Application of (123)I-MIBG myocardial maximum standardized uptake value to characterize cardiac function in patients with pheochromocytoma: comparison with echocardiography

PURPOSE: This study examined the usefulness of the maximum standardized uptake value (SUVmax) of myocardial [(123)I]-metaiodobenzylguanidine ([(123)I]-MIBG) to characterize myocardial function by comparing it with echocardiographic parameters in patients with pheochromocytoma. MATERIALS AND METHODS: This study included 18 patients with pheochromocytoma who underwent both planar and [(123)I]-MIBG single-photon emission computed tomography/computed tomography scans and echocardiography before surgery. Myocardial [(123)I]-MIBG visibility and SUVmax were compared with echocardiographic parameters related to systolic and diastolic functions. The Mann–Whitney U test, Fisher exact test, or Spearman rank correlation assessed differences or relationships between two quantitative variables. RESULTS: On visual analysis, 6 patients showed normal myocardial [(123)I]-MIBG uptake, whereas 12 patients showed decreased myocardial [(123)I]-MIBG uptake. No patients showed systolic dysfunction. A significant difference was observed in the incidence of diastolic dysfunction between the groups with normal and decreased uptake (p = 0.009), and left ventricular (LV) diastolic dysfunction was observed in 9 (75%) of 12 patients with decreased myocardial uptake. The myocardial SUVmax was significantly lower in 9 patients with LV diastolic dysfunction than in 9 patients with normal cardiac function (1.67 ± 0.37 vs. 3.03 ± 1.38, p = 0.047). Myocardial SUVmax was positively correlated with septal e′ (early diastolic velocity of septal mitral annulus) (ρ = 0.51, p = 0.031) and negatively correlated with the septal E/e′ ratio (early mitral E-velocity to early diastolic velocity of septal mitral annulus; ρ = − 0.64, p = 0.004), respectively. CONCLUSIONS: LV diastolic dysfunction was inversely related to myocardial [(123)I]-MIBG uptake. Myocardial [(123)I]-MIBG SUVmax may be useful for characterizing cardiac function in patients with pheochromocytoma. Second abstract. The semiquantitative analysis using the myocardial SUVmax in (123)I-MIBG SPECT/CT was found to be potentially useful for characterizing cardiac function in patients with pheochromocytoma. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11604-022-01365-z.