The time has come to standardize 123I-MIBG heart-to-mediastinum ratios including planar and SPECT methods

  • Kenichi NakajimaEmail author
  • Koichi Okuda
  • Shinro Matsuo
  • Denis Agostini
Letter to the Editor

Dear Sir,

Bellevre et al. used D-SPECT (Spectrum Dynamics, Israel) with a cadmium zinc telluride-based camera for the determination of the heart-to-mediastinum ratio (HMR) of myocardial 123I-metaiodobenzylguanidine (MIBG) uptake [1]. Since some institutions have changed their SPECT equipment from Anger SPECT to D-SPECT for cardiac studies, conventional planar images are not available in the routine clinical setting. Although the European Association of Nuclear Medicine (EANM) Cardiovascular Committee and the European Council of Nuclear Cardiology have recommended the use of medium-energy (ME) collimators for 123I-MIBG studies [2], a number of hospitals still use low-energy (LE) collimators, and SPECT MIBG HMRs have been added recently.

While the 123I-MIBG study has been widely used to patients with chronic heart failure and Lewy body disease, most studies have used planar HMR [3, 4, 5]. Whether we can still use the previous numerous stock of data and how we can connect the follow-up...


Nuclear Cardiology European Council Conversion Coefficient Lewy Body Disease Cadmium Zinc 
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Compliance with ethical standards

Conflicts of interest

K.N. has a collaborative research work for development of the software with FUJIFILM RI Pharma, Co. Ltd, Japan, supplier of 123I-MIBG (MyoMIBG) in Japan. The other authors declare no conflicts of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Kenichi Nakajima
    • 1
    Email author
  • Koichi Okuda
    • 2
  • Shinro Matsuo
    • 1
  • Denis Agostini
    • 3
  1. 1.Department of Nuclear MedicineKanazawa University HospitalKanazawaJapan
  2. 2.Department of PhysicsKanazawa Medical UniversityUchinadaJapan
  3. 3.Department of Nuclear Medicine, CHU Côte de NacreNormandy University EA 4650CaenFrance

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