Abstract
Purpose
We ascertained the difference in the level of pulmonary hilar (PH) gallium-67 (Ga-67) uptake in autoimmune pancreatitis (AIP) patients between the active (before corticosteroid therapy) and remittent (after 4 weeks of corticosteroid therapy) phases using a semiquantitative measurement method based on single photon emission computed tomography (SPECT) with integrated low-dose computed tomography (CT).
Materials and methods
Ga-67 planar scans and SPECT were performed in 11 AIP patients before and after 4 weeks of corticosteroid therapy. A region of interest (ROI) was drawn over the bilateral pulmonary hilum and the liver, and average counts of the pulmonary hilum and liver were calculated. The average counts of the pulmonary hilum divided by those of the liver gave the pulmonary hilum/liver ratio (H/L).
Results
A significant difference was observed in the H/L between active and remittent phases. H/L in the active phase was 1.03 ± 0.32 and that in the remittent phase was 0.58 ± 0.25 (t-test, P = 0.0016).
Conclusions
PH Ga-67 uptake in patients with active AIP was semiquantitatively higher than that in those with remittent AIP. Hence, this may be a useful finding for an early diagnosis, estimating the effectiveness of corticosteroid therapy, and following up patients with this disease.
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References
Sarles H, Sarles JC, Muratore R, Guien C. Chronic inflammatory sclerosis of the pancreas: an autonomous pancreatitis disease? Am J Dig Dis 1961;6:688–698.
Sarles H, Sarles JC, Camatte R, Muratore R, Gaini M, Guien C, et al. Observations on 205 confirmed cases of acute pancreatitis, recurring pancreatitis, and chronic pancreatitis. Gut 1965;6:545–559.
Yoshida K, Toki F, Takeuchi T, Watanabe S, Shiratori K, Hayashi N. Chronic pancreatitis caused by an autoimmune abnormality, proposal of the concept of autoimmune pancreatitis. Dig Dis Sci 1995;40:1561–1568.
Horiuchi A, Kaneko T, Yamamura N, Nagata A, Nakamura T, Akamatsu T, et al. Autoimmune chronic pancreatitis simulating pancreatic lymphoma. Am J Gastroenterol 1996;91:2607–2609.
Ito T, Nakano I, Koyanagi S, Miyahara T, Migita Y, Ogoshi K, et al. Autoimmune pancreatitis as a new clinical entity: three cases of autoimmune pancreatitis with effective steroid therapy. Dig Dis Sci 1997;42:1458–1468.
Motoo Y, Minamoto T, Watanabe H, Skai J, Okai T, Sawabu N. Sclerosing pancreatitis showing rapidly progressive changes with recurrent mass formation. Int J Pancreatol 1997;21:85–90.
Erkelens GW, Vleggaar FP, Lesterhuis W, van Buuren HR, van der Werf SD. Sclerosing pancreatico-cholangitis responsive to steroid therapy. Lancet 1999;354:43–44.
Horiuchi A, Kawa S, Hamano H, Ochi Y, Kiyosawa K. Sclerosing pancreato-cholangitis responsive to corticosteroid therapy: report of 2 case reports and review. Gastrointest Endosc 2001;53:518–522.
Hamano H, Kawa S, Ochi Y, Unno H, Shiba N, Wajiki M, et al. Hydronephrosis associated with retroperitoneal fibrosis and sclerosing pancreatitis. Lancet 2002;359:1403–1404.
Horiuchi A, Kawa S, Akamatsu T, Aoki Y, Mukawa K, Furuya N, et al. Characteristic pancreatic duct appearance in autoimmune chronic pancreatitis: a case report and review of the Japanese literature. Am J Gastroenterol 1998;93:260–263.
Wakabayashi T, Motoo Y, Kojima Y, Makino H, Sawabu N. Chronic pancreatitis with diffuse irregular narrowing of the main pancreatic duct. Dig Dis Sci 1998;43:2415–2425.
Horiuchi A, Kawa S, Hamano H, Hayama M, Ota H, Kiyosawa K. ERCP features in 27 patients with autoimmune pancreatitis. Gastrointest Endosc 2002;55:494–499.
Saegusa H, Momose M, Kawa S, Hamano H, Ochi Y, Takayama M, et al. Hilar and pancreatic gallium-67 accumulation is characteristic feature of autoimmune pancreatitis. Pancreas 2003;27:20–25.
Fujinaga Y, Kadoya M, Kawa S, Hamano H, Ueda K, Momose M, et al. Characteristic findings in image of extrapancreatic lesions associated with autoimmune pancreatitis. Eur J Radiol 2009; Jul 4. [Epub ahead of print].
Okazaki K, Uchida K, Ohana M, Nakase H, Uose S, Inai M, et al. Autoimmune-related pancreatitis is associated with autoantibodies and Th1/Th2-type cellular immune response. Gastroenterology 2000;118:573–581.
Okazaki K, Uchida K, Chiba T. Recent concept of autoimmune-related pancreatitis. J Gastroenterol 2001;36:293–302.
Kawa S, Ota M, Yoshizawa K, Horiuchi A, Hamano H, Ochi Y, et al. HLA DRB10405-DQB10401 haplotype is associated with autoimmune pancreatitis in the Japanese population. Gastroenterology 2002;122:1264–1269.
Hamano H, Kawa S, Horiuchi A, Unno H, Furuya N, Akamatsu T, et al. High serum IgG4 concentrations in patients with sclerosing pancreatitis. N Engl J Med 2001;344:732–738.
Members of the Criteria Committee for Autoimmune Pancreatitis of the Japan Pancreas Society. Diagnostic criteria for autoimmune pancreatitis by the Japan Pancreas Society. Suizo (J Jpn Pancreas Soc) 2002;17:585–587 (in Japanese with English abstract).
Matsubayashi H, Furukawa H, Maeda A, Matsunaga K, Kanemoto H, Uesaka K, et al. Usefulness of positron emission tomography in the evaluation of distribution and activity of systemic lesions associated with autoimmune pancreatitis. Pancreatology 2009;9:694–699.
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Momose, M., Kadoya, M., Yano, K. et al. Semiquantitative measurement of pulmonary hilar gallium-67 uptake using single photon emission computed tomography/computed tomography for the diagnosis of autoimmune pancreatitis. Jpn J Radiol 28, 733–739 (2010). https://doi.org/10.1007/s11604-010-0502-5
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DOI: https://doi.org/10.1007/s11604-010-0502-5