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Prone-position acquisition of myocardial 123I-metaiodobenzylguanidine (MIBG) SPECT reveals regional uptake similar to that found using 11C-hydroxyephedrine PET/CT

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Abstract

Objectives

123I-metaiodobenzylguanidine (MIBG) has been used to estimate cardiac sympathetic nervous innervation. Heterogeneous MIBG distribution is mainly associated with high physiological MIBG uptakes in the liver. We postulate that prone position acquisition might be especially effective for MIBG, providing for separation from high liver uptake similar to that provided by perfusion single-photon emission computed tomography (SPECT). We investigated whether prone-position acquisition improved MIBG image quality by comparing our results to those acquired using supine MIBG and high-quality 11C-hydroxyephedrine (HED) positron emission tomography/computed tomography PET/CT.

Methods

Ten male volunteers (body mass index (BMI) 22.7 ± 3.4) underwent prone and supine MIBG and HED PET. Relative regional tracer uptake was estimated in early MIBG and HED. Acquired images were divided into 17 segments and were grouped into 4 regions: anterior, inferior, septum, and lateral. For each patient, the inferior/anterior ratio was calculated.

Results

The quality of images acquired using prone MIBG was better than that using supine MIBG (p < 0.05). Inferior and septum relative MIBG uptake was reduced in comparison with anterior or lateral MIBG uptake in the supine position (inferior vs. anterior: 69.0 ± 5.6 vs. 82.3 ± 4.6 %, p < 0.01; septum vs. lateral: 66.2 ± 5.1 vs. 81.9 ± 5.4 %, p < 0.01). Prone MIBG showed a significantly higher inferior/anterior uptake ratio in comparison with supine MIBG (n = 24, seg: 92.2 ± 7.2 vs. 83.6 ± 5.7 %, p < 0.05). However, intergroup differences in uptake ratio were demonstrated among prone and supine MIBG and HED. HED PET/CT still showed a higher uptake ratio in comparison with prone MIBG SPECT (103.9 ± 8.0 vs. 92.2 ± 7.2 %, p < 0.05).

Conclusion

Even in normal male subjects, standard supine MIBG imaging showed reduced inferior and septum uptake. Uptake with prone MIBG imaging showed a significant improvement over that with supine imaging and was closer to uptake for HED PET/CT. This improvement may be the result of preventing intense uptake by the liver. Prone data acquisition may be a viable alternative in evaluating regional abnormalities using MIBG SPECT in men.

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Acknowledgments

The authors thank Daiske Abo, MSc; Kumi Ajiki, and Eriko Suzuki for their support of this study.

Conflict of interest

This work is supported in part by FUJIFILM RI Pharma Co., Ltd (Osaka, Japan). All data were recorded and analyzed by Hokkaido University Graduate School of Medicine. This study was supported in part by grants from the Ministry of Education, Culture, Sports, Science and Technology (Category B, No. 23390294), Adult Vascular Disease Foundation (#H22-23) (Kyoto, Japan), and North-Tech Research Foundation (#H23-S2-17, Sapporo, Japan). Yuuki Tomiyama is supported by the National Institute of Radiological Sciences Human Resource Development Program (Chiba, Japan).

Dr. Yoshinaga is supported by the Imura Clinical Research Award (Adult Vascular Disease Foundation, Kyoto, Japan).

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Authors and Affiliations

  1. Department of Molecular Imaging, Hokkaido University Graduate School of Medicine, Kita15 Nishi7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan

    Keiichiro Yoshinaga

  2. Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Yuuki Tomiyama, Osamu Manabe, Katsuhiko Kasai, Kenichi Magota, Eriko Suzuki & Nagara Tamaki

  3. Faculty of Health Science, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Chietsugu Katoh

  4. Tracer Kinetics, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Ken-ichi Nishijima

  5. Radio Isotope Center, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Yuji Kuge

  6. Biostatistics, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Yoichi M. Ito

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  1. Keiichiro Yoshinaga
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  2. Yuuki Tomiyama
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Correspondence to Keiichiro Yoshinaga.

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Yoshinaga, K., Tomiyama, Y., Manabe, O. et al. Prone-position acquisition of myocardial 123I-metaiodobenzylguanidine (MIBG) SPECT reveals regional uptake similar to that found using 11C-hydroxyephedrine PET/CT. Ann Nucl Med 28, 761–769 (2014). https://doi.org/10.1007/s12149-014-0868-z

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  • DOI: https://doi.org/10.1007/s12149-014-0868-z

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