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Correlation of Lung Gallium-67 Scintigraphy with Lung X-Ray and Pulmonary Function Tests in Patients with Sarcoidosis

Antonija Ivičević
Tatjana Peroš-Golubičić
Dražen Huić
Stanko Težak
Marjan Gorečan
Jasna Tekavec-Trkanjec
Marija Alilović

Sažetak

In order to assess the usefulness of Ga-67 scintigraphy in the evaluation of sarcoidosis activity, 44 patients including 14, 20 and 10 patients with radiologic stage I, II and III, respectively, were examined. Control group consisted of 22 subjects with healthy lungs who underwent Ga-67 scintigraphy for extrathoracic disease. An objective method of quantitative computer analysis was used on scintigram interpretation. Results were expressed as mean impulse count per pixel of the given area in the left and right hilar region, left and right lung, and in the area of focal accumulation if present. In sarcoidosis patients, the mean impulse count was statistically significantly higher in all regions than in the control group (p<0.0001 for left hilum, right hilum and right lung; and p<0.001 for left lung). The mean impulse count showed correlation with pathologic finding. Pathologic accumulation of Ga-67 in the hilar region was evident in 37 (84.1%) patients, and in the region of pulmonary parenchyma in 31 (70.5%) patients, and showed statistically significant correlation with radiologic staging of sarcoidosis (p<0.01). However, scintigraphy supplemented radiologic staging by providing additional information on the disease extent. In 35.7% of patients with X-ray stage I sarcoidosis, scintigraphy revealed pathologic accumulation of Ga-67 also in pulmonary parenchyma, whereas in as many as 70% of patients with X-ray stage III sarcoidosis the pathologic accumulation of Ga-67pointed to the disease activity in the lymph nodes of the hilum. Only three (6.7%) patients were free from any form of pathologic Ga-67 accumulation. The patients with pathologic Ga-67 accumulation in the lung parenchyma (n=31) had a more severe form of the disease with lower values of pulmonary function tests, i.e. forced vital capacity (FVC), forced expiratory volume in first second (FEV 1), diffusion capacity for carbon monoxide (DLCO) and arterial blood partial oxygen pressure (pO 2). Forced vital capacity as an indicator of ventilation restrictive impairments was statistically significantly lower in the group of patients with pathologic accumulation of Ga-67 in pulmonary parenchyma as compared with the group of patients without it (p<0.01). The decrease in diffusion capacity correlated statistically significantly with the increase in the pathologic accumulation of Ga-67 in pulmonary parenchyma (p<0.01). Thus, lung Ga-67scintigraphy was found to be a highly sensitive marker of the extent and activity of sarcoidosis, however, due to the low specificity of the method its use in good clinical practice should be reserved for diagnostically and therapeutically vague cases, with due consideration of the irradiation dose and cost.

Ključne riječi

Lung diseases, radiography; Lung diseases, radionuclide imaging; Sarcoidosis, diagnosis; Sarcoidosis, radiography; Gallium radioisotopes, diagnostic use

Hrčak ID:

14589

URI

https://hrcak.srce.hr/14589

Datum izdavanja:

2.6.2003.

Podaci na drugim jezicima: hrvatski

Posjeta: 3.108 *