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@ARTICLE{Hagen:275835,
      author       = {Hagen, Johannes and Scheifele, Maximilian and Zacherl,
                      Mathias J and Katzdobler, Sabrina and Bernhardt, Alexander
                      and Brendel, Matthias and Levin, Johannes and Höglinger,
                      Günter U and Clauß, Sebastian and Kääb, Stefan and
                      Todica, Andrei and Boening, Guido and Fischer, Maximilian},
      title        = {{D}iagnostic {E}fficacy of
                      123{I}odo-{M}etaiodobenzylguanidine {SPECT}/{CT} in
                      {C}ardiac vs. {N}eurological {D}iseases: {A} {C}omparative
                      {S}tudy of {A}rrhythmogenic {R}ight {V}entricular
                      {C}ardiomyopathy and α-{S}ynucleinopathies.},
      journal      = {Diagnostics},
      volume       = {15},
      number       = {1},
      issn         = {2075-4418},
      address      = {Basel},
      publisher    = {MDPI},
      reportid     = {DZNE-2025-00070},
      pages        = {24},
      year         = {2025},
      abstract     = {Background/Objectives: 123Iodo-metaiodobenzylguanidine
                      single photon emission computed tomography/computed
                      tomography (123I-MIBG SPECT/CT) is used to evaluate the
                      cardiac sympathetic nervous system in cardiac diseases such
                      as arrhythmogenic right ventricular cardiomyopathy (ARVC)
                      and α-synucleinopathies such as Parkinson's diseases. A
                      common feature of these diseases is denervation. We aimed to
                      compare quantitative and semi-quantitative cardiac
                      sympathetic innervation using 123I-MIBG imaging of ARVC and
                      α-synucleinopathies. Methods: Cardiac innervation was
                      assessed using 123I-MIBG SPECT/CT in 20 patients diagnosed
                      with definite ARVC and 8 patients with clinically diagnosed
                      α-synucleinopathies. Heart-to-mediastinum-ratio
                      (H/M-ratio), as semi-quantitative, was evaluated.
                      Additionally, standardized uptake value (SUV), as
                      quantitative, was measured as SUVmedian, SUVmax, and SUVpeak
                      in the left ventricle (LV), the right ventricle (RV), and in
                      the global heart, based on a CT scan following quantitative
                      image reconstruction. Results: The quantification of
                      123I-MIBG uptake in the LV, the RV, and the global heart was
                      feasible in patients suffering from α-synucleinopathies.
                      SUVmedian, and SUVpeak demonstrated a significant difference
                      between ARVC and α-synucleinopathies across all regions,
                      with the α-synucleinopathy group showing a lower uptake. In
                      addition, the H/M ratio showed significantly lower uptake in
                      patients with α-synucleinopathies than in patients with
                      ARVC. Conclusions: Patients with α-synucleinopathies
                      demonstrate significantly lower cardiac innervation in
                      semi-quantitative and quantitative examinations than ARVC
                      patients. The comparison of semi-quantitative and
                      quantitative examinations suggests that quantitative
                      examination offers an advantage. Quantitative analysis can
                      be performed separately for the LV, RV, and global heart.
                      However, analyzing the LV or RV does not provide additional
                      benefit over analyzing the global heart in distinguishing
                      between α-synucleinopathies and ARVC. Considering the
                      different clinical manifestations of these two diseases, the
                      absolute SUV values should not be generalized across
                      different pathologies, and disease-specific ranges should be
                      used instead.},
      keywords     = {123I-MIBG (Other) / ARVC (Other) / RV (Other) / SUV (Other)
                      / heart (Other) / α-synucleinopathies (Other)},
      cin          = {Clinical Research (Munich) / AG Haass / AG Levin},
      ddc          = {610},
      cid          = {I:(DE-2719)1111015 / I:(DE-2719)1110007 /
                      I:(DE-2719)1111016},
      pnm          = {353 - Clinical and Health Care Research (POF4-353) / 352 -
                      Disease Mechanisms (POF4-352)},
      pid          = {G:(DE-HGF)POF4-353 / G:(DE-HGF)POF4-352},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:39795552},
      pmc          = {pmc:PMC11720076},
      doi          = {10.3390/diagnostics15010024},
      url          = {https://pub.dzne.de/record/275835},
}