Jiang Chengzhi, Deng Zilong, Huang Jin, Deng Haoyu, Tan Jia, Li Xinhui, Zhao Min
Department of Nuclear Medicine, Xiangya Hospital, Central South University, Changsha, China.
Department of PET-CT Center, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.
Front Med (Lausanne). 2021 Dec 16;8:791131. doi: 10.3389/fmed.2021.791131. eCollection 2021.
To investigate single-photon emission computed tomography/computed tomography (SPECT/CT) for assessing inflammation in the extraocular muscles (EOMs) and predicting the therapeutic efficacy of periocular glucocorticoid therapy (PGT) for Grave's ophthalmopathy (GO). A total of 412 eyes from 206 patients with GO referred for Tc-DTPA orbital SPECT/CT were enrolled. Fourteen age- and gender-matched healthy controls (28 eyes) were included. The thickness and uptake ratio (UR) of four EOMs were derived from SPECT/CT. Eighty-six eyes from patients with GO patients received PGT. Changes in SPECT/CT parameters were evaluated between the pre- and post-treatment. 195 eyes and 217 eyes were classified as active and inactive stages by clinical activity score (CAS). Values of the thickness and UR of each EOM, T, and U were all significantly higher in the active GO than in the inactive GO and controls ( < 0.01). Among the 86 eyes (48 GO patients) included in the efficacy analysis, 56 eyes and 30 eyes were classified as responders and non-responders. Values of thicknesses and UR of each EOM, the maximum thickness (T), and the maximum UR (U) all dropped following PGT in the responders ( < 0.01). Logistic regression analysis identified the U as an independent predictor for the responders ( < 0.01). Moreover, the U demonstrated incremental predictive value over clinical characters and CAS, as evidenced by the improved area under the curve (0.85 vs. 0.78) and global chi-square (34.12 vs. 18.1). Tc-DTPA SPECT/CT has the potential to assess inflammatory activity by detecting the involvement of EOMs in GO. Pre-treatment UR provides independent and incremental values for the prediction of PGT treatment response.
研究单光子发射计算机断层扫描/计算机断层扫描（SPECT/CT）用于评估眼外肌（EOM）炎症以及预测眼眶糖皮质激素治疗（PGT）对格雷夫斯眼病（GO）的治疗效果。纳入了206例因GO接受锝-二乙三胺五乙酸（Tc-DTPA）眼眶SPECT/CT检查的患者的412只眼。纳入了14名年龄和性别匹配的健康对照者（28只眼）。从SPECT/CT得出四条EOM的厚度和摄取率（UR）。86只GO患者的眼接受了PGT。评估治疗前后SPECT/CT参数的变化。根据临床活动评分（CAS），195只眼和217只眼被分类为活动期和非活动期。活动期GO中每条EOM的厚度和UR值、T和U均显著高于非活动期GO和对照组（P<0.01）。在纳入疗效分析的86只眼（48例GO患者）中，56只眼和30只眼被分类为反应者和无反应者。反应者接受PGT后，每条EOM的厚度和UR值、最大厚度（T）和最大UR（U）均下降（P<0.01）。逻辑回归分析确定U是反应者的独立预测因素（P<0.01）。此外，U在预测价值上高于临床特征和CAS，曲线下面积改善（0.85对0.78）和整体卡方检验（34.12对18.1）证明了这一点。Tc-DTPA SPECT/CT有潜力通过检测GO中EOM的受累情况来评估炎症活动。治疗前的UR为预测PGT治疗反应提供了独立且递增的价值。
