title: I-123 mIBG and Tc-99m myocardial SPECT imaging to predict inducibility of ventricular arrhythmia on electrophysiology testing: a retrospective analysis.
abstract: OBJECTIVE
  The purpose of this study is to assess mIBG uptake in scar border zone and its relation with ventricular arrhythmia (VA) inducibility on electrophysiology (EP) testing using I-123 mIBG SPECT and resting Tc-99m SPECT myocardial perfusion imaging (MPI).
  
  
  METHODS
  Forty-seven patients from a previous clinical trial were retrospectively analyzed. These patients underwent I-123 mIBG and resting Tc-99m tetrofosmin SPECT, and EP testing. Twenty-eight patients were positive (EP+) and 19 patients were negative (EP-) for inducibility of sustained (>30 seconds) VA on EP testing. MPI scar extent, border zone extent, and mIBG uptake in border zone were used to predict VA inducibility on EP testing, respectively.
  
  
  RESULTS
  There was no significant difference in scar extent between the EP+ and EP- groups. The EP+ group had significantly larger border zone and lower mIBG uptake ratio in the border zone than the EP- group. Receiver operating characteristic (ROC) curve analysis showed that the prediction accuracy for border zone extent (area under ROC = 0.75) was better than scar extent (area under ROC = 0.66). The prediction accuracy was further improved (area under ROC = 0.78), when assessing mIBG uptake in the border zone.
  
  
  CONCLUSIONS
  A new tool has been developed to measure scar and border zone and to assess mIBG uptake in scar and border zone from combined I-123 MIBG SPECT and resting Tc-99m SPECT MPI. The mIBG uptake in the border zone predicted VA inducibility on EP testing with a promising accuracy.
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA, 30322, USA.
authors.forename: Yanli
authors.initials: Y
authors.lastname: Zhou
authors.forename: Weihua
authors.initials: W
authors.lastname: Zhou
authors.forename: Russell D
authors.initials: RD
authors.lastname: Folks
authors.forename: Daya N
authors.initials: DN
authors.lastname: Manatunga
authors.forename: Arnold F
authors.initials: AF
authors.lastname: Jacobson
authors.forename: Jeroen J
authors.initials: JJ
authors.lastname: Bax
authors.forename: Ernest V
authors.initials: EV
authors.lastname: Garcia
authors.forename: Ji
authors.initials: J
authors.lastname: Chen
mesh_terms: D019797:3-Iodobenzylguanidine; D000368:Aged; D022062:Electrophysiologic Techniques, Cardiac / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D011379:Prognosis; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D017180:Tachycardia, Ventricular / Q000000981:diagnostic imaging*; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014693:Ventricular Fibrillation / Q000000981:diagnostic imaging*
chemical_list: D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine; C078700:technetium tc-99m tetrofosmin