11/2021] [Indexed: 12/02/2022]
Abstract
OBJECTIVE Impaired cardiac adrenergic activity has been demonstrated in heart failure (HF) and in diabetes mellitus (DM). [123I]I-metaiodobenzylguanidine (MIBG) enables assessment of the cardiac adrenergic nervous system. Tomographic imaging of the heart is expected to be superior to planar imaging. This study aimed to determine the quality and utility of MIBG SPECT in the assessment of cardiac innervation in postinfarction HF patients without DM, qualified for implantable cardioverter defibrillator (ICD) in primary prevention of sudden cardiac death. METHODS Consecutive patients receiving an ICD on the basis of contemporary guidelines were prospectively included. Planar MIBG studies were followed by SPECT. The essential analysis was based on visual assessment of the quality of SPECT images ("high", "low" or "unacceptable"). The variables used in the further analysis were late summed defect score for SPECT images and heart-to-mediastinum rate for planar images. MIBG images were assessed independently by two experienced readers. RESULTS Fifty postinfarction nondiabetic HF subjects were enrolled. In 13 patients (26%), the assessment of SPECT studies was impossible. In addition, in 13 of 37 patients who underwent semiquantitative SPECT evaluation, the assessment was equivocal. Altogether, in 26/50 patients (52%, 95% confidence interval 38-65%), the quality of SPECT images was unacceptable or low and was limited by low MIBG cardiac uptake and by comparatively high, interfering MIBG uptake in the neighboring structures (primarily, in the lungs). CONCLUSIONS The utility of MIBG SPECT imaging, at least with conventional imaging protocols, in the qualification of postinfarction HF patients for ICD, is limited. In approximately half of the postinfarction HF patients, SPECT assessment of cardiac innervation can be impossible or equivocal, even without additional damage from diabetic cardiac neuropathy. The criteria predisposing the patient to good-quality MIBG SPECT are: high values of LVEF from the range characterizing the patients qualified to ICD (i.e., close to 35%) and left lung uptake intensity in planar images comparable to or lower than heart uptake.
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Affiliation(s)
- Anna Teresińska
- National Institute of Cardiology, Alpejska 42, 04-628, Warsaw, Poland.
| | - Olgierd Woźniak
- National Institute of Cardiology, Alpejska 42, 04-628, Warsaw, Poland
| | - Aleksander Maciąg
- National Institute of Cardiology, Alpejska 42, 04-628, Warsaw, Poland
| | - Jacek Wnuk
- National Institute of Cardiology, Alpejska 42, 04-628, Warsaw, Poland
| | | | - Aneta Fronczak
- National Institute of Cardiology, Alpejska 42, 04-628, Warsaw, Poland
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5
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Todica A, Siebermair J, Schiller J, Zacherl MJ, Fendler WP, Massberg S, Bartenstein P, Cyran CC, Kääb S, Hacker M, Wakili R, Lehner S. Assessment of right ventricular sympathetic dysfunction in patients with arrhythmogenic right ventricular cardiomyopathy: An 123I-metaiodobenzylguanidine SPECT/CT study. J Nucl Cardiol 2020; 27:2402-2409. [PMID: 30560521 PMCID: PMC7749057 DOI: 10.1007/s12350-018-01545-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 09/21/2018] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of the study was to evaluate a novel approach for the quantification of right ventricular sympathetic dysfunction in patients diagnosed with ARVC/D through state-of-the-art functional SPECT/CT hybrid imaging. METHODS Sympathetic innervation of the heart was assessed using 123I-MIBG-SPECT/CT in 17 patients diagnosed with ARVC according to the modified task force criteria, and in 10 patients diagnosed with idiopathic ventricular fibrillation (IVF). The 123I-MIBG-uptake in the left (LV) and right ventricle (RV) was evaluated separately based on anatomic information derived from the CT scan, and compared to the uptake in the mediastinum (M). RESULTS There was a significant difference in the LV/M ratio between the ARVC/D and the IVF groups (3.2 ± 0.5 vs. 3.9 ± 0.8, P = 0.014), with a cut-off value of 3.41 (77% sensitivity, 80% specificity, AUC 0.78). There was a highly significant difference in the mean RV/M ratios between both groups (1.6 ± 0.3 vs. 2.0 ± 0.2, P = 0.001), with optimal cut-off for discrimination at 1.86 (88% sensitivity, 90% specificity, AUC 0.93). CONCLUSION Employing state-of-the-art functional SPECT/CT hybrid imaging, we could reliably assess and quantify right and left ventricular sympathetic innervation. The RV/M ratio was significantly lower in patients diagnosed with ARVC/D and provided sensitive and specific discrimination between patients with ARVC/D and IVF patients.
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Affiliation(s)
- Andrei Todica
- Department of Nuclear Medicine, University of Munich, Munich, Germany
| | - Johannes Siebermair
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University Duisburg-Essen, Essen, Germany
- Department of Cardiology, University of Munich, Munich, Germany
| | - Julia Schiller
- Department of Nuclear Medicine, University of Munich, Munich, Germany
| | - Mathias J Zacherl
- Department of Nuclear Medicine, University of Munich, Munich, Germany
| | | | | | - Peter Bartenstein
- Department of Nuclear Medicine, University of Munich, Munich, Germany
| | - Clemens C Cyran
- Department of Clinical Radiology, University of Munich, Munich, Germany
| | - Stefan Kääb
- Department of Cardiology, University of Munich, Munich, Germany
| | - Marcus Hacker
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
| | - Reza Wakili
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University Duisburg-Essen, Essen, Germany
- Department of Cardiology, University of Munich, Munich, Germany
| | - Sebastian Lehner
- Department of Nuclear Medicine, University of Munich, Munich, Germany
- Ambulatory Healthcare Center Dr. Neumaier & Colleagues, Radiology, Nuclear Medicine, Radiation Therapy, Regensburg, Germany
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Tsukita K, Tachibana N, Hamano T. Appropriate assessment method of 123I-MIBG myocardial scintigraphy for the diagnosis of Lewy body diseases and idiopathic REM sleep behavior disorder. J Neurol 2020; 267:3248-3257. [DOI: 10.1007/s00415-020-09992-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 06/09/2020] [Accepted: 06/10/2020] [Indexed: 02/07/2023]
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Tamaki S, Yamada T, Morita T, Furukawa Y, Kawasaki M, Kikuchi A, Kawai T, Seo M, Abe M, Nakamura J, Yamamoto K, Kayama K, Kawahira M, Tanabe K, Ueda K, Kimura T, Sakamoto D, Tamura Y, Fujita T, Fukunami M. Impact of adjunctive tolvaptan on sympathetic activity in acute heart failure with preserved ejection fraction. ESC Heart Fail 2020; 7:933-937. [PMID: 32243100 PMCID: PMC7261536 DOI: 10.1002/ehf2.12690] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 03/01/2020] [Accepted: 03/11/2020] [Indexed: 11/06/2022] Open
Abstract
AIMS Acute decompensated heart failure (ADHF) is generally treated by decongestion using diuretic therapy. However, the use of loop diuretics is associated with increased cardiac sympathetic nerve activity (CSNA). We aimed to evaluate the effect of adjunctive tolvaptan therapy on CSNA in ADHF patients with preserved left ventricular ejection fraction (LVEF). METHODS AND RESULTS We enrolled 51 consecutive ADHF patients with LVEF ≥45%. Patients were randomly assigned to receive either tolvaptan add-on (n = 25) or conventional diuretic therapy (n = 26). Cardiac iodine-123 metaiodobenzylguanidine (MIBG) imaging was performed after stabilisation of heart failure symptoms, and the cardiac MIBG heart-to-mediastinum ratio (HMR) and washout rate (WR) were calculated. There were no significant differences in the body weight change and total urine volume during 2 days after randomisation or in the HMR on delayed image (HMR(d)) and WR between the tolvaptan and conventional groups. After stratification based on the median change in body weight, the patients with higher weight reduction had a significantly lower HMR(d) (P = 0.0128) and tended to have a higher WR (P = 0.0786) in the conventional group, whereas the cardiac MIBG imaging results were not influenced by body weight reduction in the tolvaptan group. CONCLUSIONS Adjunctive tolvaptan therapy may provide rapid decongestion without a harmful effect on CSNA in ADHF patients with preserved LVEF.
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Affiliation(s)
- Shunsuke Tamaki
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Takahisa Yamada
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Takashi Morita
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Yoshio Furukawa
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Masato Kawasaki
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Atsushi Kikuchi
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Tsutomu Kawai
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Masahiro Seo
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Makoto Abe
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Jun Nakamura
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Kyoko Yamamoto
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Kiyomi Kayama
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | | | - Kazuya Tanabe
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Kunpei Ueda
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Takanari Kimura
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Daisuke Sakamoto
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Yuto Tamura
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
| | - Takeshi Fujita
- Division of Cardiology, Osaka General Medical Center, Osaka, Japan
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Left-ventricular innervation assessed by 123I-SPECT/CT is associated with cardiac events in inherited arrhythmia syndromes. Int J Cardiol 2020; 312:129-135. [PMID: 32201099 DOI: 10.1016/j.ijcard.2020.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 02/15/2020] [Accepted: 03/04/2020] [Indexed: 12/13/2022]
Abstract
AIMS Impaired myocardial sympathetic innervation assessed by 123Iodine-Metaiodobenzylguanidine (123I-MIBG) scintigraphy is associated with cardiac events. Since regional disparities of structural abnormalities are common in inherited arrhythmia syndromes (iAS), a chamber-specific innervation assessment of the right (RV) and left ventricle (LV) could provide important insights for a patient-individual therapy. Aim of this study was to evaluate chamber-specific patterns of autonomic innervation by Single-photon emission computed tomography/computed tomography (SPECT/CT) in patients with iAS with respect to clinical outcome regarding cardiac events. METHODS AND RESULTS We assessed ventricular sympathetic innervation (LV, RV and planar heart/mediastinum-ratios, and washout-rates) by 123I-MIBG-SPECT/CT in 48 patients (arrhythmogenic right ventricular cardiomyopathy [ARVC], n = 26; laminopathy, n = 8; idiopathic ventricular fibrillation [iVF], n = 14) in relation to a composite clinical endpoint (ventricular arrhythmia; cardiac death; cardiac hospitalization). RV tracer uptake was lower in patients with ARVC than in laminopathy and iVF patients (1.7 ± 0.4 vs. 2.1 ± 0.7 and 2.1 ± 0.5, respectively). Over a median follow-up of 2.2 years, the combined endpoint was met in 18 patients (n = 12 ventricular tachyarrhythmias, n = 5 hospitalizations, n = 1 death). LV, but not RV H/M ratio was associated with the combined endpoint (hazard-ratio 2.82 [1.30-6.10], p < 0.01). After adjustment for LV and RV function, LV H/M-ratio still remained a significant predictor for cardiac events (hazard-ratio 2.79 [1.06-7.35], p = 0.04). CONCLUSION We demonstrated that chamber-specific 123MIBG-SPECT/CT imaging is feasible and that reduced LV sympathetic innervation was associated with worse outcome in iAS. These findings provide novel insights into the potential role of regional autonomic nervous system heterogeneity for the evolution of life-threatening cardiac events in iAS.
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9
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Teresińska A. Iodine-123-metaiodobenzylguanidine cardiac SPECT imaging in the qualification of heart failure patients for ICD implantation. J Nucl Cardiol 2019; 26:1182-1187. [PMID: 29696486 PMCID: PMC6660574 DOI: 10.1007/s12350-018-1288-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 04/17/2018] [Indexed: 01/06/2023]
Affiliation(s)
- Anna Teresińska
- The Cardinal Stefan Wyszyński Institute of Cardiology, Alpejska 42, 04-628, Warsaw, Poland.
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Wu J, Gallezot JD, Lu Y, Ye Q, Liu H, Esserman DA, Kyriakides TC, Thorn SL, Zonouz TH, Liu YH, Lampert RJ, Sinusas AJ, Carson RE, Liu C. Simplified Quantification and Acquisition Protocol for 123I-MIBG Dynamic SPECT. J Nucl Med 2018; 59:1574-1580. [PMID: 29476001 DOI: 10.2967/jnumed.117.202143] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 02/03/2018] [Indexed: 01/08/2023] Open
Abstract
Previous studies have demonstrated the feasibility of absolute quantification of dynamic 123I-metaiodobenzylguanidine (123I-MIBG) SPECT imaging in humans. This work reports a simplified quantification method for dynamic 123I-MIBG SPECT using practical protocols with shortened acquisition time and voxel-by-voxel parametric imaging. Methods: Twelve healthy human volunteers underwent five 15-min dynamic SPECT scans at 0, 15, 90, 120, and 180 min after 123I-MIBG injection. List-mode SPECT data were binned into 29 frames and reconstructed with corrections for attenuation, scatter, and decay. Population-based blood-to-plasma correction and metabolite correction were applied to the image-derived input function. Likelihood estimation in graphical analysis (LEGA) was used as a simplified model to obtain volume of distribution (V T) values, which were compared with those obtained with the reversible 2-tissue (2T) compartment model. Three simplified protocols were evaluated with 2T and LEGA using a 30-min scan started simultaneously with tracer injection plus a 15-min scan at 90, 120, or 180 min after injection. Voxel-by-voxel LEGA fitting was applied to the aligned dynamic images using both the full protocol (five 15-min scans) and the simplified protocols. Results: Correlation analysis (y = 0.955x + 0.547, R 2 = 0.997) and Bland-Altman plot (mean difference, -0.8 mL/cm3; 95% limits of agreement, [-2.5, 1.0] mL/cm3; normal V T range, 29.0 ± 12.4 mL/cm3) showed that LEGA can be used as a simplified model of 2T for 123I-MIBG. High-quality V T parametric images could be obtained with LEGA. Region-of-interest (ROI) modeling and parametric imaging results were in excellent agreement as determined by correlation analysis (y = 0.999x - 1.026, R 2 = 0.982) and Bland-Altman plot (mean difference, -1.0 mL/cm3; 95% limits of agreement, [-4.2, 2.1] mL/cm3). V T correlated reasonably well between all simplified protocols and the full protocol with LEGA but not with 2T. The V T results were more reliable when there was a longer interval between the 2 acquisitions in the simplified protocols. Conclusion: For ROI-based kinetic modeling and parametric imaging, reliable quantification of dynamic 123I-MIBG SPECT can be achieved with LEGA using a simplified protocol of a 30-min scan starting with tracer injection plus a 15-min scan no earlier than 180 min after injection.
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Affiliation(s)
- Jing Wu
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, Connecticut
| | | | - Yihuan Lu
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, Connecticut
| | - Qing Ye
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, Connecticut.,Department of Engineering Physics, Key Laboratory of Particle and Radiation Imaging (Tsinghua University), Ministry of Education, Beijing, China
| | - Hui Liu
- Department of Internal Medicine (Cardiology), Yale University, New Haven, Connecticut
| | - Denise A Esserman
- Yale School of Public Health (Biostatistics), Yale University, New Haven, Connecticut
| | - Tassos C Kyriakides
- Yale School of Public Health (Biostatistics), Yale University, New Haven, Connecticut
| | - Stephanie L Thorn
- Department of Internal Medicine (Cardiology), Yale University, New Haven, Connecticut
| | | | - Yi-Hwa Liu
- Department of Internal Medicine (Cardiology), Yale University, New Haven, Connecticut.,Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan; and.,Department of Biomedical Engineering, Chung Yuan Christian University, Taoyuan, Taiwan
| | - Rachel J Lampert
- Department of Internal Medicine (Cardiology), Yale University, New Haven, Connecticut
| | - Albert J Sinusas
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, Connecticut.,Department of Internal Medicine (Cardiology), Yale University, New Haven, Connecticut
| | - Richard E Carson
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, Connecticut
| | - Chi Liu
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, Connecticut
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Kamiya Y, Ota S, Tanaka Y, Yamashita K, Takaki A, Ito S. Development of an 123I-metaiodobenzylguanidine Myocardial Three-Dimensional Quantification Method for the Diagnosis of Lewy Body Disease. ASIA OCEANIA JOURNAL OF NUCLEAR MEDICINE & BIOLOGY 2018; 6:129-138. [PMID: 29998146 PMCID: PMC6038978 DOI: 10.22038/aojnmb.2018.10595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES We recently developed a new uptake index method for 123I-metaiodobenzylguanidine (123I-MIBG) heart uptake measurements by using planar images (radioisotope angiography and planar image) for the diagnosis of Lewy body disease (LBD), including Parkinson's disease (PD) and dementia with Lewy bodies (DLB). However, the diagnostic accuracy of the uptake index was approximately equal to that of the heart-to-mediastinum ratio (H/M) for the discrimination of the LBD and non-LBD patients. A simple and pain-free uptake index method using 123I-MIBG SPECT images by modifying the uptake index method may show better diagnostic accuracy than the planar uptake index method. We hypothesized that the development of a new uptake index method for the determination of 123I-MIBG using single-photon emission computed tomography (SPECT) imaging would provide a reliable and reproducible diagnostic tool for clinical application. Regarding this, the purpose of this study was to develop a new uptake index method with a simple protocol to determine 123I-MIBG uptake on SPECT. METHODS The 123I-MIBG input function was determined from the input counts of the pulmonary artery, assessed by analyzing the pulmonary artery time-activity curves. The 123I-MIBG output function was obtained from 123I-MIBG SPECT counts on the polar map. The uptake index was calculated through dividing the output function by the input function (SPECT uptake method). For the purpose of the study, 77 patients underwent 123I-MIBG SPECT, with an average of 31.5 min after clinical assessment and injection of the tracer. The H/M values, as well as planar and SPECT uptake indices were calculated, and then correlated with clinical features. RESULTS According to the results, values obtained for LBD were significantly lower than those for non-LBD in all analyses (P<0.01). The overlap of the H/M values between the LBD and non-LBD cases ranged from 2.06 to 2.50. Furthermore, the overlap in uptake index values between LBD and non-LBD cases in planar image analysis was 1.05-1.29. The SPECT uptake index method showed the least overlap of 1.23-1.25, with the highest value for LBD patients clearly distinguished from the lowest value for the non-LBD patients. CONCLUSION The new 123I-MIBG SPECT quantification method, developed by the input counts of the pulmonary artery, clearly distinguished LBD from non-LBD. Therefore, this method may be appropriate for routine clinical study.
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Affiliation(s)
- Yoshito Kamiya
- Graduate School of Health Sciences, Kumamoto University, Kumamoto, Japan,Chibana Clinic, Okinawa, Japan
| | - Satoru Ota
- Graduate School of Health Sciences, Kumamoto University, Kumamoto, Japan
| | - Yuta Tanaka
- Graduate School of Health Sciences, Kumamoto University, Kumamoto, Japan
| | | | - Akihiro Takaki
- Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Shigeki Ito
- Department of Medical Imaging, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan,Corresponding author: Shigeki Ito, Department of Medical Imaging, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan. Tel: +81963735482; Fax: +81963735482;
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Area at risk can be assessed by iodine-123-meta-iodobenzylguanidine single-photon emission computed tomography after myocardial infarction: a prospective study. Nucl Med Commun 2017; 39:118-124. [PMID: 29194288 DOI: 10.1097/mnm.0000000000000782] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Myocardial salvage is an important surrogate endpoint to estimate the impact of treatments in patients with ST-segment elevation myocardial infarction (STEMI). AIM The aim of this study was to evaluate the correlation between cardiac sympathetic denervation area assessed by single-photon emission computed tomography (SPECT) using iodine-123-meta-iodobenzylguanidine (I-MIBG) and myocardial area at risk (AAR) assessed by cardiac magnetic resonance (CMR) (gold standard). PATIENTS AND METHODS A total of 35 postprimary reperfusion STEMI patients were enrolled prospectively to undergo SPECT using I-MIBG (evaluates cardiac sympathetic denervation) and thallium-201 (evaluates myocardial necrosis), and to undergo CMR imaging using T2-weighted spin-echo turbo inversion recovery for AAR and postgadolinium T1-weighted phase sensitive inversion recovery for scar assessment. RESULTS I-MIBG imaging showed a wider denervated area (51.1±16.0% of left ventricular area) in comparison with the necrosis area on thallium-201 imaging (16.1±14.4% of left ventricular area, P<0.0001). CMR and SPECT provided similar evaluation of the transmural necrosis (P=0.10) with a good correlation (R=0.86, P<0.0001). AAR on CMR was not different compared with the denervated area (P=0.23) and was adequately correlated (R=0.56, P=0.0002). Myocardial salvage evaluated by SPECT imaging (mismatch denervated but viable myocardium) was significantly higher than by CMR (P=0.02). CONCLUSION In patients with STEMI, I-MIBG SPECT, assessing cardiac sympathetic denervation may precisely evaluate the AAR, providing an alternative to CMR for AAR assessment.
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Wu J, Liu H, Hashemi Zonouz T, Sandoval VM, Mohy-ud-Din H, Lampert RJ, Sinusas AJ, Liu C, Liu YH. A blind deconvolution method incorporated with anatomical-based filtering for partial volume correction: Validations with 123
I-mIBG cardiac SPECT/CT. Med Phys 2017; 44:6435-6446. [DOI: 10.1002/mp.12622] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 09/28/2017] [Accepted: 10/04/2017] [Indexed: 01/08/2023] Open
Affiliation(s)
- Jing Wu
- Department of Radiology and Biomedical Imaging; Yale University; New Haven CT 06520 USA
| | - Hui Liu
- Department of Internal Medicine (Cardiology); Yale University; New Haven CT 06520 USA
| | | | | | - Hassan Mohy-ud-Din
- Department of Radiology and Biomedical Imaging; Yale University; New Haven CT 06520 USA
| | - Rachel J. Lampert
- Department of Internal Medicine (Cardiology); Yale University; New Haven CT 06520 USA
| | - Albert J. Sinusas
- Department of Radiology and Biomedical Imaging; Yale University; New Haven CT 06520 USA
- Department of Internal Medicine (Cardiology); Yale University; New Haven CT 06520 USA
| | - Chi Liu
- Department of Radiology and Biomedical Imaging; Yale University; New Haven CT 06520 USA
| | - Yi-Hwa Liu
- Department of Internal Medicine (Cardiology); Yale University; New Haven CT 06520 USA
- Department of Biomedical Imaging and Radiological Sciences; National Yang-Ming University; Taipei 100 Taiwan
- Department of Biomedical Engineering; Chung Yuan Christian University; Taoyuan 330 Taiwan
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14
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Alvi R, Miller EJ, Zonouz TH, Sandoval V, Tariq N, Lampert R, Sinusas AJ, Liu YH. Quantification and Determination of Normal 123I-Meta Iodobenzylguanidine Heart-to-Mediastinum Ratio (HMR) from Cardiac SPECT/CT and Correlation with Planar HMR. J Nucl Med 2017; 59:652-658. [DOI: 10.2967/jnumed.117.197152] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 08/30/2017] [Indexed: 01/08/2023] Open
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15
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Wu J, Lin SF, Gallezot JD, Chan C, Prasad R, Thorn SL, Stacy MR, Huang Y, Zonouz TH, Liu YH, Lampert RJ, Carson RE, Sinusas AJ, Liu C. Quantitative Analysis of Dynamic 123I-mIBG SPECT Imaging Data in Healthy Humans with a Population-Based Metabolite Correction Method. J Nucl Med 2016; 57:1226-32. [PMID: 27081169 DOI: 10.2967/jnumed.115.171710] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 03/11/2016] [Indexed: 01/08/2023] Open
Abstract
UNLABELLED Conventional 2-dimensional planar imaging of (123)I-metaiodobenzylguanidine ((123)I-mIBG) is not fully quantitative. To develop a more accurate quantitative imaging approach, we investigated dynamic SPECT imaging with kinetic modeling in healthy humans to obtain the myocardial volume of distribution (VT) for (123)I-mIBG. METHODS Twelve healthy humans underwent 5 serial 15-min SPECT scans at 0, 15, 90, 120, and 180 min after bolus injection of (123)I-mIBG on a hybrid cadmium zinc telluride SPECT/CT system. Serial venous blood samples were obtained for radioactivity measurement and radiometabolite analysis. List-mode data of all the scans were binned into frames and reconstructed with attenuation and scatter corrections. Myocardial and blood-pool volumes of interest were drawn on the reconstructed images to derive the myocardial time-activity curve and input function. A population-based blood-to-plasma ratio (BPR) curve was generated. Both the population-based metabolite correction (PBMC) and the individual metabolite correction (IMC) curves were generated for comparison. VT values were obtained from different compartment models, using different input functions with and without metabolite and BPR corrections. RESULTS The BPR curve reached the peak value of 2.1 at 13 min after injection. Parent fraction was approximately 58% ± 13% at 15 min and stabilized at approximately 40% ± 5% by 180 min after injection. Two radiometabolite species were observed. When the reversible 2-tissue-compartment fit was used, the mean VT value was 29.0 ± 12.4 mL/cm(3) with BPR correction and PBMC, a 188% ± 32% increase compared with that without corrections. There was significant difference in VT with BPR correction (P = 2.3e-04) as well as with PBMC (P = 1.6e-05). The mean difference in VT between PBMC and IMC was -3% ± 8%, which was insignificant (P = 0.39). The intersubject coefficients of variation after PBMC (43%) and IMC (42%) were similar. CONCLUSION The myocardial VT of (123)I-mIBG was established in healthy humans for the first time. Accurate kinetic modeling of (123)I-mIBG requires both BPR and metabolite corrections. Population-based BPR correction and metabolite correction curves were developed, allowing more convenient absolute quantification of dynamic (123)I-mIBG SPECT images.
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Affiliation(s)
- Jing Wu
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, Connecticut
| | - Shu-Fei Lin
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, Connecticut
| | | | - Chung Chan
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, Connecticut
| | - Rameshwar Prasad
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, Connecticut
| | - Stephanie L Thorn
- Department of Internal Medicine (Cardiology), Yale University, New Haven, Connecticut
| | - Mitchel R Stacy
- Department of Internal Medicine (Cardiology), Yale University, New Haven, Connecticut
| | - Yiyun Huang
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, Connecticut
| | | | - Yi-Hwa Liu
- Department of Internal Medicine (Cardiology), Yale University, New Haven, Connecticut Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan; and Department of Biomedical Engineering, Chung Yuan Christian University, Taoyuan, Taiwan
| | - Rachel J Lampert
- Department of Internal Medicine (Cardiology), Yale University, New Haven, Connecticut
| | - Richard E Carson
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, Connecticut
| | - Albert J Sinusas
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, Connecticut Department of Internal Medicine (Cardiology), Yale University, New Haven, Connecticut
| | - Chi Liu
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, Connecticut
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Chan C, Dey J, Grobshtein Y, Wu J, Liu YH, Lampert R, Sinusas AJ, Liu C. The impact of system matrix dimension on small FOV SPECT reconstruction with truncated projections. Med Phys 2016; 43:213. [PMID: 26745914 PMCID: PMC4691252 DOI: 10.1118/1.4938098] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 10/02/2015] [Accepted: 11/25/2015] [Indexed: 11/07/2022] Open
Abstract
PURPOSE A dedicated cardiac hybrid single photon emission computed tomography (SPECT)/CT scanner that uses cadmium zinc telluride detectors and multiple pinhole collimators for stationary acquisition offers many advantages. However, the impact of the reconstruction system matrix (SM) dimension on the reconstructed image quality from truncated projections and 19 angular samples acquired on this scanner has not been extensively investigated. In this study, the authors aimed to investigate the impact of the dimensions of SM and the use of body contour derived from adjunctive CT imaging as an object support in reconstruction on this scanner, in relation to background extracardiac activity. METHODS The authors first simulated a generic SPECT/CT system to image four NCAT phantoms with various levels of extracardiac activity and compared the reconstructions using SM in different dimensions and with/without body contour as a support for quantitative evaluations. The authors then compared the reconstructions of 18 patient studies, which were acquired on a GE Discovery NM570c scanner following injection of different radiotracers, including (99m)Tc-Tetrofosmin and (123)I-mIBG, comparing the scanner's default SM that incompletely covers the body with a large SM that incorporates a patient specific full body contour. RESULTS The simulation studies showed that the reconstructions using a SM that only partially covers the body yielded artifacts on the edge of the field of view (FOV), overestimation of activity and increased nonuniformity in the blood pool for the phantoms with higher relative levels of extracardiac activity. However, the impact on the quantitative accuracy in the high activity region, such as the myocardium, was subtle. On the other hand, an excessively large SM that enclosed the entire body alleviated the artifacts and reduced overestimation in the blood pool, but yielded slight underestimation in myocardium and defect regions. The reconstruction using the larger SM with body contour yielded the most quantitatively accurate results in all the regions of interest for a range of uptake levels in the extracardiac regions. In patient studies, the SM incorporating patient specific body contour minimized extracardiac artifacts, yielded similar myocardial activity, lower blood pool activity, and subsequently improved myocardium-to-blood pool contrast (p < 0.0001) by an average of 7% (range 0%-18%) across all the patients, compared to the reconstructions using the scanner's default SM. CONCLUSIONS Their results demonstrate that using a large SM that incorporates a CT derived body contour in the reconstruction could improve quantitative accuracy within the FOV for clinical studies with high extracardiac activity.
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Affiliation(s)
- Chung Chan
- Department of Diagnostic Radiology, Yale University, New Haven, Connecticut 06520
| | - Joyoni Dey
- Department of Physics and Astronomy, Medical Physics Program, Louisiana State University, Baton Rouge, Louisiana 70803
| | | | - Jing Wu
- Department of Diagnostic Radiology, Yale University, New Haven, Connecticut 06520
| | - Yi-Hwa Liu
- Department of Internal Medicine, Yale University, New Haven, Connecticut 06520
| | - Rachel Lampert
- Department of Internal Medicine, Yale University, New Haven, Connecticut 06520
| | - Albert J Sinusas
- Department of Diagnostic Radiology, Yale University, New Haven, Connecticut 06520 and Department of Internal Medicine, Yale University, New Haven, Connecticut 06520
| | - Chi Liu
- Department of Diagnostic Radiology, Yale University, New Haven, Connecticut 06520
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Dimitriu-Leen AC, Scholte AJHA, Jacobson AF. 123I-MIBG SPECT for Evaluation of Patients with Heart Failure. J Nucl Med 2015; 56 Suppl 4:25S-30S. [PMID: 26033900 DOI: 10.2967/jnumed.115.157503] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Heart failure (HF) is characterized by activation of the sympathetic cardiac nerves. The condition of cardiac sympathetic nerves can be evaluated by (123)I-metaiodobenzylguanidine ((123)I-MIBG) imaging. Most cardiac (123)I-MIBG studies have relied on measurements from anterior planar images of the chest. However, it has become progressively more common to include SPECT imaging in clinical and research protocols. This review examines recent trends in (123)I-MIBG SPECT imaging and evidence that provides the basis for the increased use of the procedure in the clinical management of patients with HF. (123)I-MIBG SPECT has been shown to be complementary to planar imaging in patients with HF in studies of coronary artery disease after an acute myocardial infarction. Moreover, (123)I-MIBG SPECT has been used in numerous studies to document regional denervation for arrhythmic event risk assessment. For better quantification of the size and severity of innervation abnormalities in (123)I-MIBG SPECT, programs and protocols specifically for (123)I have been developed. Also, the introduction of new solid-state cameras has created the potential for more rapid SPECT acquisitions or a reduction in radiopharmaceutical activity. Although PET imaging has superior quantitative capabilities, (123)I-MIBG SPECT is, for the foreseeable future, the only widely available nuclear imaging method for assessing regional myocardial sympathetic innervation.
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Affiliation(s)
| | - Arthur J H A Scholte
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; and
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Nagao M, Baba S, Yonezawa M, Yamasaki Y, Kamitani T, Isoda T, Kawanami S, Maruoka Y, Kitamura Y, Abe K, Higo T, Sunagawa K, Honda H. Prediction of adverse cardiac events in dilated cardiomyopathy using cardiac T2* MRI and MIBG scintigraphy. Int J Cardiovasc Imaging 2014; 31:399-407. [DOI: 10.1007/s10554-014-0562-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 10/23/2014] [Indexed: 10/24/2022]
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Slomka PJ, Mehta PK, Germano G, Berman DS. Quantification of I-123-meta-iodobenzylguanidine heart-to-mediastinum ratios: not so simple after all. J Nucl Cardiol 2014; 21:979-83. [PMID: 25005347 DOI: 10.1007/s12350-014-9943-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 06/05/2014] [Indexed: 01/11/2023]
Affiliation(s)
- Piotr J Slomka
- Departments of Imaging and Medicine, and Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA,
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Flotats A. Advances in Molecular Imaging: Innervation Imaging. CURRENT CARDIOVASCULAR IMAGING REPORTS 2013. [DOI: 10.1007/s12410-013-9209-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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