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Review ArticleContinuing Education

123I-MIBG Imaging: Patient Preparation and Technologist’s Role

S. Seth Van Vickle and Randall C. Thompson
Journal of Nuclear Medicine Technology June 2015, 43 (2) 82-86; DOI: https://doi.org/10.2967/jnmt.115.158394
S. Seth Van Vickle
Saint Luke’s Mid America Heart Institute and Saint Luke’s Cardiovascular Consultants, Kansas City, Missouri
CNMT, NCT,
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Randall C. Thompson
Saint Luke’s Mid America Heart Institute and Saint Luke’s Cardiovascular Consultants, Kansas City, Missouri
MD, FASNC
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  • FIGURE 1.
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    FIGURE 1.

    Anterior view of 123I-MIBG 3 h 50 min after injection.

  • FIGURE 2.
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    FIGURE 2.

    Proper technique for drawing a 123I-MIBG dose.

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    FIGURE 3.

    Association of cardiac death with heart-to-mediastinum (H/M) ratio.

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    FIGURE 4.

    Heart-to-mediastinum (H/M) ratio obtained with 123I-MIBG.

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    FIGURE 5.

    Classic SPECT myocardial display of 123I-MIBG images after reconstruction.

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    TABLE 1

    Medications That Affect 123I-MIBG Imaging (13)

    Drug or classExamplesMechanism of interference (known or expected)Discontinuation before 123I-MIBG scan (d)
    OpioidUptake inhibition7–14
    CocaineUptake inhibition7–14
    TramadolUptake inhibition7–14
    Tricyclic antidepressantsAmitriptyline and derivatives, imipramine and derivatives, amoxapine, doxepin, othersUptake inhibition7–21
    Sympathicomimetics * Phenylpropanolamine, ephedrine, pseudoephedrine, phenylephrine, amphetamine, dopamine, isoproterenol, salbutamol, terbutaline, fenoterol, xylometazolineDepletion of granules7–14
    Antihypertensive or cardiovascular agentsLabetalolInhibition of uptake and depletion21
    ReserpineDepletion and transport inhibition14
    Bretylium, guanethidineDepletion and transport inhibition14
    Calcium channel blockers (nifedipine, nicardipine, amlodipine)Increased uptake and retention14
    AntipsychoticsPhenothiazines † (chlorpromazine, promethazine, fluphenazine, others)Uptake inhibition21–28
    Thioxanthenes (maprotiline, trazodone)Uptake inhibition21–28
    Butyrophenones (droperidol, haloperidol)Uptake inhibition21–28
    LoxapineUptake inhibition7–21
    • ↵ * Components of bronchodilators, decongestants, and diet aids.

    • ↵ † Frequent components of antiemetic and antiallergic agents.

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Journal of Nuclear Medicine Technology: 43 (2)
Journal of Nuclear Medicine Technology
Vol. 43, Issue 2
June 1, 2015
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123I-MIBG Imaging: Patient Preparation and Technologist’s Role
S. Seth Van Vickle, Randall C. Thompson
Journal of Nuclear Medicine Technology Jun 2015, 43 (2) 82-86; DOI: 10.2967/jnmt.115.158394
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  • Article
    • Abstract
    • EQUIPMENT PREPARATION
    • PATIENT PREPARATION
    • RADIOPHARMACEUTICAL PREPARATION
    • THE 123I-MIBG ACQUISITION
    • THE SPECT ACQUISITION
    • IMAGE PROCESSING
    • CONCLUSION
    • DISCLOSURE
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Keywords

  • 123I-MIBG
  • cardiac sympathetic imaging
  • cardiac denervation
  • Techniques for MIBG imaging
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123I-MIBG Imaging: Patient Preparation and Technologist’s Role
S. Seth Van Vickle, Randall C. Thompson
Journal of Nuclear Medicine Technology Jun 2015, 43 (2) 82-86; DOI: 10.2967/jnmt.115.158394

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