¹²³I-Meta-iodobenzylguanidine Sympathetic Imaging: Standardization and Application to Neurological Diseases
10.4068/cmj.2016.52.3.145
- Author:
Kenichi NAKAJIMA
1
;
Masahito YAMADA
Author Information
1. Department of Nuclear Medicine, Kanazawa University, Kanazawa, Japan. nakajima@med.kanazawa-u.ac.jp
- Publication Type:Review
- Keywords:
Lewy Body Disease;
Parkinson Disease;
Dementia;
Nuclear Medicine;
Quantitation
- MeSH:
3-Iodobenzylguanidine;
Cardiology;
Dementia;
Diagnosis;
Japan;
Lewy Bodies;
Lewy Body Disease;
Neurology;
Nuclear Medicine;
Parkinson Disease;
Parkinsonian Disorders;
Quality Control
- From:Chonnam Medical Journal
2016;52(3):145-150
- CountryRepublic of Korea
- Language:English
-
Abstract:
¹²³I-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 ¹²³I-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 ¹²³I-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 ¹²³I-MIBG, whereas activity is decreased on images of Lewy-body diseases using both ¹²³I-ioflupane for the striatum and ¹²³I-MIBG. Despite being a simple index, the H/M ratio of ¹²³I-MIBG uptake is reproducible and can serve as an effective tool to support a diagnosis of Lewy-body diseases in neurological practice.
