The application of extraocular muscle maximum standardized uptake value of 99mTc-diethylenetriamine pentaacetic acid orbital single photon emission computed tomography/computed tomography in the assessment of Graves' orbitopathy.

IF 1.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Nuclear Medicine Communications Pub Date : 2025-02-01 Epub Date: 2025-01-07 DOI:10.1097/MNM.0000000000001927
Chao Lu, Yang Yu, Shen Wang, Xue Yin, Hongyuan Zheng, Xiangxiang Li, Qiang Jia, Wei Zheng
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Abstract

Purpose: To study the feasibility and value of assessing patients with Graves' orbitopathy (GO) in 99mTc-diethylenetriamine pentaacetic acid (DTPA) orbital single photon emission computed tomography/computed tomography (SPECT/CT) with extraocular muscle maximum standardized uptake value (SUVmax).

Methods: A total of 235 patients underwent 99mTc-DTPA orbital SPECT/CT, including 176 patients with GO and 59 patients with Graves' disease (GD) as controls. The SUVmax of extraocular muscles, including right medial rectus muscle (RMR), right lateral rectus muscle (RLR), left medial rectus muscle (LMR), left lateral rectus muscle (LLR), was compared between groups, correlation analyses with clinical activity scores (CAS) and serological indices was performed, and the diagnostic efficacy was evaluated using receiver operating characteristic curves. The consistency of SPECT/CT and MRI in assessing extraocular muscle activity was compared.

Results: SUVmax in the extraocular muscles of active GO patients was significantly higher than in inactive GO patients and controls. In GO patients, SUVmax of the medial rectus (LMR most prominent) was higher than that of the lateral rectus. SUVmax correlated with CAS, thyroid-stimulating hormone, total cholesterol, low-density lipoprotein (positively) and free triiodothyronine and free thyroxine (negatively), but not with GO duration. The optimal cutoff values for distinguishing between active and inactive SUVmax were identified. RLR had high sensitivity and RMR had high specificity. SPECT/CT and MRI showed moderate agreement in assessing extraocular muscle activity in 87 GO patients, with high concordance.

Conclusions: The extraocular muscle SUVmax of 99mTc-DTPA orbital SPECT/CT may be used as an adjunct method in combination with CAS to more accurately assess GO activity, which can help in clinical diagnosis and individualized treatment.

眼外肌最大标准化摄取值99mtc -二乙烯三胺五乙酸眶单光子发射计算机断层扫描/计算机断层扫描在Graves眼病评估中的应用
目的:探讨99mtc -二乙烯三胺五乙酸(DTPA)眶单光子发射计算机断层扫描/计算机断层扫描(SPECT/CT)眼外肌最大标准化摄取值(SUVmax)评估Graves眼病(GO)患者的可行性和价值。方法:235例患者行99mTc-DTPA眶位SPECT/CT检查,其中GO患者176例,Graves病(GD)患者59例作为对照。比较两组眼外肌包括右内直肌(RMR)、右外直肌(RLR)、左内直肌(LMR)、左外直肌(LLR)的SUVmax,并与临床活动评分(CAS)和血清学指标进行相关性分析,采用受试者工作特征曲线评价诊断效果。比较SPECT/CT与MRI评价眼外肌活动的一致性。结果:活动性GO患者眼外肌的SUVmax明显高于非活动性GO患者和对照组。GO患者中,内侧直肌(LMR最突出)的SUVmax高于外侧直肌。SUVmax与CAS、促甲状腺激素、总胆固醇、低密度脂蛋白呈正相关(正相关),与游离三碘甲状腺原氨酸和游离甲状腺素呈负相关(负相关),但与氧化石墨烯持续时间无关。确定了区分活动和非活动SUVmax的最佳截止值。RLR敏感性高,RMR特异性高。SPECT/CT和MRI在87例GO患者的眼外肌活动评估中显示中度一致,一致性高。结论:99mTc-DTPA眶位SPECT/CT眼外肌SUVmax可作为联合CAS的辅助方法,更准确地评估GO活性,有助于临床诊断和个体化治疗。
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来源期刊
CiteScore
2.20
自引率
6.70%
发文量
212
审稿时长
3-8 weeks
期刊介绍: Nuclear Medicine Communications, the official journal of the British Nuclear Medicine Society, is a rapid communications journal covering nuclear medicine and molecular imaging with radionuclides, and the basic supporting sciences. As well as clinical research and commentary, manuscripts describing research on preclinical and basic sciences (radiochemistry, radiopharmacy, radiobiology, radiopharmacology, medical physics, computing and engineering, and technical and nursing professions involved in delivering nuclear medicine services) are welcomed, as the journal is intended to be of interest internationally to all members of the many medical and non-medical disciplines involved in nuclear medicine. In addition to papers reporting original studies, frankly written editorials and topical reviews are a regular feature of the journal.
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