Possibilities of Hybrid SPECT/CT with 123I-MIBG for Visualizing the Ganglia of the Cardiac Autonomic Nervous System in Healthy Volunteers

Objective – to study the characteristics of the distribution and visualization of ganglionated plexuses in the left atrium (LAGP) in healthy volunteers.

Objective and methods. The investigation enrolled 15 healthy volunteers (median age 31 [26; 41] years). The investigation participants successively underwent cardiac computed tomography (CT) and SPECT using the neurotropic radiopharmaceutical 123I-MIBG. The obtained images were combined to identify and assess sympathetic activity foci (SAF) in the left atrium. The identified SAFs were ranked with a confidence probability (CP) on the basis of their correspondence to the anatomical location of LAGP, as well as the discreteness and prevalence of the surrounding structures.

Results. A total of 36 SAFs (median per participant was 2 [2; 3]) were identified; of them 20 (56%) had a low CP (median per participant was 1 [1; 2]); 16 (44%) had intermediate and/or high CP (median per participant was 1 [1; 1]). Three investigation participants (3/15) were found to have no SAFs with an intermediate and/or high CP. SAFs with an intermediate and/or high CP most frequently corresponded to the location of the left and right upper LAGPs (4/16 and 3/16 cases, respectively).

Conclusion. Hybrid SPECT/CT with the neurotropic 123I-MIBG allows the identification of SAFs in healthy volunteers, which correspond to the typical location of LAGPs. 

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