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Assessment of myocardial sympathetic innervation with [123I]mIBG myocardial scintigraphy : A comparative study between an Anger and a ring-configured cadmium-zinc-telluride gamma camera

Hagerman, Jessica LU ; Engblom, Shahnaz Akil LU ; Andelius, Irma Cerić ; Stenvall, Anna LU ; Minarik, David LU ; Hall, Sara LU ; Stomrud, Erik LU orcid ; Nahimi, Adjmal LU ; Smith, Ruben LU and Hansson, Oskar LU orcid , et al. (2025) In Journal of Nuclear Cardiology
Abstract

Background Assessment of myocardial sympathetic innervation with iodine-123-metaiodobenzylguanidine ([123I]mIBG) scintigraphy is conventionally performed by determining the heart-to-mediastinum ratio (HMR) on planar images. This study aimed to investigate the feasibility of determining HMR from reprojected [123I]mIBG planar images derived from tomographic data by a ring-configured cadmium-zinc-telluride (CZT) gamma camera and its agreement with HMR determined from [123I]mIBG planar images by an Anger gamma camera, in the assessment of myocardial sympathetic innervation. Methods A total of 105 study participants (suspected idiopathic rapid-eye-movement sleep behavior disorder n = 55, early-stage... (More)

Background Assessment of myocardial sympathetic innervation with iodine-123-metaiodobenzylguanidine ([123I]mIBG) scintigraphy is conventionally performed by determining the heart-to-mediastinum ratio (HMR) on planar images. This study aimed to investigate the feasibility of determining HMR from reprojected [123I]mIBG planar images derived from tomographic data by a ring-configured cadmium-zinc-telluride (CZT) gamma camera and its agreement with HMR determined from [123I]mIBG planar images by an Anger gamma camera, in the assessment of myocardial sympathetic innervation. Methods A total of 105 study participants (suspected idiopathic rapid-eye-movement sleep behavior disorder n = 55, early-stage Parkinson's Disease n = 36, and healthy controls n = 14) who were referred for [123I]mIBG myocardial scintigraphy were included, in addition to eight phantom experiments simulating a range of HMR. HMR was determined from planar and reprojected planar images acquired with an Anger gamma camera and a ring-configured CZT gamma camera, respectively, for all study participants and phantom experiments. Agreement in HMR between the two imaging methods was analyzed in Bland-Altman plots. Intra- and interobserver variability was evaluated for both imaging methods in a subset of images. Results The agreement between planar and reprojected planar images was good, with a mean difference in HMR of 0.11 (95% limits of agreement −0.16 to 0.38) for the study participants. Intra- and interobserver variability was low and comparable for both imaging methods. Results from the phantom experiments were consistent with those from the study participants. Conclusions Determining HMR from reprojected [123I]mIBG myocardial scintigraphy planar images acquired with a ring-configured CZT gamma camera is feasible and shows good agreement with HMR determined from planar images by a conventional Anger gamma camera.

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publishing date
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Contribution to journal
publication status
in press
subject
keywords
CZT, Heart-to-mediastinum ratio, Iodine-123-metaiodobenzylguanidine, Myocardial sympathetic innervation, Reprojected planar images, Ring-configured, StarGuide, [I]mIBG
in
Journal of Nuclear Cardiology
article number
102574
publisher
Springer
external identifiers
  • scopus:105025450136
  • pmid:41318052
ISSN
1071-3581
DOI
10.1016/j.nuclcard.2025.102574
language
English
LU publication?
yes
id
82da28a2-b078-45a6-acbc-18f3901da6c4
date added to LUP
2026-02-26 14:41:08
date last changed
2026-02-26 15:32:44
@article{82da28a2-b078-45a6-acbc-18f3901da6c4,
  abstract     = {{<p>Background Assessment of myocardial sympathetic innervation with iodine-123-metaiodobenzylguanidine ([<sup>123</sup>I]mIBG) scintigraphy is conventionally performed by determining the heart-to-mediastinum ratio (HMR) on planar images. This study aimed to investigate the feasibility of determining HMR from reprojected [<sup>123</sup>I]mIBG planar images derived from tomographic data by a ring-configured cadmium-zinc-telluride (CZT) gamma camera and its agreement with HMR determined from [<sup>123</sup>I]mIBG planar images by an Anger gamma camera, in the assessment of myocardial sympathetic innervation. Methods A total of 105 study participants (suspected idiopathic rapid-eye-movement sleep behavior disorder n = 55, early-stage Parkinson's Disease n = 36, and healthy controls n = 14) who were referred for [<sup>123</sup>I]mIBG myocardial scintigraphy were included, in addition to eight phantom experiments simulating a range of HMR. HMR was determined from planar and reprojected planar images acquired with an Anger gamma camera and a ring-configured CZT gamma camera, respectively, for all study participants and phantom experiments. Agreement in HMR between the two imaging methods was analyzed in Bland-Altman plots. Intra- and interobserver variability was evaluated for both imaging methods in a subset of images. Results The agreement between planar and reprojected planar images was good, with a mean difference in HMR of 0.11 (95% limits of agreement −0.16 to 0.38) for the study participants. Intra- and interobserver variability was low and comparable for both imaging methods. Results from the phantom experiments were consistent with those from the study participants. Conclusions Determining HMR from reprojected [<sup>123</sup>I]mIBG myocardial scintigraphy planar images acquired with a ring-configured CZT gamma camera is feasible and shows good agreement with HMR determined from planar images by a conventional Anger gamma camera.</p>}},
  author       = {{Hagerman, Jessica and Engblom, Shahnaz Akil and Andelius, Irma Cerić and Stenvall, Anna and Minarik, David and Hall, Sara and Stomrud, Erik and Nahimi, Adjmal and Smith, Ruben and Hansson, Oskar and Hedeer, Fredrik}},
  issn         = {{1071-3581}},
  keywords     = {{CZT; Heart-to-mediastinum ratio; Iodine-123-metaiodobenzylguanidine; Myocardial sympathetic innervation; Reprojected planar images; Ring-configured; StarGuide; [I]mIBG}},
  language     = {{eng}},
  publisher    = {{Springer}},
  series       = {{Journal of Nuclear Cardiology}},
  title        = {{Assessment of myocardial sympathetic innervation with [<sup>123</sup>I]mIBG myocardial scintigraphy : A comparative study between an Anger and a ring-configured cadmium-zinc-telluride gamma camera}},
  url          = {{http://dx.doi.org/10.1016/j.nuclcard.2025.102574}},
  doi          = {{10.1016/j.nuclcard.2025.102574}},
  year         = {{2025}},
}