Pertechnetate Salivary Gland Scintigraphy Research Articles

Scintigraphic evaluation of salivary gland function in thyroid cancer patients after radioiodine remnant ablation.

Radioiodine (131I, RAI) has traditionally been used in thyroid cancer treatment but its benefit should be balanced against possible risks. Among them, salivary gland dysfunction has often been discussed, although the reported data have been inconsistent. The aim of our prospective study was to evaluate salivary gland function in 31 thyroidectomised patients (6 men, 25 women; median age 52 yr) before and 4–6 months after RAI remnant ablation (RRA), using activity of 3.7 GBq 131I‐NaI. Salivary gland uptake and excretion fractions were quantitatively assessed with 99mTc – pertechnetate salivary gland scintigraphy. Pre‐ and post‐treatment values were compared using Wilcoxon signed rank test. No statistically significant difference in the pre‐ and post‐treatment values was observed in parotid or submandibular glands uptake, or in the parotid or submandibular excretion fractions. The calculated power for minimum relevant difference of 25% with the sample size of 31 ranged between 86% and 96% for the individual variables, making our negative results reasonably reliable. The results suggest that RRA with the most commonly used activity of 3.7 GBq has no important impact on salivary gland function. Therefore, the concerns about putative salivary gland functional deterioration following RRA are probably unjustified.

Evaluation of Sialendoscopy-Assisted Treatment of Submandibular Gland Stones

The aim of the present study was to evaluate the therapeutic efficiency of sialendoscopy-assisted operations in the treatment of submandibular gland stones. The data from 8 patients with sialolithiasis who underwent sialendoscopy from August 2015 to January 2016 at the Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University (Shenyang, China) were retrospectively reviewed. All the patients had undergone preoperative technetium-99m pertechnetate salivary gland scintigraphy. The results revealed that the salivary glands exhibited normal or slightly reduced uptake and excretion dysfunction. Computed tomography examinations revealed stones located in the intraductal area near the glands or in the branches that could not be removed owing to their deep locations within the mouth. Therefore, an endoscope was inserted, the stones were located intraductally using sialendoscopy, and a transcervical incision was made to remove the stones and preserve the submandibular gland. The stones were completely removed, and the submandibular gland was preserved in all cases. The patients recovered well postoperatively, and no complications developed. Our results suggest that sialendoscopy-assisted sialolithectomy is an effective and safe surgical technique for the removal of proximal and intraglandular submandibular gland stones. The patients' quality of life had obviously improved postoperatively.

The Diagnostic Value of Technetium 99m Pertechnetate Salivary Gland Scintigraphy in Patients With Certain Salivary Gland Diseases

To evaluate the diagnostic value of technetium 99m pertechnetate salivary gland scintigraphy in patients with certain salivary gland diseases. We evaluated 47 patients: 25 with chronic obstructive parotitis, 12 with sialolithiasis, and 10 with Sjögren syndrome. All of the patients underwent preoperative (99m)Tc-pertechnetate salivary gland scintigraphy. Patients with chronic obstructive parotitis also underwent ultrasonography, sialography, and sialoendoscopy; patients with sialolithiasis also underwent ultrasonography and computed tomography; and patients with Sjögren syndrome also underwent ultrasonography and sialography. We made comparisons between (99m)Tc-pertechnetate salivary gland scintigraphy and the other aforementioned diagnostic tests to investigate the role of (99m)Tc-pertechnetate salivary gland scintigraphy in diseases of the salivary glands. In patients with chronic obstructive parotitis, (99m)Tc-pertechnetate salivary gland scintigraphy showed reduced excretion by the affected glands, whereas uptake was nearly normal. Among patients with sialolithiasis, (99m)Tc-pertechnetate salivary gland scintigraphy showed reduced excretion by the affected glands and decreased uptake in 5 patients. In patients with Sjögren syndrome, (99m)Tc-pertechnetate salivary gland scintigraphy showed a decrease in both excretion and uptake by the 4 glands. Technetium 99m pertechnetate salivary gland scintigraphy played a substantial role in the diagnosis and differential diagnosis of salivary gland diseases.

Evaluation of salivary gland function in allergic rhinitis patients by [99mTc] pertechnetate salivary gland scintigraphy

Abstract The purpose of this study was to compare the quantitative parameters of salivary gland functions in patients with allergic rhinitis and healthy volunteers using [99mTc] pertechnetate salivary gland scintigraphy. Thirty-six patients with allergic rhinitis (14 males and 22 females, mean age 30.6 ± 5.2 years) and thirty-nine healthy controls (18 males and 21 females, mean age 32.2 ± 5.6 years) were evaluated. Dynamic salivary gland scintigraphy was performed after intravenous administration of 185 MBq (5 mCi) of [99mTc] pertechnetate for 25 minutes. Lemon juice was used to stimulate the salivary glands. On the basis of the time-activity curves, the following glandular function parameters were calculated for the parotid and submandibular salivary glands: uptake ratio, maximum accumulation, and ejection fraction. Statistically, all the functional parameters of the parotid and submandibular glands obtained for the allergic rhinitis patients were significantly lower than those of the healthy controls group (p < 0.05). This study demonstrated that there was a significant difference in salivary gland function between patients with allergic rhinitis and healthy controls, which can easily be evaluated by [99mTc] pertechnetate salivary gland scintigraphy.

Using Tc-99m Pertechnetate Scintigraphy to Predict the Outcome of Sialoendoscopy in Obstructive Submaxillaritis

The purpose of this study was to investigate whether the findings of Tc-99m pertechnetate salivary gland scintigraphy (SGS) can predict the outcome of sialoendoscopic intervention in patients with obstructive submaxillaritis. Eleven patients with obstructive submaxillaritis were prospectively recruited. All patients underwent sialoendoscopy. Tc-99m pertechnetate SGS was performed both before and after sialoendoscopy. Sialoendoscopy was effective in the glands with tracer uptake (n = 9) demonstrated on SGS before the procedure, evidenced by not only relief of the symptoms but also improvement in excretion in post therapy salivary gland scintigraphy. In contrast, sialoendoscopy was ineffective in the glands without tracer uptake (n = 2) in pretherapy scans. In patients with submaxillaritis, whether a sialoendoscopy should be performed depends on the results of salivary gland scintigraphy.

Effects of gender and age on the quantitative parameters of [99mTc]pertechnetate salivary gland scintigraphy in normal subjects

To assess the effect of gender and age on [99mTc]pertechnetate salivary gland scintigraphy (SGS) in healthy subjects. The study population consisted of 93 normal subjects (46 women, 47 men; age range 20-59 years). The subjects were categorized into eight (four female and four male) subgroups according to age decades. Dynamic SGS was performed after intravenous injection of 370 MBq [99mTc]pertechnetate. Anterior salivary gland images were acquired for 30 min. On the basis of the time-activity curves, three functional parameters were calculated for the parotid and submandibular salivary glands: (1) the first minute uptake ratio, (2) the maximum uptake ratio, and (3) the maximum secretion percentage. For women, all parotid and submandibular functional parameters had a peak in the fourth decade group. The comparison of four age groups in the female subjects showed significant differences, except for the third versus the fifth decades, at least for one parameter. The number of significant differences was highest in the comparison between the second versus the fourth decades. Among men, the highest values for all parotid and submandibular parameters were in the second decade, except for the first minute uptake ratio in the submandibular gland. The number of parameters that were significantly different among the four age groups in men was lower than in women. The first minute uptake ratio of the submandibular gland had the most significant differences among the groups of male subjects. Age and gender differences have a significant effect on salivary gland functions which is more apparent in women than in men.

Diagnostic Value of FDG PET and Salivary Gland Scintigraphy for Parotid Tumors

The purpose of this study was to examine the diagnostic value of the combination of F-18 fluorodeoxyglucose (FDG) PET and Tc-99m pertechnetate salivary gland scintigraphy in parotid tumors. Seventy-two patients with benign parotid gland tumors (n = 52), malignant parotid tumors (n = 12), and inflammation (n = 8) underwent both FDG PET and salivary gland scintigraphy within 1 week, and 66 of the patients also underwent gallium scintigraphy. All patients were negative on their first fine-needle aspiration (FNA). Malignant parotid tumors showed significantly higher FDG uptake (standard uptake values [SUVs]) than both benign tumors and inflammation, except in Warthin's tumor (5.82 +/- 3.95 vs. 2.07 +/- 1.33; P <0.01). Although the SUV values of Warthin's tumor and malignant parotid tumors overlapped somewhat, Warthin's tumor did demonstrate increased radiotracer uptake, and it was reliably distinguished from other parotid gland tumors by the use of salivary gland scintigraphy. Considering a SUV value >3 as being positive for malignancy and excluding Warthin's tumor on the basis of salivary gland scintigraphy, sensitivity and specificity of FDG PET were 75% and 80%, respectively. These results were superior to those of gallium scintigraphy (58% and 72%, respectively). Although the diagnostic value of FDG PET in the differentiation of malignant from benign parotid gland tumors was limited because of the high FDG uptake in some benign tumors, and particularly pleomorphic adenomas, combining salivary gland scintigraphy with FDG PET may help to negate this drawback, and this combination may be a more promising approach for differentiation of various parotid gland tumors in patients compared with nondiagnostic needle aspiration.

Discordance of Sialography and Scintigraphy in Unilateral Chronic Sialadenitis

A Tc-99m pertechnetate salivary gland scintigraphy, digital subtraction sialography (DSS) and cytological findings of a 48-year-old female who received I-131 therapy for the treatment of follicular carcinoma of thyroid are presented. Post radioiodine therapy sialoscintigraphy showed increased blood flow and uptake with decreased secretion in the left parotid gland suggesting acute inflammation. In contrast, DSS and fine needle aspiration biopsy (FNAB) findings were consistent with chronic sialoadenitis. Follow-up scintigraphy one month later showed normal blood flow and decreased uptake and confirmed the diagnosis of chronic sialoadenitis. In right of this case, we conclude that since management of sialoadenitis depends on the stage of inflammation scintigraphic findings should be interpreted together with radiology and FNAB findings if necessary. When chronic sialoadenitis is followed by acute exacerbations, diagnosis based exclusively on sialoscintigraphic findings may result in inadequate patient management.