The role of Iodine-123-labeled 15-(p-iodophenyl)-3R,S-methylpentadecanoic acid scintigraphy in the detection of local myocardial involvement of sarcoidosis

Purpose: The purpose of this study is to examine the role of Iodine-123-labeled 15-(p-iodophenyl)-3R,S-methylpentadecanoic acid (BMIPP) scintigraphy in patients with cardiac sarcoidosis. Methods and Materials: Study materials were six patients with pathologically proven cardiac sarcoidosis. BMIPP and resting Thallium-201 (201Tl) myocardial scintigraphy, echocardiography, were performed within 22 days in each patient. Results: Myocardium was divided into nine areas per one case. A total of 24 areas had involvement by sarcoidosis. A total of 18 areas with defects of BMIPP accumulation and 14 areas with defects of 201Tl accumulation were detected. A total of 12 areas were determined as showing reduced wall motion. The sensitivity, specificity, positive and negative predictive values of wall motion abnormality for the detection of myocardial involvement were 50%, 100%, 100% and 71%. The sensitivities of BMIPP and 201Tl scintigraphy for the detection of local myocardial involvement were 75% and 58%. The specificities of BMIPP and 201Tl scintigraphy were both 100%. The positive predictive values of BMIPP and 201Tl scintigraphy were both 100%. The negative predictive values of BMIPP and 201Tl scintigraphy were 83% and 75%. Conclusion: BMIPP scintigraphy was more sensitive and had a higher negative predictive value compared to 201Tl scintigraphy and echocardiography for the detection of myocardial involvement of sarcoidosis.