Cited 17 times since 2014 (1.6 per year) source: EuropePMC Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, Volume 21, Issue 5, 24 4 2014, Pages 913-920 I-123 mIBG and Tc-99m myocardial SPECT imaging to predict inducibility of ventricular arrhythmia on electrophysiology testing: a retrospective analysis. Zhou Y, Zhou W, Folks RD, Manatunga DN, Jacobson AF, Bax JJ, Garcia EV, Chen J

Objectives

The purpose of this study is to assess mIBG uptake in scar border zone and its relation with ventricular arrhythmia (VA) inducibility on electrophysiology (EP) testing using I-123 mIBG SPECT and resting Tc-99m SPECT myocardial perfusion imaging (MPI).

Methods

Forty-seven patients from a previous clinical trial were retrospectively analyzed. These patients underwent I-123 mIBG and resting Tc-99m tetrofosmin SPECT, and EP testing. Twenty-eight patients were positive (EP+) and 19 patients were negative (EP-) for inducibility of sustained (>30 seconds) VA on EP testing. MPI scar extent, border zone extent, and mIBG uptake in border zone were used to predict VA inducibility on EP testing, respectively.

Results

There was no significant difference in scar extent between the EP+ and EP- groups. The EP+ group had significantly larger border zone and lower mIBG uptake ratio in the border zone than the EP- group. Receiver operating characteristic (ROC) curve analysis showed that the prediction accuracy for border zone extent (area under ROC = 0.75) was better than scar extent (area under ROC = 0.66). The prediction accuracy was further improved (area under ROC = 0.78), when assessing mIBG uptake in the border zone.

Conclusion

A new tool has been developed to measure scar and border zone and to assess mIBG uptake in scar and border zone from combined I-123 MIBG SPECT and resting Tc-99m SPECT MPI. The mIBG uptake in the border zone predicted VA inducibility on EP testing with a promising accuracy.

J Nucl Cardiol. 2014 5;21(5):913-920