Abstract
The 123I-labeled meta-iodobenzylguanidine (MIBG) is an analogue of noradrenaline that can evaluate cardiac sympathetic activity in scintigraphy. Quantitative analysis of 123I-MIBG images has been verified in patients with heart failure and neurodegenerative diseases. However, quantitative results differ due to variations in scintigraphic imaging procedures. Here, we created and assessed the clinical feasibility of a calibration method for 123I-MIBG imaging. The characteristics of scintigraphic imaging systems were determined using an acrylic calibration phantom to generate a multicenter phantom imaging database. Calibration factors corresponding to the scintigraphic imaging procedures were calculated from the database and applied to a clinical study. The results of this study showed that the calibrated analysis eliminated inter-institutional differences among normal individuals. In summary, our standardization methodology for 123I-MIBG scintigraphy could provide the basis for improved diagnostic precision and better outcomes for patients.
Highlights
The 123I-labeled meta-iodobenzylguanidine (MIBG) is an analogue of noradrenaline that can evaluate cardiac sympathetic activity in scintigraphy
When the simulation and experimental 123I-MIBG phantom images were compared in terms of LE, LME, and ME collimators, image blurring due to 529-keV high-energy photon was visualized under both conditions with the LE collimator (Fig. 1c)
We examined conversion coefficients in the following collimator categories (Fig. 3a): cardiac high-resolution (CHR), low-energy high-resolution (LEHR), low-energy general-purpose (LEGP), low-energy all-purpose (LEAP), low-energy general-all-purpose (LEGAP), extended low-energy general-purpose (ELEGP), low-medium-energy generalpurpose (LMEGP,) medium-energy (ME), medium-energy general-purpose (MEGP), medium-energy generalall-purpose (MEGAP), and medium-energy low-penetration (MELP)
Summary
The 123I-labeled meta-iodobenzylguanidine (MIBG) is an analogue of noradrenaline that can evaluate cardiac sympathetic activity in scintigraphy. The method is based on an acrylic chest phantom that was designed for 123I-MIBG planar imaging[23] It can calibrate collimator performance differences in clinical HMR calculations that lead to standardized HMR. We validated this method in multicenter phantom studies in Japan and E urope[28,29,30,31,32,33]. A multicenter phantom imaging database was created to identify the cause of HMR variations in imaging conditions, revealed that the energy-window setting for 123I is indispensable for robust HMR values This database allows the determination of mean calibration factors in combinations of gamma cameras and collimators. Our results indicate a vital role of HMR calculations in cardiac 123I-MIBG examinations
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