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Thyroid uptake of 67Ga-citrate is associated with thyroid autoimmunity and hypothyroidism in patients with sarcoidosis

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the association of gallium-67 (67Ga)-citrate thyroid uptake with the presence of thyroid disorders in patients with sarcoidosis (S patients).

Methods

Eighty-four S patients were evaluated by a complete thyroid work-up (neck ultrasound, circulating thyroid hormones and anti-thyroid antibodies, fine-needle aspiration).

Results

In S patients with 67Ga thyroid uptake (respect those without): serum thyroid-stimulating hormone, the titre of anti-thyroid peroxidase (AbTPO) and/or anti-thyroglobulin antibodies (AbTg), and the prevalence of S patients with hypothyroidism or with positive AbTg or AbTPO was significantly higher; a thyroid hypoechoic pattern was more frequent. The prevalence of thyroid nodules was not significantly different between the two groups. Two cases of papillary thyroid cancer were observed in S patients without 67Ga thyroid uptake, whilst no case in those with 67Ga thyroid uptake.

Conclusions

67Ga thyroid uptake is associated with the presence of aggressive autoimmune thyroiditis and hypothyroidism in S patients; thyroid function and ultrasonography should be performed in the presence of 67Ga thyroid uptake.

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References

  1. Sulavik SB, Spencer RP, Weed DA, Shapiro HR, Shiue ST, Castriotta RJ. Recognition of distinctive patterns of gallium-67 distribution in sarcoidosis. J Nucl Med. 1990;31:1909–14.

    PubMed  CAS  Google Scholar 

  2. Leung AN, Brauner MW, Caillat-Vigneron N, Valeyre D, Grenier P. Sarcoidosis activity: correlation of HRCT findings with those of 67Ga scanning, bronchoalveolar lavage, and serum angiotensin-converting enzyme assay. J Comput Assist Tomogr. 1998;22:229–34.

    Article  PubMed  CAS  Google Scholar 

  3. Mana J. Nuclear imaging. 67Gallium, 201thallium, 18F-labeled fluoro-2-deoxy-D-glucose positron emission tomography. Clin Chest Med. 1997;18:799–811.

    Article  PubMed  CAS  Google Scholar 

  4. Ando A, Nitta K, Ando I, et al. Mechanism of gallium 67 accumulation in inflammatory tissue. Eur J Nucl Med. 1990;17:21–7.

    Article  PubMed  CAS  Google Scholar 

  5. Nejmeddine F, Raphael M, Martin A, Le Roux G, Moretti JL, Caillat-Vigneron N. 67Ga scintigraphy in B-cell non-Hodgkin’s lymphoma: correlation of 67Ga uptake with histology and transferrin receptor expression. J Nucl Med. 1999;40:40–5.

    PubMed  CAS  Google Scholar 

  6. Palestro CJ. The current role of gallium imaging in infection. Semin Nucl Med. 1994;24:128–41.

    Article  PubMed  CAS  Google Scholar 

  7. Kostakoglu L, Leonard JP, Kuji I, Coleman M, Vallabhajosula S, Goldsmith SJ. Comparison of fluorine-18 fluorodeoxyglucose positron emission tomography and Ga-67 scintigraphy in evaluation of lymphoma. Cancer 2002;94:879–88.

    Article  PubMed  Google Scholar 

  8. Moreno AJ, Brown JM, Salinas JA, Feaster BL 3rd, Brown TJ. Ga-67 positivity in sarcoidosis of the skin with coincident thyroid uptake of uncertain etiology. Clin Nucl Med. 1984;9:165–6.

    Article  PubMed  CAS  Google Scholar 

  9. Higasi T, Nakayama Y, Murata A, Sugiyama M, Nakamura K. Clinical evaluation of 67 Ga-citrate scanning. J Nucl Med. 1972;13:196–201.

    PubMed  CAS  Google Scholar 

  10. Matsuoka S, Uchiyama K, Shima H, Oishi S, Nojiri Y, Ueno N. Positivity of extrapulmonary Ga-67 uptake in sarcoidosis: thyroid uptake due to chronic thyroiditis and bone uptake due to fibrous dysplasia. Ann Nucl Med. 2001;15:537–9.

    Article  PubMed  CAS  Google Scholar 

  11. Higashi T, Ito K, Nishikawa Y, et al. Gallium-67 imaging in the evaluation of thyroid malignancy. Clin Nucl Med. 1988;13:792–9.

    Article  PubMed  CAS  Google Scholar 

  12. Reuter E, Bethge N, Matthes M, Koppenhagen K. 99 mTc-phosphonates for imaging of amyloid in C-cell carcinoma. Eur J Nucl Med. 1983;8:398–400.

    Article  PubMed  CAS  Google Scholar 

  13. Yoshimura M, Kawamoto A, Nakasone K, et al. Gallium-67 accumulation to the tumor thrombus in anaplastic thyroid cancer. Ann Nucl Med. 2003;17:689–91.

    Article  PubMed  Google Scholar 

  14. Higashi T, Watanabe Y, Yamaguchi M, et al. The relationships between the Ga-67 uptake and nuclear DNA Feulgen content in thyroid tumors: concise communication. J Nucl Med. 1982;23:988–92.

    PubMed  CAS  Google Scholar 

  15. Senga O, Miyakawa M, Shirota H, et al. Comparison of Tl-201 chloride and Ga-67 citrate scintigraphy in the diagnosis of thyroid tumor: concise communication. J Nucl Med. 1982;23:225–8.

    PubMed  CAS  Google Scholar 

  16. Rasmusson B. Scintigraphic studies in patients with medullary carcinoma of the thyroid. Eur J Nucl Med. 1982;7:150–1.

    Article  PubMed  CAS  Google Scholar 

  17. Ogawa T, Kanauchi H, Kammori M, Mimura Y, Ota S, Kaminishi M. Diffuse large B-cell lymphoma in the thyroid gland associated with primary hyperparathyroidism. Int J Clin Oncol. 2007;12:48–51.

    Article  PubMed  Google Scholar 

  18. Bhatnagar P, Sahu M, Jain M, Rawat H, Bhatnagar A, Kashyap R. Ga-67 citrate and Tc-99 m pertechnetate scintigraphy in thyroid lymphoma. Clin Nucl Med. 2004;29:51–2.

    Article  PubMed  Google Scholar 

  19. Nishiyama Y, Yamamoto Y, Yokoe K, Satoh K, Ohkawa M. Diagnosis of thyroid lymphoma and follow-up evaluation using Ga-67 scintigraphy. Ann Nucl Med. 2003;17:351–7.

    Article  PubMed  Google Scholar 

  20. Howman-Giles R, Uren RF, Shaw PJ. Thallium-201 scintigraphy in pediatric soft-tissue tumors. J Nucl Med. 1995;36:1372–6.

    PubMed  CAS  Google Scholar 

  21. Murthy S, Sharkey RM, Goldenberg DM, et al. Lymphoma imaging with a new technetium-99 m labelled antibody, LL2. Eur J Nucl Med. 1992;19:394–401.

    Article  PubMed  CAS  Google Scholar 

  22. Miyamoto S, Kasagi K, Takeuchi R, et al. Ga-67 citrate accumulation in adenomatous goiter. Clin Nucl Med. 1992;17:803–5.

    Article  PubMed  CAS  Google Scholar 

  23. Erjavec M, Auersperg M, Golouh R, Snajder J, Turnsek T. Computer-assisted scanning in evaluation of 67Ga-citrate uptake in thyroid disease. J Nucl Med. 1974;15:810–3.

    PubMed  CAS  Google Scholar 

  24. Castellucci RP, Gardner DF, Haden HT, Adler RA. Autoimmune thyroiditis manifested as a systemic febrile illness: diagnosis by gallium scan and fine needle aspiration biopsy. South Med J. 1989;82:647–9.

    PubMed  CAS  Google Scholar 

  25. Sjoberg RJ, Blue PW, Kidd GS. Gallium-67 uptake by the thyroid associated with progressive systemic sclerosis. Am J Med Sci. 1989;297:42–5.

    Article  PubMed  CAS  Google Scholar 

  26. Bando Y, Notumata K, Toya T, Tanaka N, Fugisawa M. A case of acute exacerbation of Hashimoto’s thyroiditis with a nontender thyroid. Endocr J. 1997;44:603–9.

    Article  PubMed  CAS  Google Scholar 

  27. Jung WK, Slavin JD Jr., Spencer RP. Thyroid lymphoma and Hashimoto’s thyroiditis: Tc-99 m pertechnetate and Ga-67 citrate imaging in two cases. Clin Nucl Med. 1996;21:894–6.

    Article  PubMed  CAS  Google Scholar 

  28. Bando Y, Ushiogi Y, Toya D, Tanaka N, Fujisawa M. Painless thyroiditis associated with severe inflammatory reactions in amyloid goiter: a case report. Endocr J. 2001;48:323–9.

    Article  PubMed  CAS  Google Scholar 

  29. Tembl A, Berna L, Camacho V, Martin JC, Mari C, Flotats A. 67 Ga-citrate scintigraphy as a determiner in the diagnosis of a subacute thyroiditis. Rev Esp Med Nucl. 2001;20:36–9.

    PubMed  CAS  Google Scholar 

  30. Yung BC, Loke TK, Fan WC, Chan JC. Acute suppurative thyroiditis due to foreign body-induced retropharyngeal abscess presented as thyrotoxicosis. Clin Nucl Med. 2000;25:249–52.

    Article  PubMed  CAS  Google Scholar 

  31. Antonelli A, Fazzi P, Fallahi P, Ferrari SM, Ferrannini E. Prevalence of hypothyroidism and Graves disease in sarcoidosis. Chest 2006;130:526–32.

    Article  PubMed  Google Scholar 

  32. Hunninghake GW, Crystal RG. Pulmonary sarcoidosis: a disorder mediated by excess helper T-lymphocyte activity at sites of disease activity. N Engl J Med. 1981;305:429–34.

    PubMed  CAS  Google Scholar 

  33. Hunninghake GW, Gadek JE, Young RC Jr., Kawanami O, Ferrans VJ, Crystal RG. Maintenance of granuloma formation in pulmonary sarcoidosis by T lymphocytes within the lung. N Engl J Med. 1980;302:594–8.

    PubMed  CAS  Google Scholar 

  34. Fazzi P, Solfanelli S, Di Pede F, Begliomini E, Diviggiano E, Giuntini C. Sarcoidosis in Tuscany. A preliminary report. Sarcoidosis 1992;9:123–6.

    PubMed  CAS  Google Scholar 

  35. Solfanelli S, Fazzi P, Diviggiano E, Frediani M, Giuntini C. 67 Ga uptake quantification in pulmonary sarcoidosis. An implement to Line’s method. Sarcoidosis 1991;8:194.

    Google Scholar 

  36. Line BR, Hunninghake GW, Keogh BA, Jones AE, Johnston GS, Crystal RG. Gallium-67 scanning to stage the alveolitis of sarcoidosis: correlation with clinical studies, pulmonary function studies, and bronchoalveolar lavage. Am Rev Respir Dis. 1981;123:440–6.

    PubMed  CAS  Google Scholar 

  37. Antonelli A, Fallahi P, Nesti C, et al. Anti-CD38 autoimmunity in patients with chronic autoimmune thyroiditis or Graves’ disease. Clin Exp Immunol. 2001;126:426–31.

    Article  PubMed  CAS  Google Scholar 

  38. Antonelli A, Rotondi M, Fallahi P, et al. Increase of interferon-gamma inducible alpha chemokine CXCL10 but not beta chemokine CCL2 serum levels in chronic autoimmune thyroiditis. Eur J Endocrinol. 2005;152:171–7.

    Article  PubMed  CAS  Google Scholar 

  39. Antonelli A, Rotondi M, Fallahi P, et al. High levels of circulating CXC chemokine ligand 10 are associated with chronic autoimmune thyroiditis and hypothyroidism. J Clin Endocrinol Metab. 2004;89:5496–9.

    Article  PubMed  CAS  Google Scholar 

  40. Muller AF, Drexhage HA, Berghout A. Postpartum thyroiditis and autoimmune thyroiditis in women of childbearing age: recent insights and consequences for antenatal and postnatal care. Endocr Rev. 2001;22:605–30.

    Article  PubMed  CAS  Google Scholar 

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Conflict of interest

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Metabolism Unit, Department of Internal Medicine, University of Pisa and CNR Institute of Clinical Physiology, Via Roma, 67, 56126, Pisa, Italy

    Alessandro Antonelli, Poupak Fallahi, Silvia Martina Ferrari & Ele Ferrannini

  2. Respiratory Pathophysiology Section, Cardiac and Thoracic Department, University of Pisa, Pisa, Italy

    Piera Fazzi

  3. Regional Center of Nuclear Medicine, Medical School, University of Pisa, Pisa, Italy

    Mariano Grosso, Giuseppe Boni & Giuliano Mariani

Authors
  1. Alessandro Antonelli
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  2. Piera Fazzi
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  3. Poupak Fallahi
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  4. Silvia Martina Ferrari
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  5. Mariano Grosso
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  6. Giuseppe Boni
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  7. Ele Ferrannini
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  8. Giuliano Mariani
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Correspondence to Alessandro Antonelli.

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Antonelli, A., Fazzi, P., Fallahi, P. et al. Thyroid uptake of 67Ga-citrate is associated with thyroid autoimmunity and hypothyroidism in patients with sarcoidosis. Eur J Nucl Med Mol Imaging 36, 137–143 (2009). https://doi.org/10.1007/s00259-008-0932-9

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  • DOI: https://doi.org/10.1007/s00259-008-0932-9

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