Variations in 123I-metaiodobenzylguanidine (MIBG) late heart mediastinal ratios in chronic heart failure: a need for standardisation and validation

Eur J Nucl Med Mol Imaging. 2008 Mar;35(3):547-53. doi: 10.1007/s00259-007-0611-2. Epub 2007 Oct 6.


Background: There is lack of validation and standardisation of acquisition parameters for myocardial (123)I-metaiodobenzylguanidine (MIBG). This lack of standardisation hampers large scale implementation of (123)I-MIBG parameters in the evaluation of patients with chronic heart failure (CHF).

Methods: In a retrospective multi-centre study (123)I-MIBG planar scintigrams obtained on 290 CHF patients (82% male; 58% dilated cardiomyopathy; New York Heart Association [NYHA classification] > I) were reanalysed to determine the late heart-to-mediastinum ratio (H/M).

Results: There was a large variation in acquisition parameters. Multivariate forward stepwise regression showed that a significant proportion (31%, p < 0.001) of the variation in late H/M could be explained by a model containing patient-related variables and acquisition parameters. Left ventricular ejection fraction (p < 0.001), type of collimation (p < 0.001), acquisition duration (p = 0.001), NYHA class (p = 0.028) and age (p = 0.034) were independent predictors of late H/M.

Conclusions: Acquisitions parameters are independent contributors to the variation of semi-quantitative measurements of cardiac (123)I-MIBG uptake. Improved standardisation of cardiac (123)I-MIBG imaging parameters would contribute to increased clinical applicability for this procedure.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • 3-Iodobenzylguanidine*
  • Adult
  • Aged
  • Aged, 80 and over
  • Chronic Disease
  • Coronary Artery Disease / diagnostic imaging*
  • Europe
  • Heart / diagnostic imaging*
  • Heart Failure / diagnostic imaging*
  • Humans
  • Mediastinum / diagnostic imaging
  • Middle Aged
  • Prognosis
  • Radionuclide Imaging
  • Radiopharmaceuticals
  • Reference Standards
  • Reproducibility of Results
  • Retrospective Studies
  • Risk Assessment / methods*
  • Risk Factors
  • Sensitivity and Specificity
  • Ventricular Dysfunction, Left / diagnostic imaging*


  • Radiopharmaceuticals
  • 3-Iodobenzylguanidine