Application of quantitative orbital analysis to assess the activity of Graves' ophthalmopathy

Shuang Li; Yue-Jun Liu

Application of quantitative orbital analysis to assess the activity of Graves' ophthalmopathy

Am J Nucl Med Mol Imaging. 2023 Dec 25;13(6):259-268. eCollection 2023.

Authors

Shuang Li¹, Yue-Jun Liu²

Affiliations

¹ Department of Nuclear Medicine, Xiangyang No. 1 People's Hospital, Hubei University of Medicine Xiangyang 441000, Hubei, China.
² Department of Ophthalmology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine Xiangyang 441000, Hubei, China.

PMID: 38204608
PMCID: PMC10774606

Abstract

This study aimed to evaluate the diagnostic value of uptake ratios in the extraocular muscles (EOMs), lacrimal glands, and optic nerves to detect the inflammation activity of Graves' ophthalmopathy (GO) using quantitative analysis of 99m technetium (^99mTc)-labeled diethylene triamine pentaacetic acid (DTPA) orbital single-photon emission computed tomography/computed tomography (SPECT/CT) images. The patients were categorized into an active stage (clinical activity score ≥ 3/7, n=23) or an inactive stage (clinical activity score < 3/7, n=38), based on their clinical activity score. The uptake ratio was manually determined by placing a region of interest within the area of highest uptake, as agreed upon by consensus, in the EOMs, lacrimal gland, and optic nerve on SPECT images corrected for CT attenuation. Patients with active GO exhibited significantly higher uptake ratios in the EOMs, lacrimal glands, and optic nerves compared to patients with inactive GO (all P < 0.01). These parameters have been proven effective in differentiating between active and inactive disease.

Keywords: 99mTc-DTPA; Graves’ ophthalmopathy; extraocular muscle; lacrimal gland; optic nerve; uptake ratio.