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KMID : 1148920180520050368
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Nuclear Medicine and Molecular Imaging
2018 Volume.52 No. 5 p.368 ~ p.376
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Quantitative Single-Photon Emission Computed Tomography/Computed Tomography for Evaluation of Salivary Gland Dysfunction in Sjogren’s Syndrome Patients
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Kim Ji-Hyun
Lee Hyun-Jong
Lee Hwan-Hee
Bang Ji-In
Kang Yeon-Koo
Bae Sung-Woo
Lee Won-Woo
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Abstract
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Purpose: The purpose of the study was to investigate the usefulness of quantitative salivary single-photon emission computed tomography/computed tomography (SPECT/CT) using Tc-99m pertechnetate in Sjogren’s syndrome (SS).
Methods: We retrospectively reviewed quantitative salivary SPECT/CT data from 95 xerostomic patients who were classified as either SS (n?=?47, male:female?=?0:47, age?=?54.60?±?13.16 y [mean?±?SD]) or non-SS (n?=?48, male:female?=?5:43, age?=?54.94?±?14.04 y) by combination of anti-SSA/Ro antibody, labial salivary gland biopsy, unstimulated whole saliva flow rate, and Schirmer’s test. Thyroid cancer patients (n?=?43, male:female?=?19:24, age?=?46.37?±?12.13 y) before radioactive iodine therapy served as negative controls. Quantitative SPECT/CT was performed pre-stimulatory 20 min and post-stimulatory 40 min after injection of Tc-99m pertechnetate (15 mCi). The %injected dose at 20 min and the %excretion between 20 and 40 min were calculated for parotid and submandibular glands, generating four quantitative parameters: %parotid uptake (%PU), %submandibular uptake (%SU), %parotid excretion (%PE), and %submandibular excretion (%SE). The most useful parameter for SS diagnosis was investigated.
Results: The uptake parameters (%PU and %SU) were significantly different among the SS, non-SS, and negative controls (p?=?0.005 for %PU and p??0.05 for both). The %PU and %SU were significantly lower in SS than in the negative controls and non-SS (p?
Conclusion: Reduced submandibular uptake of Tc-99m pertechnetate at 20 min (%SU) was proved useful for the diagnosis of SS. Quantitative salivary gland SPECT/CT holds promise as an objective imaging modality for assessment of salivary dysfunction and may facilitate accurate classification of SS.
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KEYWORD
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Sjogren’s syndrome, Single-photon emission computed tomography, Computed tomography, Tc-99m pertechnetate, Quantitation
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