Skip to main content
Log in

BMIPP compared with PET metabolism

  • Published:
The International Journal of Cardiac Imaging Aims and scope Submit manuscript

Abstract

I-123 15-(p-iodophenyl)-3-(R,S)-methylpentadecanoic acid (BMIPP) was introduced as an approved radiopharmaceutical in Japan in 1993. This article reviews our clinical comparisons between BMIPP and PET metabolism conducted at Kyoto University. BMIPP uptake was suggested to reflect exogenous fatty acid utilization in the myocardium. By the comparison between FDG PET and BMIPP SPECT, reduced uptake of BMIPP relative to thallium was considered metabolically damaged but viable myocardium in ischemic coronary artery disease. In hypertrophic cardiomyopathy, reduction of BMIPP uptake was shown to precede suppression of oxidative or glucose metabolism. Occasionally we encounter subjects with absent myocardial BMIPP uptake. The majority of these subjects showed metabolic switching from normal free fatty acid metabolism to abnormally enhanced glucose metabolism in the fasting state. Thus, BMIPP provides us with the valuable metabolic information which is unattainable using a perfusion tracer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Schelbert HR. Positron emission tomography. Diagnostic and therapeutic implications in human myocardial ischemia. Int J Card Imaging 1987; 2: 199-208.

    Google Scholar 

  2. Bax JJ, Visser FC, van Lingen A, Cornel JH, Fioretti PM, van der Wall EE. Metabolic imaging using F18-fluorodeoxyglucose to assess myocardial viability. Int J Card Imaging 1997; 13: 145-155.

    Google Scholar 

  3. Schwaiger M, Schelbert HR, Keen R, Vinten-Johansen J, Hansen H, Selin C, et al. Retention and clearance of C-11 palmitic acid in ischemic and reperfused canine myocardium. J Am Coll Cardiol 1985 Aug; 6(2): 311-320.

    Google Scholar 

  4. Walsh MN, Geltman EM, Brown MA, Henes CG, Weinheimer CJ, Sobel BE, et al. Noninvasive estimation of regional myocardial oxygen consumption by positron emission tomography with carbon-11 acetate in patients with myocardial infarction. J Nucl Med 1989; 30: 1798-1808.

    Google Scholar 

  5. Armbrecht JJ, Buxton DB, Schelbert HR. Validation of [1–11C]acetate as a tracer for noninvasive assessment of oxidative metabolism with positron emission tomography in normal, ischemic, postischemic, and hyperemic canine myocardium. Circulation 1990; 81: 1594-1605.

    Google Scholar 

  6. Beanlands RS, Bach DS, Raylman R, Armstrong WF, Wilson V, Montieth M, et al. Acute effects of dobutamine on myocardial oxygen consumption and cardiac efficiency measured using carbon-11 acetate kinetics in patients with dilated cardiomyopathy. J Am Coll Cardiol 1993; 22: 1389-1398.

    Google Scholar 

  7. Hata T, Nohara R, Fujita M, Hosokawa R, Lee L, Kudo T et al. Noninvasive assessment of myocardial viability by positron emission tomography with C-11 acetate in patients with old myocardial infarction. Usefulness of low-dose dobutamine infusion. Circulation 1996; 94: 1834-1841.

    Google Scholar 

  8. Marhsall RC, Tillisch JH, Phelps ME, Huang SC, Carson R, Henze E, et al. Identification and differentiation of resting myocardial ischemia and infarction in man with positron computed tomography, 18F-labeled fluorodeoxyglucose and N-13 ammonia. Circulation 1983; 67: 766-778.

    Google Scholar 

  9. Tillisch J, Brunken R, Marshall R, Schwaiger M, Mandelkern M, Phelps M, et al. Reversibility of cardiac wall-motion abnormalities predicted by positron tomography. N Engl J Med 1986; 314: 884-888.

    Google Scholar 

  10. Tamaki N, Ohtani H, Yamashita K, Magata Y, Yonekura Y, Nohara R, et al. Metabolic activity in the areas of new fill-in after thallium-201 reinjection: comparison with positron emission tomography using fluorine-18-deoxyglucose. J Nucl Med 1991; 32: 673-678.

    Google Scholar 

  11. Knuuti MJ, Nuutila P, Ruotsalainen U, Saraste M, Harkonen R, Ahonen A, et al. Euglycemic hyperinsulinemic clamp and oral glucose load in stimulating myocardial glucose utilization during positron emission tomography. J Nucl Med 1992; 33: 1255-1262.

    Google Scholar 

  12. Tamaki N, Kawamoto M, Tadamura E, Magata Y, Yonekura Y, Nohara R, et al. Prediction of reversible ischemia after revascularization. Perfusion and metabolic studies with positron emission tomography. Circulation 1995; 91: 1697-1705.

    Google Scholar 

  13. Iida H, Rhodes CG, Araujo LI, Yamamoto Y, de Silva R, Maseri A, et al. Noninvasive quantification of regional myocardial metabolic rate for oxygen by use of 15O2 inhalation and positron emission tomography. Theory, error analysis, and application in humans, Circulation 1996 15; 94: 792-807.

    Google Scholar 

  14. Knapp FF Jr, Goodman MM, Callahan AP, Kirsch G. Radioiodinated 15-(p-iodophenyl)-3,3-dimethylpentadecanoic acid: a useful new agent to evaluate myocardial fatty acid uptake. J Nucl Med 1986; 27: 521-531.

    Google Scholar 

  15. Knapp FF, Franken P, Kropp J. Cardiac SPECT with iodine-123-labeled fatty acids: evaluation of myocardial viability with BMIPP. J Nucl Med 1995; 36: 1022-1030.

    Google Scholar 

  16. Tamaki N, Kawamoto M, Yonekura Y, Fujibayashi Y, Takahashi N, Konishi J, et al. Regional metabolic abnormality in relation to perfusion and wall motion in patients with myocardial infarction: assessment with emission tomography using an iodinated branched fatty acid analog. J Nucl Med 1992; 33: 659-667.

    Google Scholar 

  17. Tateno M, Tamaki N, Yukihiro M, Kudoh T, Hattori N, Tadamura E, et al. Assessment of fatty acid uptake in ischemic heart disease without myocardial infarction. J Nucl Med 1996; 37: 1981-1985.

    Google Scholar 

  18. Takeishi Y, Fujiwara S, Atsumi H, Takahashi K, Sukekawa H, Tomoike H. Iodine-123-BMIPP imaging in unstable angina: a guide for interventional strategy. J Nucl Med 1997; 38: 1407-1411.

    Google Scholar 

  19. Kurata C, Tawarahara K, Taguchi T, Aoshima S, Kobayashi A, Yamazaki N, et al. Myocardial emission computed tomography with iodine-123-labeled beta-methyl-branched fatty acid in patients with hypertrophic cardiomyopathy. J Nucl Med 1992; 33: 6-13.

    Google Scholar 

  20. Takeishi Y, Chiba J, Abe S, Tonooka I, Komatani A, Tomoike H. Heterogenous myocardial distribution of iodine-123 15-(p-iodophenyl)-3-R,S-methylpentadecanoicacid (BMIPP) in patients with hypertrophic cardiomyopathy. Eur J Nucl Med 1992; 29: 775-782.

    Google Scholar 

  21. Kawamoto M, Tamaki N, Yonekura Y, Magata Y, Tadamura E, Nohara R, et al. Significance of myocardial uptake of iodine 123-labeled beta-methyl iodophenyl pentadecanoic acid: comparison with kinetics of carbon 11-labeled palmitate in positron emission tomography. J Nucl Cardiol 1994; 1: 522-528.

    Google Scholar 

  22. Kawamoto M, Tamaki N, Yonekura Y, Tadamura E, Fujibayashi Y, Magata Y, et al. Combined study with I-123 fatty acid and thallium-201 to assess ischemic myocardium: comparison with thallium redistribution and glucose metabolism. Ann Nucl Med 1994; 8: 47-54.

    Google Scholar 

  23. Tamaki N, Tadamura E, Kawamoto M, Magata Y, Yonekura Y, Fujibayashi Y, et al. Decreased uptake of iodinated branched fatty acid analog indicates metabolic alterations in ischemic myocardium. J Nucl Med 1995; 36: 1974-1980.

    Google Scholar 

  24. Kudoh T, Tamaki N, Magata Y, Konishi J, Nohara R, Iwasaki A, et al. Metabolism substrate with negative myocardial uptake of iodine-123-BMIPP. J Nucl Med 1997; 38: 548-553.

    Google Scholar 

  25. Tadamura E, Tamaki N, Matsumori A, Magata Y, Yonekura Y, Nohara R, et al. Myocardial metabolic changes in hypertrophic cardiomyopathy. J Nucl Med 1996; 37: 572-577.

    Google Scholar 

  26. Ishiwata S, Maruno H, Senda M, Toyama H, Nishiyama S, Seki A. Myocardial blood flow and metabolism in patients with hypertrophic cardiomyopathy — a study with carbon-11 acetate and positron emission tomography. Jpn Circ J 1997; 61: 201-210.

    Google Scholar 

  27. Tadamura E, Kudoh T, Hattori N, Inubushi M, Magata Y, Konishi J, et al. Impairment of BMIPP uptake precedes abnormalities in oxygen and glucose metabolism in hypertrophic cardomyopathy. J Nucl Med 1998; 39: 390-396.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tadamura, E., Tamaki, N., Kudoh, T. et al. BMIPP compared with PET metabolism. Int J Cardiovasc Imaging 15, 61–69 (1999). https://doi.org/10.1023/A:1006148619691

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1006148619691

Navigation