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ASNC 2014 Presentation

September 30, 2014

Emory Toolbox 4.0 and AdreView Tool used to assess myocardial innervation in heart failure patients having I-123 mIBG SPECT studies 


(September 25, 2014 -- Atlanta, GA) At the recent American Society of Nuclear Cardiology annual meeting, Ernest V Garcia, PhD, Nuclear Cardiology Research and Development, Emory University reported new clinical attributes of Emory Toolbox 4.0 with AdreView Tools software.  He stated during an ASNC challenging case workshop that proper mIBG SPECT image normalization is key for visual interpretation of congestive heart failure.


Emory University researchers assessed two SPECT innervation parameters: LV extent of denervation and the presence and extent of mIBG/MPI mismatch while including blinded nuclear cardiology expert interpretation.  All selected patient cases came from a pool of more than 1,000 patients with a heart-to-mediastinum range of 1.41 to 3.81; 50 patients then had a four-hour mIBG SPECT and rest Tc99m-tetrofosmin MPI imaging study. The nuclear cardiology readers estimated the %LV denervated and scored segmental mIBG and MPI uptake using a 5-point scale for each vascular territory. The studies were quantitatively analyzed using Emory Toolbox and AdreView Tools OSEM.  Differences in mIBG/MPI scores were used to determine mismatch. Overall, the accuracy of detecting LV global dysinnervation, segmental dysinnervation, LV mismatch and segmental mismatch were 97%, 82%, 80% and 76% respectively.  


Previously these Emory University researchers reported (JNC 2012; 19:92-9) that the heart-to-mediastinum ratio (H/M) obtained from mIBG SPECT was equivalent to the accepted planar H/M for differentiating subjects with normal and abnormal mIBG uptake. In this study, the authors concluded that the quantitative nuclear cardiology software Emory Toolbox 4.0 with AdreView Tools added a clinical benefit for the assessment myocardial innervation in heart failure patients having I-123 mIBG SPECT studies.


ASNC 2014 abstract :

Initial Validation of Quantitative Software to Assist in Assessing Myocardial Innervation in Heart Failure Patients Using I-123 mIBG SPECT Studies


Ernest V Garcia 1, Dianfu LI 2, Gustavo Camarano1, Russell Folks 1, Ji Chen1, Arnold F. Jacobson3 1Emory University, Atlanta, GA,  2 Nanjing Medical University, Nanjing, China ,  3GE Healthcare, Princeton, NJ

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