Quantitative iodine-123-metaiodobenzylguanidine (MIBG) SPECT imaging in heart failure with left ventricular systolic dysfunction: Development and validation of automated procedures in conjunction with technetium-99m tetrofosmin myocardial perfusion SPECT.

Abstract

BACKGROUND:

The purpose of this study was to develop and validate new approaches to quantitative MIBG myocardial SPECT imaging in heart failure (HF) subjects.

METHODS AND RESULTS:

Quantitative MIBG myocardial SPECT analysis methods, alone and in conjunction with 99mTc-tetrofosmin perfusion SPECT, were adapted from previously validated techniques for the analysis of SPECT and PET perfusion imaging. To account for underestimation of MIBG defect severity in subjects with global reduction in uptake, a mixed reference database based on planar heart/mediastinum (H/M) ratio categories was used. Extent and severity of voxel-based defects and number of myocardial segments with significant dysinnervation (derived score ≥2) were determined. MIBG/99mTc-tetrofosmin mismatch was quantified using regions with preserved innervation as the reference for scaling 99mTc-tetrofosmin voxel maps. Quantification techniques were tested on studies of 619 ischemic (I) and 319 non-ischemic (NI) HF subjects. Using all analytical techniques, IHF subjects had significantly greater and more severe MIBG SPECT abnormalities compared with NIHF subjects. Innervation/perfusion mismatches were also larger in IHF subjects. Findings were consistent between voxel- and myocardial-segment-based quantitation methods.

CONCLUSIONS:

Multiple objective methods for quantitation of MIBG SPECT imaging studies provided internally consistent results for distinguishing the different patterns of uptake between IHF and NIHF subjects.

• Authors: Ian P Clements, Ernest V Garcia, Ji Chen, Russell D Folks, Javed Butler, Arnold F Jacobson
• Journal: Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology (J Nucl Cardiol) Vol. 23 Issue 3 Pg. 425-35 (06 2016) ISSN: 1532-6551 [Electronic] United States
• PMID: 25788403 (Publication Type: Evaluation Study, Journal Article, Validation Study)

Chemical References

• Organophosphorus Compounds
• Organotechnetium Compounds
• 3-Iodobenzylguanidine
• technetium tc-99m tetrofosmin

Topics

• 3-Iodobenzylguanidine
• Adult
• Aged
• Aged, 80 and over
• Female
• Heart Failure (complications, diagnostic imaging)
• Humans
• Image Enhancement (methods)
• Image Interpretation, Computer-Assisted (methods)
• Machine Learning
• Male
• Middle Aged
• Multimodal Imaging (methods)
• Organophosphorus Compounds
• Organotechnetium Compounds
• Pattern Recognition, Automated (methods)
• Reproducibility of Results
• Sensitivity and Specificity
• Stroke Volume
• Tomography, Emission-Computed, Single-Photon (methods)
• Ventricular Dysfunction, Left (diagnostic imaging, etiology)