In 123I-metaiodobenzylguanidine (MIBG) scintigram, MIBG clearance from the heart is used to evaluate the severity of various heart diseases. There are two methods for calculating MIBG clearance. One involves planar images (planar method) and the other uses a bull's eye map (SPECT method). In 158 patients and 10 normal subjects, we compared these two methods. Fifteen minutes and 4 hours after intravenous injection of 111 MBq MIBG, planar images and SPECT images were obtained. Then clearance from the heart was calculated by each method. Abnormal increase was defined as present if clearance was more than the mean + standard deviation of 10 normal subjects. Then, we examined the sensitivity with which each method could detect clearance abnormality in 158 patients. Thirty-two patients showed abnormality only on SPECT images, while planar images alone showed abnormalities in only 5 patients. The reason the SPECT method was more sensitive than the planar method may be as follows; in the case of decreased MIBG clearance from the lung, for example, in congestive heart failure, clearance by planar method is apparently decreased. Thus, the SPECT method can detect clearance abnormality more sensitively than the planar method, and if we evaluate MIBG clearance from the heart by the planar method, we must take into account MIBG clearance from the lung.