Abstract
Renewed interest in the clinical use of iodine-123-labelled fatty acids is currently primarily focused on the use of iodine-123-labelled 15-(p-iodophenyl)pentadecanoic acid (IPPA) and “modified” fatty acid analogues such as 15-(p-iodophenyl)-3-R,S-methylpentadecanoic acid (BMIPP) which show delayed myocardial clearance, thus permitting single-photon emission tomographic imaging. Interest in the use of BMIPP and similar agents results from the differences which have often been observed in various types of heart disease between regional myocardial uptake patterns of [123I]BMIPP and flow tracer distribution. Although the physiological basis is not completely understood, differences between regional fatty acid and flow tracer distribution may reflect alterations in important parameters of metabolism which can be useful for patient management or therapy planning. These tracers may also represent unique metabolic probes for correlation of energy substrate metabolism with regional myocardial viability. The two agents currently most widely used clinically are123I-labelled IPPA and BMIPP. While [123I]IPPA is commercially available as a radiopharmaceutical in Europe (Cygne) and Canada (Nordion), multicenter trials are in progress in the United States as a prelude to approval for broad use. [123I]BMIPP was recently introduced as Cardiodine for commercial distribution in Japan (Nihon Medi-Physics, Inc.). [123I]BMIPP is also being used in clinical studies on an institutional approval basis at several institutions in Europe and the United States. In this review, the development of a variety of radioiodinated fatty acids is discussed. The results of clinical trials with [123I]IPPA and [123I]BMIPP are discussed in detail, as are the future prospects for fatty acid imaging.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Visser FC, ed. First Workshop on Radiolabelled Free Fatty Acids, Free University Hospital, Amsterdam, The Netherlands, July 1984.Eur Heart J 1985;6: 1–106.
Visser FC, ed. Second Workshop on Radiolabelled Free Fatty Acids, Free University Hospital, Amsterdam, The Netherlands, November 1987.NucCompact/Eur-Am Commun Nucl Med 1990;21: 201–266.
Yonekura Y, ed. Third International Workshop on Radioiodinated Free Fatty Acids, Japan, 1993.Ann Nucl Med 1993;7: SII-1–SII-116.
van der Wall EE, ed.Noninvasive imaging of cardiac metabolism. Amsterdam: Martinus Nijhoff, 1987.
Evans JR, Gunton RW, Baker RG, Beanlands DS, Spears JC. Use of radioiodinated fatty acids for photoscans of the heart.Circ Res 1965;16: 1–10.
Mach RH, Kung HF, Jungwiwattanaporn P, Guo Y-Z. Synthesis and biodistribution of a new class of Tc-99m-labelled fatty acid analogues for myocardial imaging.Nucl Med Biol 1991;18: 215–226.
Poe ND, Robinson GD, Graham S, MacDonald NS. Experimental basis for myocardial imaging with123I-labelled hexadecanoic acid.J Nucl Med 1976;17: 1077–1082.
Poe ND, Robinson DG Jr, Zielinski FW, Cabeen WR Jr, Smith JW, Gomes AS. Myocardial imaging with123I-heptadecanoic acid.Radiology 1977;124: 419–424.
Freundlich C, Hoeck A, Vyska K, Feinendegen LE, Machulla HJ, Stoecklin G. Myocardial imaging and metabolic studies with [17-123I]iodoheptadecanoic acid.J Nucl Med 1980;21: 1043–1050.
Fridrich L, Gassner A, Sommer G, Kneussl M, Kassal H, Klicpera M, Salomonowitz E. Dynamic123I-HDA myocardial scintigraphy after aortocoronary bypass grafting.Eur J Nucl Med 1986; 12: S24–826.
Visser FC, van Eenige MJ, Westera G, den Hollander W, Duwel CMB, van der Wall EE, Heidendal GAK, Roos JP. Metabolic fate of radioiodinated heptadecanoic acid in the normal canine heart.Circulation 1985;72: 565–571.
Duwel CMB, Visser FC, van Eenige MJ, et al. Metabolic testing of the heart with lactate and glucose during labelled FFA scintigraphy.Acta Cardiol 1988;43: 111–120.
Duwel CMB, Visser FC, van Eenige MJ, van der Lugt HAM, Roos JP. The influence of glucose on the myocardial time-activity curve during 17-iodo-123 heptadecanoic acid scintigraphy.Nucl Med Comm 1987;8: 207–215.
van Eenige MJ, Visser FC, Duwel CMB, Karreman AJP, van Lingen A, Roos JP. Comparison of 17-iodine-131 heptadecanoic acid kinetics from externally measured time-activity curves and from serial myocardial biopsies in an open-chest canine model.J Nucl Med 1988;29: 1934–1942.
Sloof GW, Visser FC, Teerlink T, et al. Incorporation of radioiodinated fatty acids into cardiac phospholipids of normoxic myocardium.Mol Cell Biochem 1993;116: 79–87.
Reske SN, Auner R, Winkler C. Kinetics of 17-(123I)iodoheptadecanoic acid in myocardium of rats.J Radioanalyt Chem 1983,79: 355–361.
Railton R, Rogers JC, Small DR, Harrower ADB. Myocardial scintigraphy with I-123 heptadecanoic acid as a test for coronary heart disease.Eur J Nucl Med 1987;13: 63–66.
Dudczak R, Kletter K, Frichauf H, Losert U, Angelberger P, Schmoliner R. The use of I-123-labelled heptadecanoic acid (HDA) as a metabolic tracer: preliminary report.Eur J Nucl Med 1984;9: 81–85.
Machulla HJ, Stoecklin G, Kupfernagel C, Freundlieb C, Höck A, Vyska K, Feinendegen LE. Comparative evaluation of fatty acids labelled with C-11, Cl-34m, Br-77 and I-123 for metabolic studies of the myocardium: concise communication.J Nucl Med 1978;19: 298–302.
Machulla HJ, Marsmann M, Dutschka KP. Biochemical concept and synthesis of a radioiodinated phenylfatty acid for in vivo metabolic studies of the myocardium.Eur J Nucl Med 1980;5: 171–173.
Knoop F. Der Abbau aromatischer Fettsäuren im Tierkörper.Beitr z them Physiol Path 1905;6: 150–156.
Machulla HJ, Marsmann M, Dutschka KP. Radiopharmaceuticals. I. Synthesis of radioiodinated phenylfatty acids for studying myocardial metabolism.J Radioanalyt Chem 1980; 56:253–261.
Reske SN, Sauer W, Machulla HJ, Winkler C. 15-(p-[I-123]phenyl)pentadecanoic acid as tracer of lipid metabolism. Comparison with 1-C-14 palmitic acid in murine tissues.J Nucl Med 1984;25: 1335–1342.
Schön HR, Schelbert HR, Robinson G, Najafi A, Huang SC, Hansen H, Barrio J, Kuhl DE, Phelps ME. C-11 labelled palmitic acid for the noninvasive evaluation of regional myocardial fatty acid metabolism with positron-computed tomography.Am Heart J 1982;103: 532–547.
Kropp J, Ambrose KR, Knapp FF Jr, Nissen HP, Biersack HJ. Incorporation of radioiodinated IPPA and BMIPP fatty acid analogues into complex lipids from isolated rat hearts.Nucl Med Biol 1992;19: 283–288.
Caldwell JH, Martin GV, Link JM, Krohn KA, Bassingthwaighte JB. Iodophenylpentadecanoic acid-myocardial blood flow relationship during maximal exercise with coronary occlusion.J Nucl Med 1990;31: 99–105.
Kennedy PL, Corbett JR, Kulkarni PV, Wolfe CL, Jansen DE, Hansen CL, Buja LM, Parkey RW, Willerson JT. Iodine 123-phenylpentadecanoic acid myocardial scintigraphy: usefulness in the identification of myocardial ischemia.Circulation 1986;74: 1007–1015.
Hansen CL, Corbett JR, Pippin JJ, Jansen DE, Kulkarni PV, Ugolini V, Henderson E, Akers M, Buja LM, Parkey RW, Willerson JT. Iodine-123 phenylpentadecanoic acid and single photon emission computed tomography in identifying left ventricular regional metabolic abnormalities in patients with coronary heart disease: comparison with thallium-201 myocardial tomography.J Am Coll Cardiol 1988;12: 78–87.
Zimmermann R, Rauch B, Kapp M, Bubeck B, Neumann FJ, Seitz F, Stokstad P, Mall G, Tillmanns H, Kühler W. Myocardial scintigraphy with iodine-123 phenylpentadecanoic acid and thallium-201 in patients with coronary artery disease: a comparative dual-isotope study.Eur J Nucl Med 1992;19: 946–954.
Duwel CMB, Visser FC, van Eenige MJ, Westera G, Roos JP. The influence of lactate and dipyridamole on myocardial fatty acid metabolism in man, traced wih123I-17-iodoheptadecanoic acid.NuclMed 1990;29: 8–34.
Duwel CMB, Visser FC, van Eenige MJ, Den Hollander W, Roos JP. The fate of123I-17-iodoheptadecanoic acid during lactate loading: its oxidation is strongly inhibited in favor of its esterification.NuclMed 1990;29: 24–27.
Drake AJ, Haines JR, Noble MIM. Preferential uptake of lactate by the normal myocardium in dogs.Cardiovasc Res 1980;14: 65–72.
Spitzer JJ. Effect of lactate infusion on canine myocardial free fatty acid metabolim in vivo.Am J Physiol 1974;226: 213–217.
Keul J, Doll E, Steim H, Fleer H, Reindell H. Über den Stoffwechsel des menschlichen Herzens. III. Der oxydative Stoffwechsel des menschlichen Herzens unter verschiedenen Arbeitsbedingungen.Pflügers Arch 1965;282: 43–53.
Keul J, Doll E, Steim H, Homburger H, Krn H, Reindell H. Über den Stoffwechsel des menschlichen Herzens. I. Die Substratversorgung des gesunden menschlichen Herzens in Ruhe, während und nach körperlicher Arbeit.Pflügers Arch 1965;282: 1–27.
Liedtke AJ, Nellis S, Neely JR. Effects of excess free fatty acids on mechanical and metabolic function in normal and ischemic myocardium in swine.Circ Res 1978;43: 652–661.
Kropp J, Fehske W, Krois M, Möller J, von Smekal A, Likungu J, Kirchhoff PG, Lüderitz B, Biersack HJ. Influence of revascularization on myocardial perfusion, metabolism and function.Ann Nucl Med 1993;7: SII–69-SII–78.
Eisenhut M, Lehmann WD, Sütterle A. Metabolism of 15-(4′-[123iodophenyl)pentadecanoic acid [123I]IPPA) in the rat heart: identification of new metabolites by high pressure liquid chromatography and fast atom bombardment-mass spectrometry.Nucl Med Biol 1993;6: 747–754.
Pippin JJ, Jansen DE, Henderson EB, et al. Myocardial fatty acid utilization at various workloads in normal volunteers: iodine-123 phenylpentadecanoic acid and single photon emission computed tomography to investigate myocardial metabolism.Am J Cardiol Imaging 1992;6: 99–108.
Reske SN, Knapp FF Jr, Nitsch J, Kropp J, Reichmann K, Winkler C. Ergebnisse der Fettsäure-SPECT des Myokards bei der koronaren Herzerkrankung.NuclMed 1986;25: 90–98.
Kropp J, Likungu J, Kirchhoff PG, Knapp FF Jr, Reichmann K, Reske SN, Biersack HJ. SPECT-imaging of myocardial oxidative metabolism with (I-123)IPPA in patients with coronary artery disease and aorto-coronary bypass graft surgery.Eur J Nucl Med 1991:18: 467–474.
Pippin JJ, Jansen DE, Henderson EB, Hansen C, Ugolini V, Kulkarni PV, Corbett JR. SPECT demonstration of workload and sex-related variabilitiy of myocardial fatty acid utilization in normals.J Nucl Med 1988;29: 841
Reske SN, van der Lohe E, Simon HJ, Büll U. Einfluss von Laktet auf die Oxidation freier Fettsäuren (FFAO) in normalem und ischämischem Myokard.Z Kardiol 1989;78: Suppl 1: 131.
Kropp J, Köhler U, Fehske W, Knapp FF Jr, Grünwald F, Biersack HJ. Semiquantitative 15-(p-[I-123]iodophenyl)pentad-ecanoic acid (IPPA)-SPECT in the detection of coronary artery disease.Ann Nucl Med 1993;7: SII–59-SII–67.
Hansen CL, Heo J, Oliner C, van Decker W, Iskandrian AS. Prediction of functional recovery with I-123 phenylpentadecanoic acid after coronary revascularization.J Nucl Med 1994;35 Suppl: 49P.
Heo J, Cave V, Kuhlmeier V, Cassel D, Iskandrian AS. Assessment of myocardial viability by serial tomographic iodophenylpentadecanoic acid imaging: comparison to rest-redistribution thallium imaging.J Nucl Med 1994;35 Suppl: 50P.
Wieler H, Kaiser KP, Frank J, Kuikka JT, Ladwein K, Winkens A. Standardized non-invasive assessment of myocardial free fatty acid kinetics by means of 15-(para-iodo-phenyl)pentadecanoic acid (123I-pPPA)scintigraphy. I. Method.Nucl Med Commun 1990;11: 865–878.
Wieler H, Kaiser KP, Kuikka JT, Henkel B, Frank J, Ladwein K. Standardized non-invasive assessment of myocardial free fatty acid kinetics by means of 15-(para-iodophenyl)pentad-ecanoic acid (123I-pPPA)scintigraphy. II. Clinical results.Nucl Med Commun 1992;13: 168–185.
Schad N, Daus HJ, Ciavolella M, Maccio A. Noninvasive functional imaging of regional rate of myocardial acids metabolism.Cardiologia 1987;32-N3: 239–247.
Schad N. Dynamic IPPA studies: techniques and applications.Ann Nucl Med 1993;7: SII–57-SII–58.
Davies RA, Ruddy TD, Ballinger JR, Spencer P, Habibi H. Exercise myocardial imaging: comparison between iodine-123-phenylpentadecanoic acid and thallium-201. In: Höfer R, Bergmann H, Sinzinger H, eds. Radioactive isotopes in clinical medicine and research. Stuttgart New York: Schattauer; 1989:611–615.
Kropp J, Jörgens C, Glänzer K, Köhler U, Ruhlmann J, Grünwald F, Hotze A, Bier-sack HJ. Flow and viability of the myocardium detected by isonitriles (RP-30) and IPPA fatty acid in patients with coronary artery disease (CHD).Eur J Nucl Med 1990; 16: 471.
Varetto T, Picciotto G, Baccega M, Campana M, De Filippi PG, Martiny W, De Berardinis A, Casaccia M, Cesana P, Ropolo R. Use of I-123-IPPA in evaluation of patients with coronary artery disease.Eur J Nucl Med 1990;16: 472.
Scopinaro F, Penco M, Pagan M, Banci M, Romano S, Camboni C, Dagianti A, Centi Colella A. 99m-Tc-MIBI and 123-I-iodophenylpentadecanoic acid (IPPA) in the detection of myocardial ischemia in patients with multivascular CAD.Eur J Nucl Med 1990;16: 471
Medolago G, Piti A, Tespili M, Gotti R, Virotta G, Adda FD, Balduzzi A, Mazzoleni D, Caspari A, Bertocchi C. Perfusion (Tc99m-MIBI) and metabolic (I123-IPPA) study in recent myocardial infarction by SPET imaging.Eur J Nucl Med 1990;16: 471.
Vyska K, Machulla HJ, Stremmel W, Faßbender D, Knapp WH, Notohamiprodjo G, Gleichmann U, Meyer H, Knust EJ, Körfer R. Regional myocardial free fatty acid extraction in normal and ischemic myocardium.Circulation 1988;78: 1218–1233.
Vyska K, Meyer W, Stremmel W, Notohamiprodjo G, Minami K, Machulla HJ, Gleichmann U, Meyer H, Körfer R. Fatty acid uptake in normal human myocardium.Circ Res 1991;69: 857–870.
Fox KAA, Abendschein DR, Ambos HD, Sobel BE, Bergmann SR. Efflux of metabolized and nonmetabolized fatty acid from canine myocardium.Circ Res 1985;57: 232–243.
Notohamiprodjo G, Vyska K, Stremmel W. Myocardial fatty acid uptake is a carrier mediated process. Proceedings of the First International Congress of Nuclear Cardiology, Cannes, France 1993: 4409.
Schmitz B, Reske SN, Machulla HJ, Egge H, Winkler C. Cardiac metabolism of 15-(p-iodo-phenyl)-pentadecanoic acid: a gas-liquid chromatographic-mass spectrometry analysis.J Lipid Res 1984;25: 1102–1108.
Kropp J, Köhler U, Likungu J, Kirchhoff PG, Biersack HJ. Detection of coronary artery disease with the fatty acid [123I]IPPA as a tracer of oxidative metabolism.Circulation 1992;86 Suppl I: 1–797
Ferrari R, Di Lia F, Raddino R, Bigoli C, Curello S, Ceconi C, Albertini A, Visioli O. Factors influencing the metabolic and functional alterations induced by ischemia and reperfusion. In: Ferrari R, Katz AM, Shug A, Visioli O, eds. Myocardial ischemia and lipid metabolism. New York London: Plenum, 1984; 135–157.
Parker JO, Chiong MA, West RO, Case RB. Sequential alteration in myocardial lactate metabolism, S-T segments, and left ventricular function during angina induced by atrial pacing.Circulation 1969;40: 113–131.
Kurien VA, Olver MF. A metabolic cause for arrhythmias during acute myocardial hypoxia.Lancet 1970;1: 813–815.
Reske SN. Viability as seen with radiolabelled fatty acids — a new approach to a challenging problem.Eur J Nucl Med 1994;21: 279–282.
Hansen CL. Preliminary report of an ongoing phase I/II dose range, safety and efficacy study of iodine-123-phenylpentadecanoic acid for the identification of viable myocardium.J Nucl Med 1994;35 Suppl: 38S-42S.
Kuikka JT, Mussalo H, Hietakorpi S, Vanninen E, Länsimies E. Evaluation of myocardial viability with technetium-99m hexakis-2-methoxyisobutyl isonitrile and iodine-123 phenylpentadecanoic acid and single photon emission tomography.Eur J Nucl Med 1992;19: 882–889.
Murray G, Schad N, Ladd W, Allie D, Zwagg RV, Avet P, Rockett J. Metabolic cardiac imaging in severe coronary disease: assessment of viability with iodine-123-iodophenylpentadecanoic acid and multicrystal gamma camera, and correlation with biopsy.J Nucl Med 1992;33: 1269–1277.
Murray GL, Schad N, Magill HL. Dynamic low dose I-123-iodophenylpentadecanoic acid metabolic cardiac imaging: comparison to myocardial biopsy and reinjection SPECT thallium in ischemic cardiomyopathy and cardiac transplantation.Ann Nucl Med 1993;7: SII–79-SII–85.
Kuikka JT, Hartikainen J, Mäntysaari M, Pyörälä K. Detection of hibernating myocardium by combining perfusion with pPPA and MIBG assessment.Ann Nucl Med 1993;7: SII–87-SII–92.
Knapp WH, Vyska K, Machulla HJ, Notohamiprodjo G, Schmidt U, Knust EJ, Gleichmann U. Double-nuclide study of the myocardium using201Tl and123I-labelled fatty acids in non-ischemic myocardial diseases.NuclMed 1988;27: 72–78.
Kropp J, Knapp FF Jr, Biersack HJ. Clinical use of fatty acids. In: Limouris GS, Shukla SK, Biersack HJ, eds. Radionuclides for cardiology. Athens: Mediterra Publishers 1994: 159–204.
Dimauro S, Bonilla E, Zeviani M. Mitochondrial myopathies.Ann Neurol 1985;17: 521–526.
Turnbull DM, Sherratt HSA. Mitochondrial myopathies: defects in β-oxidation.Biochem Soc Transact 1985;13: 645–648.
Hiromasa S, Ikeda T, Kubota K, et al. Ventricular tachycardia and sudden death in myotonic dystrophy.Am Heart J 1988;115: 914–915.
Schwartzkopff B, Frenzel H, Lösse B, Borggrefe M, Toyka KV, Hammerstein W, Seitz R, Deckert M, Breithardt G. Herzbeteiligung bei progressiver externer Ophthalmoplegie (Kearns-Sayre-Syndrom): elektrophysiologiscbe, hämodynamische und morphologische Befunde.Z Kardiol 1986;75: 161–169.
Zierz S, Engel AG. Regulatory properties of a mutant carnitine palmitoyl transferase in human skeletal muscle.Eur J Biochem 1985;149: 207–214.
Zierz S. Myopathien mit bekannten Stoffwechselstörungen. In: Jerusalem F, Zierz S, eds.Muskelerkrankungen. Stuttgart New York: Thieme; 1991: 317–345.
Müller-Höcker J, Johannes A, Droste M, Kadenbach B, Pongratz D, Hübner G. Fatal mitochondrial cardiomyopathy in Kearns-Sayre syndrome with deficiency of cytochrome-c-oxidase in cardiac and skeletal muscle.Virchows Arch B Cell Pathol 1986;48: 353–367.
Thies WR, Vyska K, Notohamiprodjo G, Matthies W, Knapp WH, Meyer H. Regional free fatty-extraction rates in hypertrophic and dilated cardiomyopathies in children.Circulation 1988;78 Suppl II: II-494.
Ugolini V, Hansen CL, Kulkarni PV, et al. Abnormal fatty acid metabolism in dilated cardiomyopathy detected by iodine-123 phenylpentadecanoic acid and tomographic imaging.Am J Cardiol 1988;62: 923–928.
Schad N. Routine cardiac metabolic imaging.Cardiovasc Imag 1990;2: 5–8.
Kuikka JT, Virtanen KS, Mustonen J, Kairento AL, Unsitupa M. I-123 free fatty acid metabolism in the ischemic myocardium and diabetes.J Nucl Med 1988;29: 842.
Notohamiprodjo G, Minami K, Körfer R. Noninvasive assessment of the myocardial fatty acid transport, in patients with severe aortic stenosis for evaluation of patient prognosis and of timing for surgical treatment. Proceedings of the First International Congress of Nuclear Cardiology, Cannes, France, 1993: 504.
Notohamiprodjo G, Schmidt U, Baller D, Gleichmann U. Noninvasive detection of microcirculation disturbances in hypertensives with and without myocardial hypertrophy. Proceedings of the First International Congress of Nuclear Cardiology, Cannes, France, 1993: 6601.
Chen T, Mertens S, Notohamiprodjo G, Park JW, Heinrich KW. Metabolism of the myocardium during stress in patients with transplanted hearts and with cardiomyopathy. Proceedings of the First International Congress of Nuclear Cardiology, Cannes, France, 1993: 6611.
Pippin JJ, Jansen DE, Henderson EB, Corbett JR, van den Berg E, Schmitz J, Dehmer G, Kulkarni PV, Buja LM, Parkey RW, Willerson JT. Single photon emission computed tomography utilizing I-123 phenylpentadecanoic acid metabolism before and after percutaneous transluminal coronary angioplasty.J Nucl Med 1987;28: 1084.
Lenzhofer R, Dudzak R. Indication of doxorubicin cardiotoxieity by impairment of131I-IPPA utilization.Eur J Nucl Med 1986;12: S32-S33.
Knapp FF Jr. Tellurium and selenium as carbon substitutes. In:Proceedings of the First International Symposium on Radiopharmaceuticals: Structure-Activity Relationships, USA 1980. New York: Grime and Stratton; 1981: 345–391.
Elmaleh DR, Knapp FF Jr, Yasuda T, Coofey JL, Kopiwoda S, Okada RD, Strauss HW. Myocardial imaging with123mTe-9-telluraheptadecanoic acid.J Nucl Med 1981;22: 994–999.
Okada RD, Strauss HW, Elmaleh DR, Goodman MM, Knapp FF Jr. Tellurium-labelled fatty acid analogues: relationship of heteroatom position on myocardial kinetics.Eur J Nucl Med 1985;11: 156–161.
Knapp FF Jr, Ambrose KR, Callahan AP, Ferren LA, Girgsby RA, Irgolic KJ. Effects of chain length and Te-position on the myocardial uptake of Te-123m-labelled fatty acids.J Nucl Med 1981;22: 988–993.
Goodman MM, Knapp FF Jr. Synthesis of 15-(p-iodophenyl)-6-tellurapentadecanoic acid: a new myocardial imaging agent.J Med Chem 1982;7: 3004–3006.
Goodman MM, Knapp FF Jr, Callahan AP, Ferren LA. Radioiodinated 15-(p-iodophenyl)-6-tellurapentadecanoic acid: a new myocardial imaging agent exhibiting prolonged myocardial retention.J Nucl Med 1982;23: 904–908.
Bianco JA, Alpert JS, Pape LA, Zheng M, Hnatowich D, Goodman MM, Knapp FF Jr. Accumulation of radioiodinated 15-(p-iodophenyl)-6-tellurapentadecanoic acid in necrotic and ischemic myocardium during acute coronary occlusion and reperfusion.J Am Coll Cardiol 1984;4: 80–87.
Knapp FF Jr, Kabalka GW, Goodman MM, Sastry KAR, Calahan AP, Ferren LA. New myocardial imaging agents: stabilization of radioiodine as a terminal vinyl iodide moiety on tellurium fatty acids.J Med Chem 1983;26: 1535–1537.
Knapp FF Jr, Kabalka GW, Goodman MM, Sastry KAR, Callahan AP, Ferren LA. New myocardial imaging agents: Stabilization of radioiodine as a terminal vinyl iodide moiety on tellurium fatty acids.J Med Chem 1983;26: 1293–1300.
Knapp FF Jr, Srivastava PC, Callahan AP, Cunningham EB, Kabalka GW, Sastry KAR. The effect of tellurium position on the myocardial specificity of radioiodinated 18-iodo-17-octadecanoic acid analogues.J Med Chem 1984;27: 57–62.
Knapp FF Jr, Goodman MM, Elmaleh DR, Okada RD, Strauss HW. The development of radioiodinated fatty acids for applications in nuclear cardiology. In:Proceedings of the International Symposium on the Developing Role of Short-Lived Radionuclides in Nuclear Medicine Practice. U.S. Department of Energy, 1982, Office of Scientific and Technical Information, Symposium Series 56 (CONF 850623) 1985: 289–311.
Grossman K, Kaiser KP, Geuting B, Machulla HJ, Feinendegen LE.Ortho-Iodo-phenylpentadecanoic acid (OPPA) - its metabolic acceptance without metabolism.Proceedings of the European Congress on Nuclear Medicine, Milan, Italy, 1988. Stuttgart New York: Schattauer; 1989: 691–694.
Antar MA, Spohr G, Herzog HH, Kaiser KP, Notohamiprofjo G, Vester E, Shreeve WW, Feinendegen LE. 15-(ortho-1231-phenyl)-pentadecanoic acid, a new myocardial imaging agent for clinical use.Nucl Med Commun 1986;7:683–696.
Henrich MM, Vester E, von der Lohe E, Herzog H, Simon H, Kuikka JT, Feinendegen LE. The comparison of 2-18F-deoxyglucose and 15-(ortho-1231-phenyl)-pentadecanoic acid uptake in persisting defects on thallium-201 tomography in myocardial infarction. J Nucl Med 1991;32: 1353–1357.
Geuting B, Kaiser KP, Grossman K, Vester E, Loess B, Machulla HJ, Feinendegen LE. Metabolic behavior of the ortho- and para-isomers of 15-(123I-phenyl)-2-14C-pentad-ecanoic acid (oPPA,pPPA) in human myocardium after intravenous administration.Proceedings of the European Congress on Nuclear Medicine, Milan, Italy, 1988. Stuttgart New York: Schattauer; 1989: 160–163.
Mathecourt J, Fagret D, Cinotti L, Andre-Fouet X, Wolf JE, Beaune J, Le Bars D, Rocca C, Comet M. What is more accurate for the assessment of myocardial viability after myo cardial infarction? 201-T1 and fatty acids SPECT studies were compared with FDG-PET in 15 pts [abstract].Circulation 1992;86 Suppl 1:1–108.
Eisenhut M, Liefhold J. Radioiodinated p-phenylene bridged fatty acids as new myocardial imaging agents: syntheses and biodistribution in rats.Appl Radiat Isot 1988;39: 639–649.
Zehelein J, Zimmermann R, Bubeck B, Eisenhut M, Kübler W, Georgi P. SPECT I-123 PHIPA imaging in patients with chronic coronary artery disease: a comparative study with thallium-201.Eur J Nucl Med 1994;21: 811.
Jonas M, Brandau W, Vollet B, Gildehaus FJ, Fahrenkamp A, Weyand M, Puskas C, Scheld HH, Böcker W, Schober O.123I-PHIPA 3-10: a SPET tracer for assessment myocardial viability [abstract].Eur J Nucl Med 1994;21: 736.
Chouraqui, Maddahi J, Henkin R, Karesh SM, Galie E, Berman DS. Comparison of myocardial imaging with iodine123-iodophenyl-9-methyl pentadecanoic acid and thallium 201-chloride for assessment of patients with exercise-induced myocardial ischemia.J Nucl Med 1991;32: 447–452.
Goodman MM, Kirsch G, Knapp FF Jr. Synthesis and evaluation of radioiodinated terminalp-iodophenyl-substituted α-β-methyl-branched fatty acids.J Nucl Med 1984;27: 390–397.
Goodman MM, Knapp FF Jr. New myocardial imaging agents: synthesis of 15-(p-iodophenyl)-3-R,S-methylpenta-decanoic acid by decomposition of a piperidinyl triazene precurso.J Org Chem 1984;49:2322–2325.
Knapp FF Jr, Ambrose KR, Goodman MM. New radioiodinated methyl-branched fatty acids for cardiac imaging.Eur J Nucl Med 1986;12: S539-S544.
Reske SN, Knapp FF Jr, Winkler C. Metabolic imaging of the myocardium with radioiodinated aromatic free fatty acid analogues. I. Experimental basis.J Physiol Imaging 1986;1: 214–219.
Goodman MM, Neff K, Ambrose KR, et al. Effect of 3methyl-branching on the myocardial retention of radioiodinated 19-iodo-18-nonadecanoic acid analogues.Nucl Med Biol 1989;16:813–819.
Goodman MM, Callahan AP, Knapp FF Jr. Design, synthesis and evaluation of ω-iodovinyl- and ω-iodoalkyl-substituted methyl-branched fatty acids.J Med Chem 1985;28: 807–814.
Knapp FF Jr, Goodman MM. The design and biological properties of iodine-123-labelled β-methyl-branched fatty acids. In: Proceedings of the workshop on radio-labelled free fatty acids, Netherlands 1984.Eur Heart J 1985;6: 71–84.
Knapp FF Jr, Goodman MM, Ambrose KR, Som P, Brill AB, Yamamoto K, Kubota K, Yonekura Y, Dudczak R, Angelberger P, Schmoliner R. The development of radioiodi nated 3-methyl-branched fatty acids for evaluation of myocardial disease by single photon tomography. In: van der Wall EE, ed.Noninvasive measurement of cardiac metabolism. Amsterdam: Martinus Nijhoff: 1987: 159–202.
Ambrose KR, Rice DE, Goodman MM, Knapp FF Jr. Effect of 3-methyl-branching on the metabolism in rat hearts of radioiodinated iodovinyl long-chain fatty acids.Eur J Nucl Med 1987;13: 374–379.
Knapp FF Jr, Goodman MM, Callahan AP, Kirsch G. Radioiodinated 15-(p-iodophenyl)-3,3-dimethylpentadecanoic acid: a useful new agent to evaluate myocardial fatty acid uptake. J Nucl Med 1986;27: 521–531.
Livni E, Elmaleh DR, Barlai-Kovach MM, Goodman MM, Knapp FF Jr, Strauss HW. Radioiodinated beta-methyl phenyl fatty acids as potential tracers for myocardial imaging and metabolism. In: Proceedings of the workshop on radio-labelled free fatty acids, Academic Hospital, Free University, Holland, July 6, 1984.Eur Heart J 1985;6: 85–90.
Strauss HW, Livni E, Brill B, Knapp FF Jr, Barlai-Kovach M, Keiss MC, Elmaleh DR. In vivo studies of branched-chain fatty acids. In: Heiss HW, ed.Regional myocardial metabolism by positron tomography. Advances in Clinical Pharmacology Series, vol Ill. Foundation for Advances in Clinical Medicine, Mahwah, New Jersey, USA. 1987: 102–105.
Fagret D, Bontemps L, Apparu M, et al. Kinetics of iodomethylated hexadecanoic acid metabolism in the rat myocardium: influence of the number and position of methyl radicals.Int J Nucl Med Biol 1985;12: 363–367.
Demaison L, Dubois F, Apparu M, et al. Myocardial metabolism of radioiodinated methyl-branched fatty acids. J Nucl Med 1988;29: 1230–1236.
Fagret D, Wolf J-E, Pilichowski, et al. Iodomethylated fatty acid metabolism in mice and dogs.Eur J Nucl Med 1988;14: 624–627.
Thomas G, Pepin D, Loriette C, et al. Metabolism of methyl-branched iodo palmitic acids in cultured hepatocytes.Eur J Nucl Med 1989;15: 367–372.
Ambrose KR, Owen BA, Goodman MM, Knapp FF Jr. Evaluation of the metabolism in rat hearts of two new radioiodinated 3-methyl-branched fatty acid myocardial imaging agents.Eur J Nucl Med 1987;12: 486–491.
Ambrose KR, Owen BA, Callahan, AP, Goodman MM, Knapp FF Jr. Effects of fasting on the myocardial subcellular distribution and lipid distribution of terminal p-iodophe nyl-substituted fatty acids in rat hearts.Nucl Med Biol 1988;5: 695–700.
Knapp FF Jr, Kohlen S, Kolkmeier J, Reske SN, Cunningham EB, Rice DE, Callahn AP, Ambrose KR. Formation of catabolites from methyl-branched fatty acids by isolated Langendorff perfused rat heart system. In:Proceedings, European Nuclear Medicine Congress, Hungary 1987. Stuttgart New York: Schattauer; 1988: 726–730.
Knapp FF Jr, Goodman MM, Reske SN, Ambrose KR, Kirsch G. Radioiodinated methyl-branched fatty acids — evaluation of catabolites formed in vivo.NucCompact/Eur-Am Commun Nucl Med 1990;21: 229–231.
Knapp FF Jr, Reske SN, Ambrose KR, Kohlen S, Kolkmeier J, Goodman MM, Cunningham EB. Formation of polar catabolites from radioiodinated l5-(p-iodophenyl)-3-R,S-methylpentadecanoic acid (BMIPP) by isolated Langendorff rat hearts.NucCompact/Eur-Am Commun Nucl Med 1990;21: 133–139.
Kropp J, Knapp FF Jr, Ambrose KR, Visser F, Biersack HJ, Rogers CJ. Release of an unexpected myocardial metabolite of radioiodinated 15-(p-iodophenyl)-3-R,S-methylpenta decanoic acid (BMIPP) from isolated rat hearts and canine hearts in vivo. J Nucl Med 1990;31: 896.
Ambrose KR, Kropp J; Lambert CR, Biersack HJ, Knapp FF Jr. Back diffusion (BD) and release of metabolites (“X”) contribute to washout of radioiodinated BMIPP from isolated rat hearts (RH).Eur J Nucl Med 1991;18: 671.
Humbert T, Luu-Duc C, Comet M, et al. Evaluation of cellular viability by quantitative autoradiographic study of myocardial uptake of a fatty acid analogue in isoproterenol-in duced focal rat heart necrosis.Eur J Nucl Med 1991;18: 870–878.
Humbert T, Keriel C, Batlle D, et al. Influence of the presence of a methyl group on the myocardial metabolism of 15(para-iodophenyl)-3-methyl pentadecanoic acid (IMPPA).Nucl Med Biol 1990; 17: 745–749.
Yonekura Y, Brill AB, Som P, Yamamoto K, Srivastava SC, Iwai J, Elmaleh DR, Livni E, Strauss HW, Goodman MM, Knapp FF Jr. Quantitative autoradiographic measurement of regional myocardial substrate utilization in hypertensive rats.Science 1985;227: 1494–1496.
Yamamoto K, Som P, Brill AB, Yonekura Y, Srivastava SC, Meinken GE, Iwai J, Goodman MM, Knapp FF Jr. Dual tracer autoradiographic study of β-methyl-(1-14C) heptad ecanoic acid and 15-p-(131I)-iodophenyl-β-methylpenta-decanoic acid in normotensive and hypertensive rats.J Nucl Med 1986;27: 1178–1183.
Kurata C, Kobayashi A, Yamazaki, et al. Dual tracer autoradiographic study with thallium-201 and radioiodinated fatty acid in cardiomyopathic hamsters.J Nucl Med 1989;30: 80–87.
Kurata C, Hayashi H, Kobayashi A, et al. Dual tracer autoradiographic study of radioiodinated fatty acid and thallium201 in cardiomyopathic hamsters.Circulation 1987;76: 509.
Som P, Oster ZH, Goodman MM, Knapp FF Jr. Microimaging studies with myocardial substrate utilization and perfusion in two models of non-coronary heart disease.NucCompact/Eur-Am Commun Nucl Med 1990;21: 259–262.
Som P, Wang G-J, Oster ZH, Knapp FF Jr, Yonekura Y, Fujibayashi Y, Yamamoto K, Kubota K. Myocardial uptake of cocaine and effects of cocaine on myocardial substrate utili zation and perfusion in hypertensive rats.Ann Nucl Med 1993;7: 19–26.
Wang G-J, Som P, Oster, ZH, Volkow ND, Knapp FF Jr, Sacker DF. Quantitative autoradiographic measurement of cocaine-induced regional myocardial metabolic changes in hypertensive rats.Nucl Med Biol 1994;21: 245–250.
Reske SN, Knapp FF Jr, Nitsch J. 3,3-Dimethyl-(p-1-123-phenyl)pentadecanoic acid (DMIPP) uptake is excess to rMBF in reperfused myocardium.J Nucl Med 1989;30: 797.
Reske SN, Knapp FF Jr, Nitsch J, Kohlen S, Kolkmeier J. 3,3-Dimethyl-(p-I-123-pbenyl)pentadecanoic acid (DMIPP) uptake is excess to rMBF in reperfused myocardium.Eur J Nucl Med 1989;15: 398.
Sloof GW, Visser FC, van Eenige MJ, Comans EFI, Teerlink T, Herscheid K, van der Vusse GJ, Knapp FF Jr. Comparison of uptake, oxidation and lipid distribution of 17-iod oheptadecanoic acid (IHA), 15-(p-iodophenyl)pentad-ecanoic acid (IPPA) and 15-(p-iodophenyl)-3,3-dimethylpentadecanoic acid (DMIPPA) in normal canine myocardium.J Nucl Med 1993;34: 649–657.
Bianco JA, Elmaleh DR, Leppo JA, et al. Effect of glucose and insulin infusion on the myocardial extraction of a radioiodinated methyl-substituted fatty acid.Eur J Nucl Med 1986;12: 120–124.
Kariento AL, Livni E, Mattila S, et al. Comparative evaluation of [123I] 14-p-iodophenyl-beta-methylpenadecanoic acid and thallium-201 in the detection of infarcted areas in the dog heart using SPET.Nucl Med Biol 1988;15: 333–338.
Dudczak R, Schmoliner R, Angelberger P, Knapp FF Jr, Goodman MM. Structurally modified fatty acids: clinical potential as tracers of metabolism.Eur J Nucl Med 1986;12: 45–48.
Kropp J, Jorgens M, Glanzer K, Knapp FF Jr, Biersack HJ. Evaluation of ischemia and myocardial viability in patients with CAD with the fatty acid l5-(p-[I-123]iodophenyl)-3-R,S-methylpentadecanoic acid. First International Congress of Nuclear Cardiology, France 1993.
Kropp J, Köhler U, Knapp Jr. FF, Biersack JH. 15-(p-[I-123]iodophenyl)-3-R,S-methylpentadecanoic acid to evaluate ischemia in patients with coronary artery disease.Eur J Nucl Med 1991;18: 650.
Yamamichi Y Shirakami Y, Morishita K, Kurami M, Kusuoka H, Nishimura T. Intramyocardial metabolism of β-methyl-p-iodophenylpentadecanoic acid (BMIPP).J Nucl Med 1994;35: 97P.
Kropp J, Knapp FF Jr, Assman T, Ambrose KR, Biersack HJ. Metabolites of IPPA, BMIPP and DMIPP fatty acids in rat hearts. A quantitative HPLC study. In:Nuclear medicine — state of the art in Europe. Proceedings of the European Nuclear Medicine Congress. Stuttgart New York: Schattauer; 1991: 109–111.
Sloof GW Visser FC, Teerlink T, Comans EFI, van Einige MJ, van der Vusse GJ, Knapp FF Jr. Incorporation of radio-iodinated fatty acids into cardiac phospholipids of normoxic canine myocardium. In: Proceedings of Third International Symposium on Lipid Metabolism in the Normoxic and Ischemic Heart, Netherlands 1991.J Mol Cell Biochem 1992;116: 79–87.
van der Wall EE, Barrett E, Strauss HW et al. Altered uptake and kinetics of radioiodinated 15-(p-[I-125]iodophe-nyl)-3-methylpentadecanoic acid in diabetic myocardium.Circulation 1985;72 Suppl 111: 111–424.
Kiess MC, Barlai-Kovach M, Elmaleh D, et al. Discordance between blood flow and fatty acid uptake in the myocardium following lactate infusion. J Nucl Med 1984;25: 79.
Kubota K, Takahashi T, Fujiwara T, et al. Possibility for tumor detection with fatty acid analogues.Nucl Med Biol 1991;18: 191–195.
Ogata M, Kajiyama K, Yamaguchi Y, et al. BMIPP uptake in adriamycin cardiomyopathic rat hearts.J Mol Cell Cardiol 1988;20: 28.
Fujibayashi Y, Yonekura Y, Takemura Y et al. Myocardial accumulation of iodinated beta-methyl-branched fatty acid analogue, iodine- 125-15-(p-iodophenyl)-3-(R,S)-methylpenta-decanoic acid (BMIPP), in relation to ATP concentration.J Nucl Med 1990;31: 1818–1822.
Fujibayashi Y, Yonekura Y, Tamaki N, Yamamoto K, Som P, Knapp FF Jr, Konishi J, Yokoyama A. Myocardial accumulation of BMIPP in relation to ATP concentration.Ann Nucl Med 1993;7: 15–18.
Miller DD, Gill JB, Livni E, et al. Fatty acid analogue accumulation: a marker of myocyte viability in ischemic-reperfused myocardium.Circ Res 1988; 63: 681–693.
Miller DD, Barlai-Kovach M, Gill JB, et al. Imaging characteristics of a new single-photon myocardial metabolic tracer.Circulation 1986;74: 62.
Miller DD, Gill JB, Barali-Kovach M, et al. Identification of the ischemic border zone in reperfused canine myocardium using iodinated fatty acid analogues.Circulation 1985;72: 1392.
Nishimura T, Sago M, Kihara K, et al. Fatty acid myocardial imaging using123I-β-methyl-iodophenyl pentadecanoic acid (BMIPP): comparison of myocardial perfusion and fatty acid utilization in canine myocardial infarction (occlusion and reperfusion model).Eur J Nucl Med 1989;15: 341–345.
Knapp FF Jr, Kropp J, Goodman MM, Franken P, Reske SN, Ambrose KR, Som P, Biersack III, Sloof GW, Visser FC. The development of iodine-123-methyl-branched fatty acids and their applications in nuclear cardiology. Ann Nucl Med 1993;7:1–14.
Nishimura T, Uehara T, Shimonagata T, Nagata S, Haze K. Clinical experience of 1231-BMIPP myocardial imaging for myocardial infarction and hypertrophic cardiomyopathy.Ann Nucl Med 1993;7: 35–40.
Takeishi Y, Chiba J, Abe S, et al. Heterogeneous myocardial distribution of iodine-123 15-(p-iodophenyl)-3-R,S-methy1-pentadecanoic avid (BMIPP) in patients with hypertrophic cardiomyopathy. Eur J Nucl Med 1992;19: 775–782.
Morita K, Yanagimoto S, Otsuka N, Ono S, Nagai K, Tomomitsu T, Mimura H, Neuzo S, Swayarna T, Fukunaga M. I-123-BMIPP scintigraphy in seven cases with cardiomyopathy.Ann Nucl Med 1993;7: 101–107.
Kurata C, Tawahara K, Okayama K, Wakabayashi Y, Kobayashi A, Yamazaki N, Kaneko M. Myocardial imaging with radioiodinated beta-methyl-branched fatty acid in cardiomyopathy.Ann. Nucl Med 1993;7: 27–34.
Tamaki N, Kawamoto M, Yonekura Y, et al. Regional metabolic abnormality in relation to perfusion and wall motion in patients with myocardial infarction: assessment with emis sion tomography using iodinated branched fatty acid analogue.J Nucl Med 1992;33: 659–667.
Tomiguchi S, Oyama Y, Nabeshima M, Nakashima R, Ono M, Kojima A, Hara M, Takahashi M, Motomura K, Yasue H. Quantitative evaluation of BMIPP in patients with ischemic heart disease.Ann Nucl Med 1993;7: 107–112.
Kropp J, Jörgens M, Glaenzer K, Luederitz B, Biersack H-J, Knapp FF Jr. Evaluation of ischemia and myocardial viability in patients with coronary artery disease (CAD) with io dine-123 labelled (15-(p-iodophenyl)-3-R,S-methylpenta-decanoic acid (BMIPP).Ann Nucl Med 1993;7: 93–100.
Franken PR, DeGeeter F, Dedale P, et al. 1231 β-methyl-iodophenylpentadecanoic acid (BMIPP) and99mTcMIBI to identify ischemic but viable myocardium. First International Congress of Nuclear Cardiology, Cannes, France 1993: 25–28.
DeGeeter FF, Franken P, Knapp FF Jr, Boosuyt A. Relationship between blood flow and fatty acid metabolism in subacute myocardial infarction: a study by means of Tc-99m sestamibi and iodine-123-beta-methyl iodophenylpentadecanoic acid.Eur J Nucl Med 1994;21: 283–291.
Franken PR, De Geeter F, Dendale P, Demoor D, Block P, Bossuyt A. Abnormal free fatty acid uptake in subacute myocardial infarction after coronary thrombolysis: correla tion with wall motion and inotropic reserve.J Nucl Med 1994;35: 1758–1765.
Tamaki N, Kawamoto M, Yonekura Y, Fujibayashi Y, Magata Y, Torizuka T, Tadamura E, Nohara R, Sasayama S, Konishi J. Assessment of fatty acid metabolism using I-123 branched fatty acid: comparison with positron emission tomography.Ann Nucl Med 1993;7: 41–48.
Kawamoto M, Tamaki N, Yonekura Y, Tadamura E, Fujibayashi Y, Magat Y, Nohara R, Sasayama S, Ikekubo K, Kato H, Konishi J. Combined study with 1-123 fatty acid and thallium-201 to assess ischemic myocardium: comparison with thallium redistribution and glucose metabolism.Ann Nucl Med 1994;8: 47–54.
Knabb RM, Bergmann SR, Fox KAA, et al. The temporal pattern of recovery of myocardial perfusion and metabolism delineated by positron emission tomography after coronary thrombolysis.J Nucl Med 1987;28: 1563–1570.
Stremmel W. Fatty acid uptake by isolated rat heart myocyctes represents a carrier-mediated transport process.J Clin Invest 1988;81: 844–852.
Glatz JFC, van der Vusse GJ, Reneman RS. Protective role of fatty acid-binding protein in ischemic and reperfused heart.Circ Res 1991;68: 1490–1491.
Morishita S, Suzuki N, Kurami M, Nishimura T. Myocardial intracellular kinetics of branched-chained free fatty acid, I-123 BMIPP.J Nucl Med 1994;35: 97P.
Reske SN, Koischwitz D, Reichmann K, Machulla HJ, Simon H, Knopp R, Winkler C. Cardiac metabolism of 15 (p-I-123 phenyl) pentadecanoic acid after intracoronary tracer application.Eur J Radiol 1984;4: 144–149.
Poe ND, Robinson C, MacDonald NS. Myocardial extraction of labelled longchain fatty acid analogs.Proc Soc Exp Biol Med 1975;148: 215–218.
Henrich MM, Groβmann K, Metz W, Vogt M, Vester E, Holschbach M, Hamkens W, Notobamiprodjo G, Strauer BE, Feinendegen LE. Beta-oxidation of 1-[14C]-17-[131I]-iodoheptadecanoic acid following intracoronary injection in humans results in similar release of both tracers.Eur J Nucl Med 1993;20: 225–230.
Dudzak R. Myokardszintigraphie mit Jod-123-markierten Fettsäuren.Wien Klin Wochenschr 1983; 95 Suppl 143: 1–38.
Okano S, Yoshimura H, Okano K, Itoh O, Kurami M, Ikekubo K, Yonekura Y, Nishimura T, Torizuka K. Metabolite of 15-p-iodophenyl-3-R,S-pentadecanoic acid (1231) in blood and urine. Jpn J Nucl Med 1992;29: 1489–1493.
Torizuka K, Yonekura Y, Nishimura T, Tamaki N, Uehara T, Ikekubo K, Hino M. The phase 1 study of β-methyl-p-(123I)-iodophenyl-pentadecanoic acid (1231-BMIPP).Jpn J Nucl Med 1991; 28: 681–690.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Knapp, F.F., Kropp, J. Iodine-123-labelled fatty acids for myocardial single-photon emission tomography: current status and future perspectives. Eur J Nucl Med 22, 361–381 (1995). https://doi.org/10.1007/BF00941855
Issue Date:
DOI: https://doi.org/10.1007/BF00941855