Christiane Klene1, Christiane Jungen2,3, Koichi Okuda4, Yuske Kobayashi5, Annabelle Helberg5, Janos Mester5, Christian Meyer2,3, Kenichi Nakajima6. 1. Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany. c.klene@uke.de. 2. Department of Cardiology - Electrophysiology, University Heart Centre, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany. 3. DZHK (German Centre for Cardiovascular Research, partner site Hamburg/Kiel/Lübeck, Germany), Berlin, Germany. 4. Department of Physics, Kanazawa Medical University, Uchinada, Kahoku, Japan. 5. Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany. 6. Department of Nuclear Medicine, Kanazawa University Hospital, Kanazawa, Japan.
Abstract
BACKGROUND: Iodine-123-metaiodobenzylguanidine (123I-MIBG) imaging with estimation of the heart-to-mediastinum ratio (HMR) has been established for risk assessment in patients with chronic heart failure. Our aim was to evaluate the effect of different methods of ROI definition on the renderability of HMR to normal or decreased sympathetic innervation. METHODS AND RESULTS: The results of three different methods of ROI definition (clinical routine (CLI), simple standardization (STA), and semi-automated (AUT) were compared. Ranges of 95% limits of agreement (LoA) of inter-observer variabilities were 0.28 and 0.13 for STA and AUT, respectively. Considering a HMR of 1.60 as the lower limit of normal, 13 of 32 (41%) for method STA and 5 of 32 (16%) for method AUT of all HMR measurements could not be classified to normal or pathologic. Ranges of 95% LoA of inter-method variabilities were 0.72 for CLI vs AUT, 0.65 for CLI vs STA, and 0.31 for STA vs AUT. CONCLUSION: Different methods of ROI definition result in different ranges of the LoA of the measured HMR with relevance for rendering the results to normal or pathological innervation. We could demonstrate that standardized protocols can help keep methodological variabilities limited, narrowing the gray zone of renderability.
BACKGROUND:Iodine-123-metaiodobenzylguanidine (123I-MIBG) imaging with estimation of the heart-to-mediastinum ratio (HMR) has been established for risk assessment in patients with chronic heart failure. Our aim was to evaluate the effect of different methods of ROI definition on the renderability of HMR to normal or decreased sympathetic innervation. METHODS AND RESULTS: The results of three different methods of ROI definition (clinical routine (CLI), simple standardization (STA), and semi-automated (AUT) were compared. Ranges of 95% limits of agreement (LoA) of inter-observer variabilities were 0.28 and 0.13 for STA and AUT, respectively. Considering a HMR of 1.60 as the lower limit of normal, 13 of 32 (41%) for method STA and 5 of 32 (16%) for method AUT of all HMR measurements could not be classified to normal or pathologic. Ranges of 95% LoA of inter-method variabilities were 0.72 for CLI vs AUT, 0.65 for CLI vs STA, and 0.31 for STA vs AUT. CONCLUSION: Different methods of ROI definition result in different ranges of the LoA of the measured HMR with relevance for rendering the results to normal or pathological innervation. We could demonstrate that standardized protocols can help keep methodological variabilities limited, narrowing the gray zone of renderability.
Authors: Stavros G Drakos; Theodoros Athanasoulis; Konstantinos G Malliaras; John V Terrovitis; Nikolaos Diakos; Dimitrios Koudoumas; Argirios S Ntalianis; Stergios P Theodoropoulos; Magdi H Yacoub; John N Nanas Journal: JACC Cardiovasc Imaging Date: 2010-01-12
Authors: D M Wieland; L E Brown; W L Rogers; K C Worthington; J L Wu; N H Clinthorne; C A Otto; D P Swanson; W H Beierwaltes Journal: J Nucl Med Date: 1981-01 Impact factor: 10.057
Authors: G Roberts; J J Lloyd; J P M Kane; R Durcan; S Lawley; K Howe; G S Petrides; J T O'Brien; A J Thomas Journal: J Nucl Cardiol Date: 2019-09-16 Impact factor: 5.952