Evidence map›Paper›PMID 25963285›Full record

Trial reportJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology2016

1-23I-MIBG thyroid uptake: Implications for MIBG imaging of the heart.

Raffaele Giubbini, Elisa Milan, Claudio Marcassa, Barbara Paghera, Federica Fracassi, Luca Camoni, Carlo Rodella, Francesco Bertagna, Federica Motta, Mattia Bertoli and 1 more

Abstract readClinical Trial
PubMed Publisher
In one paragraph

Trial report in Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.6field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 14 citations in OpenAlex.

  1. Article
  2. Thyroid [IBRO neuroscience reports · 2023
    Article
  3. Article
  4. Thyroid function after diagnosticAnnals of nuclear medicine · 2022
    Article
  5. Misdiagnosis of Paraganglioma byJournal of the Endocrine Society · 2020
    Article
  6. Imaging Parkinson's disease below the neck.NPJ Parkinson's disease · 2017
    Article
  7. Thyroid blockade inJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2016
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 2 countries.

Raffaele GiubbiniChair of Nuclear Medicine and Nuclear Medicine Unit, Department of Medical Imaging, University and Spedali Civili, Piazza Spedali Civili, 1, Brescia, Italy. giubbini@med.unibs.it.
Elisa MilanNuclear Medicine Unit, San Giacomo Apostolo Hospital, Castelfranco Veneto, TV, Italy.
Claudio MarcassaCardiology Department, Fondazione Maugeri Centro Medico, Veruno, NO, Italy.
Barbara PagheraChair of Nuclear Medicine and Nuclear Medicine Unit, Department of Medical Imaging, University and Spedali Civili, Piazza Spedali Civili, 1, Brescia, Italy.
Federica FracassiChair of Nuclear Medicine and Nuclear Medicine Unit, Department of Medical Imaging, University and Spedali Civili, Piazza Spedali Civili, 1, Brescia, Italy.
Luca CamoniChair of Nuclear Medicine and Nuclear Medicine Unit, Department of Medical Imaging, University and Spedali Civili, Piazza Spedali Civili, 1, Brescia, Italy.
Carlo RodellaHealth Physics Department, Spedali Civili, Brescia, Italy.
Francesco BertagnaChair of Nuclear Medicine and Nuclear Medicine Unit, Department of Medical Imaging, University and Spedali Civili, Piazza Spedali Civili, 1, Brescia, Italy.
Federica MottaChair of Nuclear Medicine and Nuclear Medicine Unit, Department of Medical Imaging, University and Spedali Civili, Piazza Spedali Civili, 1, Brescia, Italy.
Mattia BertoliChair of Nuclear Medicine and Nuclear Medicine Unit, Department of Medical Imaging, University and Spedali Civili, Piazza Spedali Civili, 1, Brescia, Italy.
Riccardo CampiniNuclear Medicine Unit, Fondazione Maugeri Centro Medico, Veruno, NO, Italy.
Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia · ITFondazione Salvatore Maugeri · ITOspedale San Giacomo Apostolo · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background123I-MIBG has been widely used in patients with heart failure and neurological disorders. The patients are pre-treated with Lugol's oral solution or potassium perchlorate to prevent thyroid uptake of unlabeled 123I to limit the thyroid radiation exposure. However, despite the inhibition of the iodide pump, the thyroid is frequently visualized. The aim of this study was to study the pattern of thyroid uptake.

methodsWe reviewed the 123I-MIBG images of 57 patients studied in three different centers in Italy for cardiac (n = 42) or neurological (n = 15) indications. They were imaged at 15 minutes and 4 hours after injection and in all patients, the thyroid was included in the imaging field of view. In 2 of the 3 centers, the patients were pre-treated with Lugol's oral solution and/or potassium perchlorate (group 1) but in the third center, they were not (group 2). The following imaging parameters were evaluated: heart-to-mediastinum ratio (H/M), thyroid-to-mediastinum ratio (T/M) at 4 hours, and tracer wash out from the heart (HWO) and from the thyroid (TWO).

resultsIn the cardiac patients, the HWO was 22.98 ± 7.16% and TWO was 11.4 ± 11.86% (P < .0001). The TWO was 12.2 ± 13.1% in group 1 and 10.05 ± 8.97% in group 2 (P = NS). In the neurological patients the HWO was 26 ± 8.1% and the TWO was 20.32 ± 6.41 (P < .05). The difference in TWO was statistically significant (P < .01) between cardiac and neurological patients, whereas the HWO was not. The 4-hour H/M was 1.49 ± 0.23 in cardiac patients vs 1.4 ± 0.39 in neurological patients (P = NS). The 4-hour T/M was 1.33 ± 0.3 in cardiac patients vs 1.15 ± 0.13 in neurological patients (P < 0.05).

conclusionThe thyroid visualization in MIBG imaging is likely an expression of thyroid sympathetic innervation. The differences in TWO and T/M ratio in cardiac and neurological patients probably express differences in thyroid dopaminergic receptors. Thus, pre-treatment with potassium perchlorate or Lugol's solution may not be justified in patients undergoing 123I-MIBG imaging in whom the risk of side effects due to pre-treatment could be higher than the risk due to thyroid radiation exposure.

Indexed as

3-IodobenzylguanidineAgedFemaleHeartHeart FailureHumansMaleMetabolic Clearance RateMyocardiumRadiopharmaceuticalsReproducibility of ResultsSensitivity and SpecificityThyroid GlandTomography, Emission-Computed, Single-Photon3-IodobenzylguanidineRadiopharmaceuticals123I-MIBGcongestive heart failureradiation exposurethyroid scintigraphy

Identifiers

PMID25963285
OpenAlexW1874862810

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.