First determination of the heart-to-mediastinum ratio using cardiac dual isotope (¹²³I-MIBG/⁹⁹mTc-tetrofosmin) CZT imaging in patients with heart failure: the ADRECARD study.

Abstract

PURPOSE:

Cardiac innervation is assessed using the heart-to-mediastinum ratio (HMR) of metaiodobenzylguanidine (MIBG) on planar imaging using Anger single photon emission computed tomography (A-SPECT). The aim of the study was to determine the HMR of MIBG obtained using a CZT-based camera (D-SPECT; Spectrum Dynamics, Israel) in comparison with that obtained using conventional planar imaging.

METHODS:

The ADRECARD study prospectively evaluated 44 patients with heart failure. They underwent planar acquisition using the A-SPECT camera 4 h after (123)I-MIBG injection (236.4 ± 39.7 MBq). To localize the heart using D-SPECT, (99m)Tc-tetrofosmin (753 ± 133 MBq) was administered and dual isotope acquisition was performed using the D-SPECT system. HMR was calculated using both planar A-SPECT imaging and front view D-SPECT cine data. In a phantom study, we estimated a model fitting the A-SPECT and the D-SPECT data that was further applied to correct for differences between the cameras.

RESULTS:

A total of 44 patients (39 men and 5 women, aged 60 ± 11 years) with ischaemic (31 patients) and nonischaemic (13 patients) cardiomyopathy completed the study. Most patients (28 of 44) were NYHA class II, and the mean left ventricular ejection fraction was 33 ± 7 %. The mean HMR values were 1.34 ± 0.15 and 1.45 ± 0.27 from A-SPECT and D-SPECT, respectively (p < 0.0001). After correction, Lin's concordance correlation showed an almost perfect concordance between corrected D-SPECT HMR and A-SPECT HMR, and Bland-Altman analysis demonstrated a high agreement between the two measurements.

CONCLUSION:

The ADRECARD study demonstrated that determination of late HMR during cardiac MIBG imaging using dual isotope ((123)I and (99m)Tc) acquisition on a CZT camera (D-SPECT) is feasible in patients with heart failure. A linear correction based on the phantom study yielded a high agreement between (123)I MIBG HMR obtained using a CZT camera and that from conventional planar imaging.

• Authors: Dimitri Bellevre, Alain Manrique, Damien Legallois, Samy Bross, Rafael Baavour, Nathaniel Roth, Tanguy Blaire, Cédric Desmonts, Alban Bailliez, Denis Agostini
• Journal: European journal of nuclear medicine and molecular imaging (Eur J Nucl Med Mol Imaging) Vol. 42 Issue 12 Pg. 1912-9 (Nov 2015) ISSN: 1619-7089 [Electronic] Germany
• PMID: 26227533 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

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

Topics

• 3-Iodobenzylguanidine
• Adult
• Aged
• Female
• Gamma Cameras
• Heart (diagnostic imaging)
• Heart Failure (diagnostic imaging)
• Humans
• Male
• Mediastinum (diagnostic imaging)
• Middle Aged
• Organophosphorus Compounds
• Organotechnetium Compounds
• Phantoms, Imaging
• Tomography, Emission-Computed, Single-Photon (instrumentation)