Absolute Quantitative Evaluation of 67Ga Scintigraphy in Lupus Nephritis

Role of [68Ga]-pentixafor positron emission tomography/computed tomography imaging in assessing disease activity in patients with lupus nephritis: A pilot study

OBJECTIVE

The primary objective of our study was to evaluate renal uptake of 68Ga-pentixafor in patients with lupus nephritis. Eighteen patients who satisfied the inclusion criteria were included in our study.

METHODS

The study participants were patients with histopathologically confirmed lupus nephritis who were referred to our department for 68Ga-pentixafor PET/CT scan. We studied the renal images in these patients for uptake patterns based on purely visual as well as semi-quantitative parameters. The visual parameters included uptake relative to the spleen and liver. Semi-quantitative analysis involved the uptake as given by SUVmax. These parameters were correlated with the patients' biochemical as well as histological parameters. Kendall's tau-b test was used to look for an association between renal uptake by visual assessment and histopathological findings. Mean SUVmax values were compared by using the Mann-Whitney U test and a p value < .05 was considered to be statistically significant.

RESULTS

No significant association between the mean renal SUVmax of the bilateral kidneys in pentixafor PET and histopathological class was observed. We did not observe any heterogeneity in uptake patterns that could be attributed to the disease process in our patients.

CONCLUSION

68Ga-pentixafor PET is not a suitable imaging modality for assessment of disease activity in lupus nephritis patients. There is a void in non-invasive testing for patients with this chronic and often disabling condition which calls for further research in this area.

Usefulness of gallium-67 scintigraphy for evaluating the histopathological activity in interstitial nephritis

BACKGROUND

Interstitial nephritis is a common cause of renal failure. Gallium-67 scintigraphy is reportedly useful for diagnosing interstitial nephritis; however, its ability to assess disease activity remains unknown. We aimed to analyze the relationship between the renal uptake of gallium-67 and the disease activity in interstitial nephritis.

METHODS

We retrospectively analyzed the data of patients who underwent gallium-67 scintigraphy at a hospital in Tokyo. The renal uptake adjusted for the soft tissues beneath the kidneys was semi-quantitatively evaluated. We compared the renal uptake levels between patients clinically diagnosed with and without interstitial nephritis. Among those undergoing renal biopsy, we evaluated the predictive ability of gallium-67 scintigraphy and analyzed the renal uptake levels regarding the disease activity through a histopathological analysis.

RESULTS

We included 143 patients; among them, 30, 17, and 96 patients were clinically diagnosed with interstitial nephritis, other kidney diseases, and non-kidney diseases, respectively. The renal uptake of gallium-67 was the highest among patients with interstitial nephritis. Among the 25 patients who underwent renal biopsy, 15 were pathologically diagnosed with interstitial nephritis. The renal uptake levels showed a high discriminative ability (C-statistic: 0.83). Furthermore, net reclassification improvement with the addition of gallium-67 scintigraphy to N-acetyl-β-D-glucosaminidase for the prediction of interstitial nephritis was 1.14. Histopathological analysis revealed a positive correlation between renal uptake and inflammation in the cortex and peritubular capillaries.

CONCLUSIONS

This study confirmed the diagnostic value and potential usefulness of gallium-67 scintigraphy for evaluating interstitial nephritis.

Gallium-67 SPECT-CT for the evaluation of head and neck: preliminary study on maximum standardised uptake value in lesions, and in the parotid and submandibular glands

Purpose

The aim of this study was to investigate the gallium-67 (⁶⁷Ga) single-photon emission-computed tomography (SPECT-CT) for the evaluation of head and neck, especially maximum standardised uptake value (SUV_max) in lesions, and in the parotid and submandibular glands.

Material and methods

Fourteen patients with head and neck lesions who underwent SPECT-CT at 72 hours after injection of ⁶⁷Ga were included in this study. The ⁶⁷Ga SPECT-CT parameters SUV_max were compared between the parotid glands and submandibular glands. Statistical analyses for the SUV_max were performed by Mann-Whitney U test. A p value lower than 0.05 was considered as statistically significant.

Results

Of all 14 patients, ⁶⁷Ga SPECT-CT was positive for two cases (one malignant lymphoma and one osteomyelitis). The SUV_max for malignant lymphoma and osteomyelitis were 11.21 and 10.95, respectively. Furthermore, SUV_max for parotid glands and submandibular glands of all patients were 4.86 ± 1.89 and 4.64 ± 1.64, respectively (p = 0.694).

Conclusions

This study investigated the ⁶⁷Ga SPECT-CT for the evaluation of head and neck, especially SUV_max of lesions, and the parotid and submandibular glands. ⁶⁷Ga SPECT-CT may be an effective technique for the evaluation of maxillofacial lesions.

Comparison between squamous cell carcinoma and inflammatory diseases of the oral and maxillofacial region using gallium-67 scintigraphy with computed tomography and magnetic resonance imaging

Purpose

This study aimed to compare squamous cell carcinoma (SCC) with inflammatory diseases of the oral and maxillofacial region using gallium 67 (⁶⁷Ga) scintigraphy with computed tomography (CT) and magnetic resonance imaging (MRI).

Material and methods

Seventy patients with SCC and 15 patients with inflammatory diseases of the oral and maxillofacial region underwent ⁶⁷Ga scintigraphy with CT and MRI. A comparison between imaging features of ⁶⁷Ga scintigraphy, CT, and MRI and lesions was performed with the Pearson’s chi-squared test.

Results

⁶⁷Ga scintigraphy was positive for 25 of 39 patients with SCC positive on CT and/or MRI (64.1%) and for 13 of 15 patients with inflammatory diseases positive on CT and/or MRI (86.7%). The detection of inflammatory diseases with ⁶⁷Ga scintigraphy was higher than that of SCC (p = 0.104).

Conclusions

This study compared SCC with inflammatory diseases of the oral and maxillofacial region using ⁶⁷Ga scintigraphy with CT and MRI. ⁶⁷Ga scintigraphy is an effective technique for detection of inflammatory diseases of the oral and maxillofacial region.