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European Journal of Nuclear Medicine and Molecular Imaging

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01.11.2015 | Original Article

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

verfasst von: Dimitri Bellevre, Alain Manrique, Damien Legallois, Samy Bross, Rafael Baavour, Nathaniel Roth, Tanguy Blaire, Cédric Desmonts, Alban Bailliez, Denis Agostini

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 12/2015

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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 ¹²³I-MIBG injection (236.4 ± 39.7 MBq). To localize the heart using D-SPECT, ^99mTc-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 (¹²³I and ^99mTc) 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 ¹²³I MIBG HMR obtained using a CZT camera and that from conventional planar imaging.

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Titel: 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
verfasst von: Dimitri Bellevre
Alain Manrique
Damien Legallois
Samy Bross
Rafael Baavour
Nathaniel Roth
Tanguy Blaire
Cédric Desmonts
Alban Bailliez
Denis Agostini
Publikationsdatum: 01.11.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 12/2015
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-015-3141-3

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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