I-123 mIBG and Tc-99m myocardial SPECT imaging to predict inducibility of ventricular arrhythmia on electrophysiology testing: a retrospective analysis.

Abstract

OBJECTIVES:

The purpose of this study is to assess mIBG uptake in scar border zone and its relation with ventricular arrhythmia (VA) inducibility on electrophysiology (EP) testing using I-123 mIBG SPECT and resting Tc-99m SPECT myocardial perfusion imaging (MPI).

METHODS:

Forty-seven patients from a previous clinical trial were retrospectively analyzed. These patients underwent I-123 mIBG and resting Tc-99m tetrofosmin SPECT, and EP testing. Twenty-eight patients were positive (EP+) and 19 patients were negative (EP-) for inducibility of sustained (>30 seconds) VA on EP testing. MPI scar extent, border zone extent, and mIBG uptake in border zone were used to predict VA inducibility on EP testing, respectively.

RESULTS:

There was no significant difference in scar extent between the EP+ and EP- groups. The EP+ group had significantly larger border zone and lower mIBG uptake ratio in the border zone than the EP- group. Receiver operating characteristic (ROC) curve analysis showed that the prediction accuracy for border zone extent (area under ROC = 0.75) was better than scar extent (area under ROC = 0.66). The prediction accuracy was further improved (area under ROC = 0.78), when assessing mIBG uptake in the border zone.

CONCLUSION:

A new tool has been developed to measure scar and border zone and to assess mIBG uptake in scar and border zone from combined I-123 MIBG SPECT and resting Tc-99m SPECT MPI. The mIBG uptake in the border zone predicted VA inducibility on EP testing with a promising accuracy.

• Authors: Yanli Zhou, Weihua Zhou, Russell D Folks, Daya N Manatunga, Arnold F Jacobson, Jeroen J Bax, Ernest V Garcia, Ji Chen
• Journal: Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology (J Nucl Cardiol) Vol. 21 Issue 5 Pg. 913-20 (Oct 2014) ISSN: 1532-6551 [Electronic] United States
• PMID: 24858625 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)

Chemical References

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

Topics

• 3-Iodobenzylguanidine
• Aged
• Electrophysiologic Techniques, Cardiac (methods)
• Female
• Humans
• Male
• Organophosphorus Compounds
• Organotechnetium Compounds
• Prognosis
• Radiopharmaceuticals
• Reproducibility of Results
• Retrospective Studies
• Sensitivity and Specificity
• Tachycardia, Ventricular (diagnostic imaging)
• Tomography, Emission-Computed, Single-Photon (methods)
• Ventricular Fibrillation (diagnostic imaging)