The role of Tc-99m polyclonal human immunoglobulin G scintigraphy in Graves' ophthalmopathy.
OBJECTIVE
The aim of this study was to clarify whether Tc-99m HIG (Polyclonal Human Immunoglobulin G) can image and determine the severity of orbital involvement in patients with Graves' ophthalmopathy.


METHODS
Twenty-six patients between 19 and 56 years old with Graves' ophthalmopathy were examined. All patients received approximately 370 MBq Tc-99m HIG by i.v. injection. Planar and SPECT examination were performed 4 hours after the injection. Visual and semiquantitative evaluations were performed for both orbits by two independent observers,


RESULTS
Clinically active ophthalmopathy patients had noticeably increased orbital accumulation of Tc-99m HIG. In patients with inactive disease, and 14 of 19 had no uptake, whereas 5 patients had orbital radioactivity accumulation. The duration of Graves' ophthalmopathy did not correlate with the presence of active ophthalmopathy and Tc-99m HIG grade. There was no correlation between clinical classification and clinical activity (r = 278). There was a good correlation between clinical activity and the radioactivity grade with r = 0.666 (p = 0.01). The clinical classification closely correlated with Tc-99m HIG grade (r = 0.423, p = 0.05).


CONCLUSIONS
Tc-99m HIG scan can clearly identified clinically active patients, and subclinicial inflammation can be shown by this scintigraphic evaluation. The current preliminary results suggested that Tc-99m HIG SPECT might be useful for the assessment of disease activity in Graves' ophthalmopathy.
Ortapamuk
Hulya
H
Department of Nuclear Medicine, Ankara Numune Hospital, Ankara, Turkey. hortapamuk@yahoo.com
Hoşal
Banu
B
Naldöken
Seniha
S
D000328:Adult; D005123:Eye / Q000000981:diagnostic imaging / Q000378:metabolism; D005260:Female; D006111:Graves Disease / Q000145:classification / Q000150:complications* / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000378:metabolism; D006801:Humans; D007136:Immunoglobulins; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D012720:Severity of Illness Index; D013667:Technetium / Q000493:pharmacokinetics
D007136:Immunoglobulins; D019275:Radiopharmaceuticals; C065376:technetium Tc 99m immunoglobulin; D013667:Technetium