Hilar and pancreatic gallium-67 accumulation is characteristic feature of autoimmune pancreatitis.
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.
Saegusa
Hisanobu
H
Second Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Momose
Mitsuhiro
M
Kawa
Shigeyuki
S
Hamano
Hideaki
H
Ochi
Yasuhide
Y
Takayama
Mari
M
Kiyosawa
Kendo
K
Kadoya
Masumi
M
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
D000305:Adrenal Cortex Hormones; D005710:Gallium Radioisotopes