123i mibg

Manufactured by GE Healthcare

Sourced in United Kingdom

123I-mIBG is a radiopharmaceutical used in nuclear medicine imaging procedures. It is a form of iodine-123 (123I) that is chemically bound to a molecule called metaiodobenzylguanidine (mIBG). 123I-mIBG is primarily used to visualize and assess the function of the sympathetic nervous system in the body.

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Lab products found in correlation

Carto 3 system, by Johnson & Johnson (1 mentions) Skylight, by Philips (1 mentions)

3 protocols using 123i mibg

Radiotracers for Molecular Imaging

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¹²³I-mIBG was purchased from GE Healthcare (AdreView Amersham, UK). ¹⁸F-mFBG was prepared using a Trasis All in One (AiO) synthesiser (Trasis SA, Liege, Belgium) housed in a shielded hot cell. A simplified synthesis is detailed in Fig. 1a. Detailed synthesis methodology is included in the Supplementary Material (Supplementary Figs. 1/2).

Turnock S., Turton D.R., Martins C.D., Chesler L., Wilson T.C., Gouverneur V., Smith G, & Kramer-Marek G. (2020). 18F-meta-fluorobenzylguanidine (18F-mFBG) to monitor changes in norepinephrine transporter expression in response to therapeutic intervention in neuroblastoma models. Scientific Reports, 10, 20918.

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Cardiac Sympathetic Innervation Imaging with 123I-mIBG

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All patients continued their HF medication prior to ¹²³I-mIBG scintigraphy. To block uptake of free ¹²³I by the thyroid gland, subjects were pretreated with 250 mg oral potassium iodide 30 minutes before intravenous (IV) injection of 185 MBq ¹²³I-mIBG (GE Healthcare, Eindhoven, the Netherlands). Fifteen minutes (early acquisition) and 4 hours (late acquisition) after administration of ¹²³I-mIBG, 10-minutes planar images were acquired with the subjects in supine position using a gamma camera equipped with a medium-energy (ME) collimator.
All planar ¹²³I-mIBG images were analyzed by one experienced observer (D.O.V.) blinded to patient data. Heart-to-mediastinum (H/M) ratios were calculated from the ¹²³I-mIBG images using a region-of-interest (ROI) over the heart and the upper part of the mediastinum (Figure 1).14 (link) The H/M ratio was calculated by dividing the mean count density in the cardiac ROI by the mean count density in the mediastinal ROI.14 (link) The ¹²³I-mIBG WO was calculated as follows:

WO = \{\frac{(early H/M ratio) - (late H/M ratio)}{early H/M ratio}\} \times 100

Figure 1

Example of processing procedure for planar ¹²³I-mIBG images. The positioning of the mediastinal ROI was standardized in relation to the lung apex, the lower boundary of the upper mediastinum, and the midline between the lungs

Verschure D.O., Lutter R., van Eck-Smit B.L., Somsen G.A, & Verberne H.J. (2016). Myocardial 123I-mIBG scintigraphy in relation to markers of inflammation and long-term clinical outcome in patients with stable chronic heart failure. Journal of Nuclear Cardiology, 25(3), 845-853.

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3D Mapping of Cardiac Innervation

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Preprocedural 123 I-MIBG SPECT images were obtained before VT ablation. Patients were administered 370 MBq (10 mCi) of 123 I-MIBG (GE Healthcare) intravenously. SPECT imaging of the chest was performed using a dual-head g-camera (SKYLight; Philips) 4 h after injection, with a minimum of 30 projections per head, 20-30 s/projection, and a 64 • 64 matrix. Camera heads were equipped with low-energy, high-resolution collimators, and all acquisitions were performed with a 20% energy window centered at the 159-keV photopeak of 123 I.
3D 123 I-MIBG Cardiac Map Reconstruction 3D reconstructions of myocardial innervation were created using Amira 5.4.2 software (Visage Imaging). On each 2-dimensional 123 I-MIBG SPECT slice, areas of abnormally innervated myocardium (,50% tracer uptake) were determined visually by 2 masked, experienced cardiac nuclear medicine physicians with previously demonstrated intraobserver or interobserver variability of less than 10% (8) . From the sequential 2-dimensional datasets, individual 3D innervation maps were created for each of the patients in the Amira environment (Figs. 1C and1D). Right ventricle (RV) reconstruction was performed to correct for rotational errors during registration. The datasets were then converted to CARTO 3 System (Biosense Webster) readable mesh files using custom-made software (7) .

Imanli H., Ume K.L., Jeudy J., Bob-Manuel T., Smith M.F., Chen W., Abdulghani M., Ghzally Y., Mahat J.B., Itah R., Restrepo A., See V.Y., Shorofsky S., Dilsizian V, & Dickfeld T. (2019). Ventricular Tachycardia (VT) Substrate Characteristics: Insights from Multimodality Structural and Functional Imaging of the VT Substrate Using Cardiac MRI Scar, ¹²³I-Metaiodobenzylguanidine SPECT Innervation, and Bipolar Voltage. Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 60(1).

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