title: Hilar and pancreatic gallium-67 accumulation is characteristic feature of autoimmune pancreatitis.
abstract: OBJECTIVE
  Autoimmune pancreatitis is characterized by severe lymphocytic inflammation, suggesting that gallium-67 scintigraphy provides a useful tool for detecting characteristic lesions of this disease, because gallium-67 concentrates in lymphoid cells. We tried to determine whether gallium-67 accumulates in the characteristic lesions.
  
  
  METHODS
  We performed gallium-67 scintigraphy in 24 patients with autoimmune pancreatitis before and after 4 weeks of corticosteroid therapy and determined the factors associated with positive images.
  
  
  RESULTS
  Sixteen patients (67%) had marked gallium-67 accumulation in the pancreas before corticosteroid therapy and negative images after 4 weeks of therapy, and they had significantly higher serum IgG4 values than did those without gallium-67 accumulation (median, 758 mg/dL versus 329 mg/dL; p = 0.011). Marked hilar gallium-67 accumulation was found in 16 patients (67%) and was also associated with significantly higher serum IgG4 values than did those without it (median, 758 versus 239 mg/dL; p = 0.0044). Among 16 patients with positive hilar images, 12 had positive pancreatic uptake and 5 had both pancreatic and salivary gland uptakes.
  
  
  CONCLUSIONS
  Hilar and pancreatic accumulation of gallium-67 is a characteristic feature of autoimmune pancreatitis during the active stage of the disease, when IgG4 serum levels are high.
authors.affiliation: Second Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Hisanobu
authors.initials: H
authors.lastname: Saegusa
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Momose
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Kawa
authors.forename: Hideaki
authors.initials: H
authors.lastname: Hamano
authors.forename: Yasuhide
authors.initials: Y
authors.lastname: Ochi
authors.forename: Mari
authors.initials: M
authors.lastname: Takayama
authors.forename: Kendo
authors.initials: K
authors.lastname: Kiyosawa
authors.forename: Masumi
authors.initials: M
authors.lastname: Kadoya
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D001327:Autoimmune Diseases / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000378:metabolism*; D005260:Female; D005710:Gallium Radioisotopes / Q000493:pharmacokinetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000378:metabolism*; D010195:Pancreatitis / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000378:metabolism*; D011877:Radionuclide Imaging; D012469:Salivary Glands / Q000378:metabolism
chemical_list: D000305:Adrenal Cortex Hormones; D005710:Gallium Radioisotopes