New Multi-Parameters Combination of Technetium-99m-Diethylene-Triamine-Pentaacetate Orbital Single-Photon Emission Computed Tomography/Computed Tomography for the Evaluation of Graves' Orbitopathy Activity.
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Abstract
Purpose: This study investigates the new combined parameters of 99mTc-DTPA orbital single-photon emission computed tomography/computed tomography (SPECT/CT) for the evaluation of Graves' orbitopathy (GO) activity.
Methods: A retrospective analysis was performed on 41 patients. All the patients undergone the 99mTc-DTPA orbital SPECT/CT and were categorized into active and inactive group based on the standard combined by the clinical active score (CAS), magnet resonance imaging (MRI) and/or follow-up results. Quantitative parameters of lacrimal gland (LG) including the protruding degree of lacrimal gland herniation (LGH) and uptake ratios (URs) of region of interest (ROI) drawn on lacrimal gland and occipital bone. SPECT/CT reading results were based on visual analysis. Parameters were compared between the two groups and the diagnostic value on discrimination of GO activity was also evaluated.
Results: All parameters of SPECT/CT for active GO groups were significantly higher than those of the inactive groups (p<.05). There were notable linear positive correlations between the assumption standard and readings as well as combination models 2 and 3 (r = .794, r = .772, r = .760, respectively). ROC analysis indicated that model 2 provided the highest diagnostic performance, exhibiting an area under the curve (AUC) of .947, a sensitivity of 92.7%, and a specificity of 88.6%.
Conclusions: The combined use of SPECT/CT reading results and DTPA uptake parameters of LG offers a more objective and precise evaluation of active GO. This study further recommends 99mTc-DTPA SPECT/CT might be serving as a supplementary beneficial approach for CAS in evaluating GO activity.
目的：本研究探讨了99m锝-DTPA眼眶单光子发射计算机断层扫描/计算机断层扫描（SPECT/CT）用于评估巴塞杜氏眼眶病（GO）活动性的新组合参数：对41名患者进行了回顾性分析。所有患者均接受了99m锝-DTPA眼眶SPECT/CT检查，并根据临床活动评分（CAS）、磁共振成像（MRI）和/或随访结果的标准将其分为活动组和非活动组。泪腺（LG）的定量参数包括泪腺突出程度（LGH）以及泪腺和枕骨感兴趣区（ROI）的摄取比（URs）。SPECT/CT阅读结果以目测分析为基础。对两组患者的参数进行了比较，并评估了GO活动的诊断价值：结果：GO活动组的SPECT/CT所有参数均明显高于非活动组（pr=.794，r=.772，r=.760）。ROC分析表明，模型2的诊断性能最高，其曲线下面积（AUC）为0.947，灵敏度为92.7%，特异度为88.6%：结论：结合使用 SPECT/CT 读数结果和 LG 的 DTPA 摄取参数，可以更客观、更精确地评估活动性 GO。本研究进一步建议，99m锝-DTPA SPECT/CT 可作为 CAS 评估 GO 活动性的有益补充方法。
期刊介绍：
Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance.
Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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