technetium-tc-99m-depreotide and Graves-Disease

The immunosuppressive treatment of Graves' orbitopathy (GO) influences the course of the disease in the early, active, retrobulbar inflammatory phase (active GO), which cannot be detected by direct clinical examination.. To evaluate the clinical effectiveness of a newly developed method for the detection of intraorbital inflammatory activity in patients suffering from Graves' orbitopathy, utilizing a four-headed single photon emission tomograph (SPET) camera and (99m)Tc-diethylenetriamine pentaacetic acid (Tc-DTPA).. The magnetic resonance imaging (MRI) T2 relaxation time score, as a measure of ongoing orbital inflammation (reference method), was compared with the uptake activities (UA) of (99m)Tc-DTPA orbital SPET and the more specific (99m)Tc-Neospect ((99m)Tc-depreotide) SPET, as well as the clinical activity scores (CAS), in 21 patients (42 orbits).. By visual inspection, the 'eye SPET' frames of patients suffering from active GO could be easily distinguished from those with inactive GO. Although the distributions of the two radiopharmaceuticals were mildly different, the information obtained was essentially the same. The MRI activity scores correlated well with both (99m)Tc-DTPA and Tc-depreotide UA. The mean (99m)Tc-DTPA UA value of 25 inactive GO orbits was (6.55 +/- 1.4) x 10(-6) ID x cm3 (where ID is the injected dose); the values of the active GO orbits (12 orbits with an MRI score of 1 and five orbits with an MRI score of 2) were significantly higher: (8.87 +/- 1.63) x 10(-6) and (10.36 +/- 1.60) x 10(-6) ID x cm3, respectively. Similar differences were observed for the (99m)Tc-depreotide UA values: the averages in the inactive and active groups with MRI scores of 1 and 2 were (5.23 +/- 1.23) x 10(-6), (7.69+/-2.24) x 10 and (10.92 +/- 3.85) x 10(-6) ID x cm3, respectively. The (99m)Tc-DTPA accumulation pattern in the orbital region of active GO patients was similar to that of the more specific (99m)Tc-depreotide. There was a good correlation (r = 0.71, P<0.001) between the UA values of the two radiopharmaceuticals, but CAS did not correlate with either of the UA values.. (99m)Tc-DTPA eye SPET is a potentially useful method, allowing rapid imaging at an acceptable cost. It provides essential supplementary information to traditional CAS in assessing disease activity in Graves' orbitopathy.

Topics: Brain; Female; Graves Disease; Humans; Image Processing, Computer-Assisted; Immunosuppressive Agents; Inflammation; Magnetic Resonance Imaging; Male; Orbit; Organotechnetium Compounds; Radiopharmaceuticals; Somatostatin; Technetium Tc 99m Pentetate; Tomography, Emission-Computed, Single-Photon

Topics: Eye; Graves Disease; Humans; Organotechnetium Compounds; Radionuclide Imaging; Radiopharmaceuticals; Receptors, Somatostatin; Somatostatin

Topics: Adult; Breast; Diagnosis, Differential; Female; Graves Disease; Humans; Lactation; Organotechnetium Compounds; Postpartum Period; Radionuclide Imaging; Radiopharmaceuticals; Somatostatin; Thyroid Gland

Topics: Graves Disease; Humans; Organotechnetium Compounds; Radiopharmaceuticals; Somatostatin; Technetium Tc 99m Pentetate; Tomography, Emission-Computed, Single-Photon

Currently there is no ideal imaging technique which could estimate the degree of inflammation in thyroid eye disease.. A new, rapid and cost-effective method, using 99mTc-labelled DTPA and 4-headed SPECT, was developed which is able to diagnose inflammatory activity in patients with endocrine orbitopathy (EOP).. The MRI T2 relaxation time was used as reference. Comparative orbital SPECT with the more specific 99mTc-Neospect (depreotide) was also performed in the same patients.. Visual evaluation of orbital SPECT frames of patients suffering from active EOP could be easily distinguished from inactive EOP patients'. Despite the supposedly different characteristics of the two tested radiopharmaceuticals, there was essentially no difference between their accumulation in the orbit and the information obtained. The MRI activity scores correlated well with 99mTc-DTPA activity uptake (AU). The mean AU value in patients with inactive EOP was 6.26 +/- 1.6 10(-6) ID/cm3, while in active EOP 10.78 +/- 0.61 10(-6) ID/cm3, significantly higher. The 99mTc-DTPA accumulation in the orbital region in active disease was similar to that of depreotide. There was a good correlation (r = 0.91, P < 0.0001) between the two methods.. The authors concluded that 99mTc-DTPA orbital SPECT is a potentially useful method, which--after initial clinical and MRI staging--gives useful quantitative estimation of disease activity in endocrine orbitopathy. It may provide important visual and quantitative information during the follow up of patients.

Topics: Adult; Female; Graves Disease; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Organotechnetium Compounds; Predictive Value of Tests; Radiopharmaceuticals; Sensitivity and Specificity; Somatostatin; Technetium Tc 99m Pentetate; Tomography, Emission-Computed, Single-Photon