title: Impact of mediastinal, liver and lung (123)I-metaiodobenzylguanidine ( (123)I-MIBG) washout on calculated (123)I-MIBG myocardial washout.
abstract: OBJECTIVE
  In planar (123)I-metaiodobenzylguanidine ((123)I-MIBG) myocardial imaging mediastinum (M) activity is often used as a background correction in calculating "washout" (WO). However, the most likely sources for counts that might produce errors in estimating myocardial (Myo) activity are lung (Lu) and liver (Li), which typically have higher counts/pixel (cpp) than M. The present study investigated the relationship between changes in Lu, Li and Myo activity between early and late planar (123)I-MIBG images, with comparison to M as the best estimator of non-specific background activity.
  
  
  METHODS
  Studies on 98 subjects with both early (e) and late (l) planar (123)I-MIBG images were analysed. There were 68 subjects with chronic heart failure (CHF), 14 with hypertension (HTN) but no known heart disease and 16 controls (C). For each image, regions of interest (ROIs) were drawn: an irregular whole Myo, Lu, upper M and Li. For each ROI, WO was calculated as [(cpp(e)-cpp(l:decay corrected))/cpp(e)]x100%.
  
  
  RESULTS
  Multivariable forward stepwise regression analysis showed that overall a significant proportion of the variation in Myo WO could be explained by a model containing M WO and Lu WO (37%, p < 0.001). Only in controls was M WO the sole variable explaining a significant proportion of the variation in Myo WO (27%, p = 0.023).
  
  
  CONCLUSIONS
  Although increased Myo WO in CHF subjects reflects disease severity, part of the count differences measured on planar (123)I-MIBG myocardial images likely reflects changes in the adjacent and surrounding Lu tissue. The results for the controls suggest that this is the only group where a mediastinum correction alone may be appropriate for cardiac WO calculations.
authors.affiliation: Department of Nuclear Medicine, Academic Medical Center, F2-238, P.O. Box 22700, 1100 DE, Amsterdam, The Netherlands. h.j.verberne@amc.uva.nl
authors.forename: Hein J
authors.initials: HJ
authors.lastname: Verberne
authors.forename: G Aernout
authors.initials: GA
authors.lastname: Somsen
authors.forename: Pavol
authors.initials: P
authors.lastname: Povinec
authors.forename: Berthe L F
authors.initials: BL
authors.lastname: van Eck-Smit
authors.forename: Arnold F
authors.initials: AF
authors.lastname: Jacobson
mesh_terms: D019797:3-Iodobenzylguanidine / Q000378:metabolism*; D000328:Adult; D016477:Artifacts; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000378:metabolism; D008099:Liver / Q000000981:diagnostic imaging / Q000378:metabolism*; D008168:Lung / Q000000981:diagnostic imaging* / Q000378:metabolism*; D008297:Male; D008482:Mediastinum / Q000000981:diagnostic imaging; D008875:Middle Aged; D015999:Multivariate Analysis; D009206:Myocardium / Q000378:metabolism*; D011877:Radionuclide Imaging; D013997:Time Factors
chemical_list: D019797:3-Iodobenzylguanidine