[111In-DTPA-D-Phe1] octreotide scintigraphy in thyroidal and orbital Graves' disease: a parameter for disease activity?

Abstract

Visualization of malignant lymphomas and granulomatous disease is possible by [111In-DTPA-D-Phe1]octreotide scintigraphy through binding of the radioligand to somatostatin receptors on activated leukocytes. Because thyroidal and orbital tissues are infiltrated by activated leukocytes in Graves' disease, a cross-sectional study to visualize disease activity with [111In-DTPA-D-Phe1]octreotide scintigraphy was performed. A correlation between thyroidal [111In-DTPA-D-Phe1]octreotide accumulation and free T4 (disease expression) and thyroid binding-inhibiting immunoglobulins (disease activity) is present in untreated hyperthyroid Graves' disease. There is also a correlation between orbital [111In-DTPA-D-Phe1]octreotide uptake and the clinical activity score (disease activity) and total eye score (disease expression), respectively, in Graves' orbitopathy. Visualization of thyroidal and orbital Graves' disease is feasible, but further investigation is necessary to establish the role of [111In-DTPA-D-Phe1]octreotide scintigraphy in representing disease activity and expression and in predicting therapeutical outcome.

99mTc-interleukin-2 scintigraphy in normal subjects and in patients with autoimmune thyroid diseases: a feasibility study

“…It is also possible that a transient, time-related expression of the IL2R occurs and that expression of IL2R might only be observed in the early phases of exophthalmos. This has already been reported for 111 In-octreotide, which showed accumulation in the retroorbital space of patients with exophthalmos only during the early phases of the disease [17,18]. Finally, a sensitivity problem cannot be ruled out due to the limited amount of radioactivity (about 100 MBq) injected in our patients.…”

Jak często wykrywamy przypadkowe zmiany w tarczycy w badaniu PET/CT z 68Ga-DOTATATE u pacjentów diagnozowanych z powodu nowotworu neuroendokrynnego?

“…The diffuse, bilateral uptake of Inpentetreotide as a dominant pattern in patients with autoimmune thyroiditis (AITD): Graves' disease and Hashimoto disease [15][16][17][18], was reported by other authors. Thyroid 111 In-pentetreotide accumulation in Graves' disease patients was increased seven fold compared to the control group and was almost absent after radioiodine-induced hypothyroidism [15].…”

“…Data in the literature regarding SSTR2 expression in vivo in benign thyroid pathologies are still limited with a very small sample size [14][15][16][17][18][19][20].…”

Novel Approaches to the Management of Graves` Ophthalmopathy

“…Octreoscan positivity is higher in Graves' patients with than in those without ophthalmopathy 11 ; in patients with active than in those with inactive GO [11][12][13] ; in patients with recent-onset than in those with longstanding eye disease 12 . Octreoscan positivity correlates with other indicators of activity of the ophthalmopathy, such as high CAS 10 or T2-relaxation time of the extraocular muscles at magnetic resonance imaging 14 . Thus, a positive octreoscan is an indicator of GO activity 15 and may predict a subsequent favorable response not only to SMSa therapy but also to high-dose glucocorticoids and/or orbital radiotherapy 11,[16][17][18] .…”

“…Side effects of this treatment are very limited. These promising results must, however, be weighed against the following considerations: i) The number of patients so far treated is too small (Table 3); ii) Most published studies are nonrandomized or uncontrolled; iii) A selection bias was probably applied in some stud- treotide and lanreotide) for the management of severe and active GO derives from the observation that SMS receptors can be visualized in vivo in the orbital tissue of GO patients by 111 In-DTPA-D-Phe-octreotide scintigraphy (octreoscan) 10 . Octreoscan positivity is higher in Graves' patients with than in those without ophthalmopathy 11 ; in patients with active than in those with inactive GO [11][12][13] ; in patients with recent-onset than in those with longstanding eye disease 12 .…”