Anzola Luz Kelly, Ramirez Sara, Moreno Sergio, Vargas Camilo, Rojas Sebastian, Rivera José Nelson
Nuclear Medicine Unit, Clinica Reina Sofia, Bogotá 110121, Colombia.
Nuclear Medicine Unit, Clinica Universitaria Colombia, Bogotá 110931, Colombia.
J Clin Med. 2025 Jun 11;14(12):4141. doi: 10.3390/jcm14124141.
Silicone breast implants have been linked to autoimmune/inflammatory syndrome induced by adjuvants (ASIA). This study evaluates the role of Tc-HYNIC-TOC somatostatin receptor scintigraphy in assessing somatostatin-mediated inflammation and the impact of explantation on inflammatory activity. Fifty patients with silicone breast implants and symptoms suggestive of ASIA were evaluated. Pre- and postexplantation imaging was performed using Tc-HYNIC-TOC scintigraphy. Matthews correlation coefficients quantified associations between clinical symptoms and imaging findings, and autoantibody profiles were analysed. Scintigraphy identified a significant uptake in organs associated with autoimmune symptoms, particularly joints and salivary glands. Strong correlations were found between imaging findings and symptoms, including knee pain (MCC = 0.81) and sicca syndrome (MCC = 0.96). Explantation resolved abnormal uptake in the surgical bed, though variable uptake persisted in other organs, reflecting systemic inflammatory heterogeneity. Autoantibody analysis revealed positivity in 66% of patients, with antinuclear antibodies being most frequent (30%). Tc-HYNIC-TOC scintigraphy effectively evaluates organ-specific inflammation in ASIA. Explantation reduces localized inflammation but does not consistently address systemic autoimmune responses. Larger prospective studies are needed to validate these findings and improve management strategies for ASIA.
硅胶乳房植入物与佐剂诱导的自身免疫/炎症综合征(ASIA)有关。本研究评估了Tc-HYNIC-TOC生长抑素受体闪烁扫描在评估生长抑素介导的炎症中的作用以及取出植入物对炎症活动的影响。对50例有硅胶乳房植入物且有ASIA症状的患者进行了评估。使用Tc-HYNIC-TOC闪烁扫描进行取出植入物前后的成像。马修斯相关系数量化了临床症状与成像结果之间的关联,并分析了自身抗体谱。闪烁扫描显示在与自身免疫症状相关的器官,特别是关节和唾液腺中有明显摄取。在成像结果与症状之间发现了强相关性,包括膝关节疼痛(MCC = 0.81)和干燥综合征(MCC = 0.96)。取出植入物后手术部位的异常摄取消失,尽管其他器官中仍存在不同程度的摄取,这反映了全身炎症的异质性。自身抗体分析显示66%的患者呈阳性,其中抗核抗体最为常见(30%)。Tc-HYNIC-TOC闪烁扫描有效地评估了ASIA中器官特异性炎症。取出植入物可减轻局部炎症,但不能始终解决全身自身免疫反应。需要更大规模的前瞻性研究来验证这些发现并改进ASIA的管理策略。