Radioactive Defect on I-123 MIBG Myocardial SPECT Imaging in a Patient with Cardiac Sarcoidosis

Imai, Erika; Kaminaga, Tatsuro; Takada, Kouichi; Kutomi, K; Furui, Shigeru

doi:10.1097/00003072-200210000-00011

Cited by 7 publications

(4 citation statements)

References 5 publications

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“…To our knowledge, this is the first report describing the details of mediastinal lymphadenopathy observed on thoracic CT of DCM-like patients with histologically proven cardiac sarcoidosis. Non-invasive techniques such as 201 Tl, 67 Ga or 123 I-metaiodobenzyl-guanidine scintigraphy, 22 magnetic resonance imaging, 23 and positron emission tomography 24,25 have been recently revealed as useful for the identification and assessment of disease activity in cardiac sarcoidosis. In addition to these modalities, evaluation of mediastinal lymphadenopathy on thoracic CT is an easy, cost-effective, and valuable initial screening method for distinguishing cardiac sarcoidosis from idiopathic DCM, particularly when there is no definite involvement of other organ(s).…”

Section: Discussionmentioning

confidence: 99%

Cardiac Sarcoidosis Underlies Idiopathic Dilated Cardiomyopathy Importance of Mediastinal Lymphadenopathy in Differential Diagnosis

Otsuka

Terasaki

Eishi

et al. 2007

Circ J

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Section: Discussionmentioning

confidence: 99%

Cardiac Sarcoidosis Underlies Idiopathic Dilated Cardiomyopathy Importance of Mediastinal Lymphadenopathy in Differential Diagnosis

Otsuka

Terasaki

Eishi

et al. 2007

Circ J

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“…Myocardial sympathetic nerve function may be assessed by scintigraphy with iodine-123 MIBG (I-123 MIBG), a norepinephrine analog possessing identical mechanisms of storage, uptake, and release in neurons. Reduced I-123 MIBG uptake in the myocardium, regional defects, or a higher washout of I-123 MIBG 41,[82][83][84][85][86] correlates with myocardial sympathetic dysfunction, however, warrants further investigation before routine clinical use.…”

Section: Small Fiber Neuropathymentioning

confidence: 99%

The Burden of Neurosarcoidosis: Essential Approaches to Early Diagnosis and Treatment

Voortman

Stern

Saketkoo

et al. 2020

Semin Respir Crit Care Med

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Neurosarcoidosis (NS) is an often severe, destructive manifestation with a likely under-reported prevalence of 5 to 15% of sarcoidosis cases, and in its active phase demands timely treatment intervention. Clinical signs and symptoms of NS are variable and wide-ranging, depending on anatomical involvement. Cranial nerve dysfunction, cerebrospinal parenchymal disease, aseptic meningitis, and leptomeningeal disease are the most commonly recognized manifestations. However, non-organ-specific potentially neurologically driven symptoms, such as fatigue, cognitive dysfunction, and small fiber neuropathy, appear frequently.Heterogeneous clinical presentations and absence of any single conclusive test or biomarker render NS, and sarcoidosis itself, a challenging definitive diagnosis. Clinical suspicion of NS warrants a thorough systemic and neurologic evaluation hopefully resulting in supportive extraneural physical exam and/or tissue findings. Treatment targets the severity of the manifestation, with careful discernment of whether NS reflects active potentially reversible inflammatory granulomatous disease versus inactive postinflammatory damage whereby functional impairment is unlikely to be pharmacologically responsive. Non-organ-specific symptoms are poorly understood, challenging in deciphering reversibility and often identified too late to respond to conventional immunosuppressive/pharmacological treatment. Physical therapy, coping strategies, and stress reduction may benefit patients with all disease activity levels of NS.This publication provides an approach to screening, diagnosis, disease activity discernment, and pharmacological as well as nonpharmacological treatment interventions to reduce disability and protect health-related quality of life in NS.

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“…This permits visualization of the presynaptic sympathetic innervation of the heart. Defects on MIBG scans in sarcoidosis have been reported [30][31][32][33], but, to date, the underlying mechanism has remained unclear. One possible explanation postulated is that local ischemia or myocardial inflammation may play an important role.…”

Section: Sarcoidosismentioning

confidence: 99%

Metaiodobenzylguanidine scintigraphy in pulmonary and cardiac disease

Kroonenburgh

Mostard²,

Vöö³

2010

Current Opinion in Pulmonary Medicine

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At this moment, there is no added clinical value to routinely use MIBG scanning of the lungs and the heart. This is partly due to the many unresolved questions such as what actually happens and which factors influence MIBG uptake and washout under normal physiological circumstances. But the technique, if standardized and when dynamic time acquisition is performed with the latest equipment, such as PET and single photon emission computed tomography-computed tomography (SPECT-CT), has a tremendous potential. It can unravel upto now unknown relationships between innervation, vascularization and endothelial integrity. Other diagnostic tools such as MRI and CT do not have this capacity, so the future looks bright for these new neuronal imaging techniques.

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Radioactive Defect on I-123 MIBG Myocardial SPECT Imaging in a Patient with Cardiac Sarcoidosis

Cited by 7 publications

References 5 publications

Cardiac Sarcoidosis Underlies Idiopathic Dilated Cardiomyopathy Importance of Mediastinal Lymphadenopathy in Differential Diagnosis

Cardiac Sarcoidosis Underlies Idiopathic Dilated Cardiomyopathy Importance of Mediastinal Lymphadenopathy in Differential Diagnosis

The Burden of Neurosarcoidosis: Essential Approaches to Early Diagnosis and Treatment

Metaiodobenzylguanidine scintigraphy in pulmonary and cardiac disease

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