Purchase this article with an account.
B.L. Tannen, R.E. Turbin, P.D. Langer, N.V. Ghesani, L.S. Zuckier, D.S. Chu; Correlation Between Gallium Scintigraphy Uptake and Lacrimal Gland Biopsy in Patients Suspected of Sarcoidosis . Invest. Ophthalmol. Vis. Sci. 2006;47(13):586.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To investigate whether the intensity of lacrimal gland uptake on gallium scintigraphy correlates with lacrimal gland biopsy results in patients suspected of sarcoidosis.
Restrospective chart review over the past 5 years at our institution was performed. We identified 27 patients suspected of sarcoidosis who underwent gallium scintigraphy to evaluate uptake in the lacrimal gland and subsequently had a lacrimal gland biopsy. The amount of lacrimal gland uptake was assessed using both a subjective visual scaling method and a semiquantitative method based on region of interest (ROI) analysis. Using the visual scaling method, two experienced readers segregated uptake into three categories (mild, moderate, and intense) depending upon visual comparison of intensity in the lacrimal region relative to internal stardards. Semiquantitative ROI analysis compared peak lacrimal counts normalized to liver activity. Using statistical analysis, the amounts of lacrimal uptake from both the scaled method and ROI analysis were compared with lacrimal gland biopsy results to determine: (1) whether a correlation exists between the amount of lacrimal uptake and biopsy positivity; and (2) whether that correlation is enhanced by use of semiquantitative ROI analysis.
Nine of twenty–seven patients (33%) had biopsy results suggestive of sarcoidosis consisting of noncaseating granulomas. Increased gallium uptake using both visual scaling and ROI analysis appears to directly correlate with increased biopsy positivity. Among patients with only mild gallium uptake by visual scaling (6 of 27), none had a positive biopsy. Among patients with moderate uptake (9 of 27), three or 33% had positive biopsies. Among patients with intense uptake (12 of 27), six or 50% had a positive biopsy.
Lacrimal gland biopsy positivity appears to be directly correlated to the amount of uptake on gallium scintigraphy, whether by subjective visual scaling or by semiquantitative ROI analysis. Both methods appear to predict biopsy results and may aid in patient selection for lacrimal gland biopsy. In cases where only mild uptake is seen, biopsy may not be warranted. A more standardized approach to reading and reporting gallium scan results may be useful in the evaluation of patients with suspected sarcoidosis.
This PDF is available to Subscribers Only