Variation of heart-to-mediastinal ratio in (123)I-mIBG cardiac sympathetic imaging: its affecting factors and potential corrections

Curr Cardiol Rep. 2011 Apr;13(2):132-7. doi: 10.1007/s11886-010-0157-y.


Studies have repeatedly shown the utility of (123)I-mIBG cardiac sympathetic imaging for identifying symptomatic heart failure patients most likely to experience adverse cardiac events. Delayed heart-to-mediastinal ratio (H/M) and washout rate derived from meta-iodobenzylguanidine (mIBG) scintigraphy have been used to monitor response to medical treatment. However, there is great variation of H/M ratio among publications from various institutions. The current article systemically reviews factors that can potentially affect H/M ratio, particularly the acquisition parameters, and proposes new approaches and/or procedures to standardize the imaging procedure and minimize the variation of H/M among institutions.

Publication types

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

MeSH terms

  • 3-Iodobenzylguanidine*
  • Heart / diagnostic imaging*
  • Heart / innervation
  • Heart Failure / diagnosis*
  • Heart Failure / diagnostic imaging
  • Heart Failure / mortality
  • Humans
  • Mediastinum / diagnostic imaging*
  • Prognosis
  • Radionuclide Imaging
  • Radiopharmaceuticals*
  • Risk Assessment
  • Sympathetic Nervous System
  • Time Factors


  • Radiopharmaceuticals
  • 3-Iodobenzylguanidine