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Inicio Revista Española de Medicina Nuclear e Imagen Molecular (English Edition) Cardiac sympathetic innervation scintigraphy with 123I-meta-iodobenzylguanidine....
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Vol. 38. Issue 4.
Pages 262-271 (July - August 2019)
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Vol. 38. Issue 4.
Pages 262-271 (July - August 2019)
Continuing Education
Cardiac sympathetic innervation scintigraphy with 123I-meta-iodobenzylguanidine. Basis, protocols and clinical applications in Cardiology
Gammagrafía de inervación simpática cardiaca con 123I-metayodobencilguanidina. Fundamento, protocolos y aplicaciones clínicas en Cardiología
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I. Casáns-Tormoa,b,
Corresponding author
castorire@gmail.com

Corresponding author.
, A. Jiménez-Heffernanb,c, V. Pubul-Núñezb,d, R. Ruano-Pérezb,e
a Servicio de Medicina Nuclear, Hospital Clínico Universitario, Valencia, Spain
b Grupo de Trabajo de Cardiología Nuclear de la Sociedad Española de Medicina Nuclear e Imagen Molecular, Spain
c Servicio de Medicina Nuclear, Hospital Universitario Juan Ramón Jiménez, Huelva, Spain
d Servicio de Medicina Nuclear, Hospital Clínico Universitario, Santiago de Compostela, A Coruña, Spain
e Servicio de Medicina Nuclear, Hospital Clínico Universitario, Valladolid, Spain
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Tables (3)
Table 1. Drugs which should be withdrawn before performing a cardiac 123I-MIBG study.
Table 2. Parameters recommended for performing 123I-MIBG cardiac scintigraphy using a conventional gamma camera (Anger).
Table 3. Dose absorbed per unit of radioactivity administered (mGy/MBq).
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Abstract

Imaging of cardiac sympathetic innervation is only possible by nuclear cardiology techniques and its assessment is key in the evaluation of and decision-making for patients with cardiac sympathetic impairment. This review includes the basis of cardiac sympathetic scintigraphy with 123I-meta-iodobenzylguanidine (123I-MIBG), recommended protocols, patient preparation, image acquisition and quantification, reproducibility, dosimetry, etc., and also the clinical indications for cardiac patients, mainly with regard to heart failure, arrhythmia, coronary artery disease, cardiotoxicity, including its contribution to establishing the indication for and monitoring the response to implantable cardiac devices, pharmacological treatment, heart transplantation and other.

Keywords:
Cardiac sympathetic innervation
123I-MIBG
Cardiac scintigraphy
Nuclear cardiology
Heart failure
Arrhythmia
Resumen

La obtención de imágenes de la inervación simpática cardiaca solo es posible mediante técnicas de cardiología nuclear, y su valoración es de importancia decisiva en la evaluación y en la toma de decisiones en pacientes en los que exista deterioro de inervación simpática. Se revisa el fundamento de la gammagrafía de inervación simpática cardiaca con 123I-metayodobencilguanidina (123I-MIBG), los protocolos recomendados para su realización, incluyendo preparación del paciente, técnicas de obtención y cuantificación de imágenes, reproducibilidad, consideraciones dosimétricas, etc., analizando las indicaciones clínicas de esta exploración en pacientes cardiológicos, principalmente en insuficiencia cardiaca, arritmias, coronariopatía, cardiotoxicidad, contribución a la indicación y seguimiento de respuesta a dispositivos de estimulación cardiaca, tratamiento farmacológico, trasplante cardiaco y otros.

Palabras clave:
Inervación simpática cardiaca
123I-MIBG
Gammagrafía cardiaca
Cardiología nuclear
Insuficiencia cardiaca
Arritmia

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