engleski

Correlation of lung Gallium-67 scintigraphy with lung X-ray and pulmonary function tests in patients with sarcoidosis

In order to assess the usefulness of Ga-67 scintigraphy in the evaluation of sarcoid activity, 44 patients -14 in I, 20 in II and 10 in III radiologic stage of lungs who due to their extrathoracic involvement underwent Ga-67 scintigraphy. To interpret the scintigrams, we used a method of an objective quantitative analysis obtained by computer system, and described our results using an average number of counts per pixel of the region of the interest in the left and right hilar region, left and right lung as well as in the area of focal accumulation if it occured. In sarcoid patients, an average number of counts for each region turned to be significantly higher than that in the control group ( p < 0.0001 for left hilus, the right hilus and the right lung, while p < 0.001 for the left lung). The average number of counts correlates with the radiologic appearance of the disease. Abnormal Ga-67 uptake in the hilar region was apparent in 37 (84.1%) of the patients, while in 31 (70.5%) of the patients it was evident in their lung parenchyma showing a significant correlation with the radiologic stage of sarcoidosis ( p < 0.01). Ga-67 lung scan, following its radiologic staging, olso provided more relevant information about the extent of the disease. Thus in 35.7% of the patients in radiographic stage I abnormal Ga-67 uptake was also present in lung parenchyma, while in 7o% of the patients in radiographic stage III the abnormal Ga-67 uptake demonstrated the activity of the process in hilar lymph nodes. Only 3 patients (6.7%) did not have abnormal Ga-67 uptake in any form. The patients with abnormal Ga-67 uptake in pulmonary parenchyma (31 patients) had significantly worse clinical disease with low levels of pulmonary function tests - forced vital capacity (VC), forced expiratory volume in first second (FEV1), diffusing capacity for carbon monoxide (DLCO) and partial oxygen pressure in arterial blood (pO2). Forces vital capacity as an indicator of restrictive disorders of ventilation was significantly lower in the group of subjects with abnormal 67Ga uptake in pulmonary parenchyma when was compared to the group without abnormal uptake ( p < 0.01). The decrease of diffusing capacity significantly correlates with the increase of abnormal Ga-67 uptake in pulmonary parenchyma ( p < 0.01). Regarding the dose of irradiation and its costs, Ga-67 pulmonary scintigraphy proved to be a very good marker of sarcoid activity which should be applied in a good clinical practice when the diagnostic and therapeutic procedures are doubted.

sarcoidosis; Gallium-67 scintigraphy

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