Metaiodobenzylguanidine scintigraphy of cardiac sympathetic innervation

Abstract

Metaiodobenzylguanidine (MIBG), a noradrenaline analogue, labelled with radioactive iodine I-123 is used for assessing pre-synaptic activity of the myocardial adrenergic system. The paper describes the mechanism of myocardial I-123-MIBG uptake and the relevant examination methods. It also refers to the necessity of standardising acquisition methods and assessment criteria in order to improve comparability of results, especially numerical results, originating from various countries and centres.Although first introduced as a cardiological diagnostic procedure 30 years ago, I-123-MIBG myocardial scintigraphy continues to be mostly applied as a research method, even though its diagnostic and/or prognostic importance, especially in the case of heart failure, has been widely reported. The recently published results of two extensive retrospective works and a major prospective, multi-centre international ADMIRE-HF study confirmed that I-123-MIBG scintigraphy has a high independent prognostic value in evaluating patients with heart failure. Abnormal myocardial I-123-MIBG uptake can also be indicative of higher risk of ventricular arrhythmias and sudden cardiac death in patients with heart failure. I-123-MIBG myocardial scintigraphy also seems to have considerable potential for the detection and differentiation of neurodegenerative diseases.

Radiosynthesis of no-carrier-added meta-[124I]iodobenzylguanidine for PET imaging of metastatic neuroblastoma

“…Its adrenergic uptake, storage and release properties allow its different radiolabelled forms to be clinically used for the radiotherapy and imaging of neuroendocrine tumours and cardiac diseases. Early studies using carrier-added [ 123 I] m IBG with gamma scintigraphy to image normal myocardium function [1] have progressed to single photon emission computed tomography (SPECT) imaging of cardiac and pulmonary abnormalities using no-carrier-added [ 123 I] m IBG [2, 3]. In comparison, limited diagnostic information can be obtained using planar scintigraphy with [ 131 I] m IBG which is also used in radiotherapy to treat neuroendocrine tumours [4].…”

Synthesis and preliminary evaluation of benzylaminoimidazoline derivatives as novel norepinephrine transporter ligands

“…Although [ 11 C]HED reflects the activity of NET and helps visualize the sympathetic nervous system (SNS) (Hiroshima et al, 2020; Pietilä et al, 2001), its clinical application is quite limited due to the short radiological half‐life of 11 C (only 20.4 min). [ 123/131 I]MIBG is a typical NET‐targeting probe with a benzylguanidine core structure that has been widely used in clinic (Teresińska, 2012; Vallabhajosula & Nikolopoulou, 2011; Wieland, Brown, Rogers, et al, 1981; Wieland, Brown, Tobes, et al, 1981). However, the in vivo deiodination, slow clearance, and high nontarget tissue uptake prevent [ 123/131 I]MIBG from being an ideal radiopharmaceutical (Brisse et al, 2011; Shapiro & Gross, 1987).…”