Journal of Nuclear Cardiology

, Volume 19, Issue 1, pp 92–99 | Cite as

Quantitative I-123 mIBG SPECT in differentiating abnormal and normal mIBG myocardial uptake

  • Ji Chen
  • Russell D. Folks
  • Liudmila Verdes
  • Daya N. Manatunga
  • Arnold F. Jacobson
  • Ernest V. Garcia
Original Article



The purpose of this study was to evaluate global quantitation of cardiac uptake on I-123 mIBG SPECT.


The study included a pilot group of 67 subjects and a validation group of 1,051 subjects. SPECT images were reconstructed by filtered backprojection, ordered subsets expectation maximization, and deconvolution of septal penetration, respectively. SPECT heart-to-mediastinum ratio (H/M) was calculated by comparing the mean counts between heart and mediastinum volumes of interest drawn on transaxial images. Receiver operating characteristic (ROC) analysis was used to assess the capability of each SPECT method to differentiate the heart disease subjects from controls in comparison with that of the planar H/M.


In the validation group, the areas under the ROC curves were not significantly different between the SPECT and planar H/M. Order subsets expectation maximization had significantly larger area under the ROC curve than the other two SPECT methods.


H/M obtained from I-123 mIBG SPECT was equivalent to the planar H/M for differentiating between subjects with normal and abnormal mIBG uptake. Global quantification of cardiac I-123 mIBG SPECT may represent a viable alternative to the planar H/M.

Key Words

Sympathetic nervous system I-123 mIBG SPECT heart failure 



This study was supported in part by GE Healthcare. Dr Chen, Dr Garcia, and Mr Folks receive royalties from the sale of the Emory Cardiac Toolbox. The terms of this arrangement have been reviewed and approved by Emory University in accordance with its conflict-of-interest practice. Dr Jacobson is an employee of GE Healthcare and owns shares in the General Electric Company.


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Copyright information

© American Society of Nuclear Cardiology 2011

Authors and Affiliations

  • Ji Chen
    • 1
  • Russell D. Folks
    • 1
  • Liudmila Verdes
    • 1
  • Daya N. Manatunga
    • 1
  • Arnold F. Jacobson
    • 2
  • Ernest V. Garcia
    • 1
  1. 1.Department of Radiology and Imaging SciencesEmory University School of MedicineAtlantaUSA
  2. 2.GE HealthcarePrincetonUSA

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