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Observer reproducibility of results from a low-dose 123I-metaiodobenzylguanidine cardiac imaging protocol in patients with heart failure

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Abstract

Purpose

Imaging of the cardiac autonomic system with 123I-metaiodobenzylguanidine (MIBG) is useful in the evaluation of patients with a variety of cardiac conditions, including heart failure (HF), but few data are available about the reproducibility of this technique. We assessed the observer reproducibility of the results from a low-dose 123I-MIBG cardiac imaging protocol in patients with HF.

Methods

A total of 74 patients (62 men, age 67 ± 10 years) with HF and left ventricular systolic dysfunction (ejection fraction 31 ± 7 %) underwent low-dose (111 MBq) planar and single-photon emission computed tomography (SPECT) 123I-MIBG cardiac sympathetic imaging. The intraclass coefficient of correlation (ICC), Lin’s concordance correlation coefficient, and Bland-Altman analysis were used to evaluate the intraobserver and interobserver reproducibility of early and late heart-to-mediastinum (H/M) ratios and of defect scores on SPECT images. The κ statistic was used to evaluate the concordance rates for the identification of patients with a low H/M ratio (<1.60) on late planar imaging.

Results

The differences between measurements obtained twice by the same examiner and by two examiners were negligible for both early and late H/M ratios and for SPECT defect scores. These findings were confirmed by the results of Bland-Altman analysis, and ICC and Lin’s coefficient values were excellent (>0.90) for all measurements. For the identification of patients with a low H/M ratio, the κ values were 0.90 for intraobserver concordance and 0.83 for interobserver concordance.

Conclusion

The present study showed a high observer reproducibility of planar H/M ratios and SPECT defect scores using a low-dose 123I-MIBG cardiac imaging protocol in patients with HF.

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Authors and Affiliations

  1. Institute of Biostructure and Bioimaging, National Council of Research, Naples, Italy

    Teresa Pellegrino

  2. Department of Translational Medical Sciences, University Federico II, Naples, Italy

    Mario Petretta

  3. SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy

    Serena De Luca, Antonio Boemio & Raffaella Carotenuto

  4. Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy

    Stefania Paolillo, Maria Piera Petretta, Carmine di Nuzzo, Pasquale Perrone-Filardi & Alberto Cuocolo

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  1. Teresa Pellegrino
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  2. Mario Petretta
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  4. Stefania Paolillo
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Correspondence to Alberto Cuocolo.

Additional information

Teresa Pellegrino and Mario Petretta contributed equally to this work.

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Pellegrino, T., Petretta, M., De Luca, S. et al. Observer reproducibility of results from a low-dose 123I-metaiodobenzylguanidine cardiac imaging protocol in patients with heart failure. Eur J Nucl Med Mol Imaging 40, 1549–1557 (2013). https://doi.org/10.1007/s00259-013-2461-4

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  • DOI: https://doi.org/10.1007/s00259-013-2461-4

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