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| The value of the radioreceptor imaging in the diagnosis of thyroid associated ophthalmopathy |
| TIAN Jin-ling, CHEN Fei, HAN Yun-feng, DONG Qing-jian, ZHAO Ming, CHEN Jing |
| Department of Nuclear Medicine, Tongji Hospital, Tongji Medical University,Huazhong University of Science and Technology, Wuhan 430030, China |
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Abstract Objective: To investigate the value of 99mTc-OCT SPECT imaging in the diagnosis of thyroid associated ophthalmopathy(TAO). Methods: Nineteen outpatients(38 eyes) in Nuclear Medicine Department whose main complaint is discomfort around the eye area(tearing, photophobia, eye pain, changes in vision, eyelid contracture and exophthalmos) underwent orbital 99mTc-OCT SPECT． Five healthy volunteers(10 eyes) recruited(healthy control group) underwent the same examination. Taking the EUGOGO clinical diagnostic criteria, all outpatients’ eyes were divided into TAO group(30) and non-TAO group(8). According to its clinical activity score(CAS), the TAO group was divided into active group(24) and inactive group(6); and at the same time, the TAO group was divided into mild group(11) and moderate-severe group(19) by the disease severity. Then the ratios of the highest eye radioactive count(T) to the lowest occipital scalp radioactive count(B) in all eyes were calculated, as the eye 99mTc-OCT intake. Receiver operating characteristic(ROC) analysis was employed to define the threshold value of T/B ratio. Results: There is a significant difference in T/B ratio between non-TAO group and healthy control group(t＝2.76, P=0.014), and a highly significant difference between TAO group and healthy control group(t＝5.86, P＜0.001). The significant difference in T/B ratios were still found between TAO group and non-TAO(t=2.78, P=0.009), while a highly significant difference also found between active group and inactive group(t=2.59, P=0.015)． The area under the curve of ROC for TAO group and non-TAO group was 0.821, and 0.854 for active group and inactive group; the threshold value of T/B ratio was 1.637 for identifying TAO, and its sensitivity, specificity and accuracy were 83.3%, 87.5% and 84.2%; the threshold value of T/B ratio for distinguishing between active group and inactive group was 1.674, and its sensitivity, specificity and accuracy was 87.5%, 83.3% and 86.7%, respectively． Conclusion: 99mTc-OCT SPECT imaging combined with semi-quantitative analysis can give more accurate diagnosis in identifying TAO and distinguishing active TAO, and it is helpful to guide the individualized treatment plan for TAO.
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Received: 15 March 2013
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2013, Vol. 24 
