(123)I-Meta-iodobenzylguanidine Sympathetic Imaging: Standardization and Application to Neurological Diseases

Overview

Journal Chonnam Med J

Specialty General Medicine

Date 2016 Oct 1

PMID 27689024

Citations 6

Authors

Kenichi Nakajima

Masahito Yamada

Affiliations

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Abstract

(123)I-meta-iodobenzylguanidine (MIBG) has become widely applied in Japan since its introduction to clinical cardiology and neurology practice in the 1990s. Neurological studies found decreased cardiac uptake of (123)I-MIBG in Lewy-body diseases including Parkinson's disease and dementia with Lewy bodies. Thus, cardiac MIBG uptake is now considered a biomarker of Lewy body diseases. Although scintigraphic images of (123)I-MIBG can be visually interpreted, an average count ratio of heart-to-mediastinum (H/M) has commonly served as a semi-quantitative marker of sympathetic activity. Since H/M ratios significantly vary according to acquisition and processing conditions, quality control should be appropriate, and quantitation should be standardized. The threshold H/M ratio for differentiating Lewy-body disease is 2.0-2.1, and was based on standardized H/M ratios to comparable values of medium-energy collimators. Parkinson's disease can be separated from various types of parkinsonian syndromes using cardiac (123)I-MIBG, whereas activity is decreased on images of Lewy-body diseases using both (123)I-ioflupane for the striatum and (123)I-MIBG. Despite being a simple index, the H/M ratio of (123)I-MIBG uptake is reproducible and can serve as an effective tool to support a diagnosis of Lewy-body diseases in neurological practice.

Citing Articles

Absolute quantitation of sympathetic nerve activity using [I] metaiodobenzylguanidine SPECT-CT in neurology.

Saito S, Nakajima K, Komatsu J, Shibutani T, Wakabayashi H, Mori H EJNMMI Rep. 2024; 8(1):15.

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Three-Dimensional Heart Segmentation and Absolute Quantitation of Cardiac I-metaiodobenzylguanidine Sympathetic Imaging Using SPECT/CT.

Saito S, Nakajima K, Shibutani T, Wakabayashi H, Yoneyama H, Konishi T Ann Nucl Cardiol. 2023; 9(1):61-67.

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Phantom-Based Standardization Method for I-metaiodobenzylguanidine Heart-to-Mediastinum Ratio Validated by D-SPECT Versus Anger Camera.

Yamashita S, Nakajima K, Okuda K, Yamamoto H, Shibutani T, Yoneyama T Ann Nucl Cardiol. 2023; 9(1):85-90.

PMID: 38058581 PMC: 10696155. DOI: 10.17996/anc.23-00003.

Cardiac I-IBG Imaging in Heart Failure.

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Cardiac Autonomic Dysfunction Is Associated with Severity of REM Sleep without Atonia in Isolated REM Sleep Behavior Disorder.

You S, Won K, Kim K, Lee H, Cho Y J Clin Med. 2021; 10(22).

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