Radiography (London, England : 1995) · 2025
Effect of early multiple acid stimulation on salivary gland Tc-99m pertechnetate uptake: a prospective study.
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Zhu H, Shen W, Zhu Y, Liu Z, Zhang Q, Li Z, Hou X, Wang Y
Аннотация
INTRODUCTION: Salivary gland dysfunction is a common side effect of radioiodine-131 (ˆ131I) therapy for differentiated thyroid cancer (DTC). We hypothesized that early repeated acid stimulation during Tc-99m salivary gland scintigraphy would reduce radioactive tracer accumulation in salivary glands.
METHODS: Eighty-one post-thyroidectomy patients with DTC were assigned to three equal groups: control (no acid stimulation), single stimulation at 2 h post-injection, and early repeated stimulation every 30 min after Tc-99m Pertechnetate (99mTcO4-) injection. 99mTcO4- salivary gland scintigraphy was performed with regions of interest delineated for bilateral parotid and submandibular glands. Time-activity curves were generated over 2.5 h, and radioactivity counts and accumulation ratios were calculated at defined intervals.
RESULTS: Baseline parotid and submandibular radioactivity counts did not differ significantly across groups (parotid: P > 0.05; submandibular: P > 0.05). Both acid stimulation protocols induced significant reductions in glandular radioactivity compared with control at all dynamic acquisition intervals (P < 0.001). Cumulative tracer accumulation was significantly lower in the early repeated stimulation group versus the control and single-stimulation groups (P < 0.001). At the same time, no significant difference was observed between control and single-stimulation groups.
CONCLUSION: Early repeated acid stimulation markedly decreases 99mTcO4- uptake and retention in salivary glands, outperforming delayed single stimulation.
IMPLICATIONS FOR PRACTICE: Implementing early repeated acid stimulation during 131I therapy may help prevent salivary gland injury and preserve gland function in DTC patients.
METHODS: Eighty-one post-thyroidectomy patients with DTC were assigned to three equal groups: control (no acid stimulation), single stimulation at 2 h post-injection, and early repeated stimulation every 30 min after Tc-99m Pertechnetate (99mTcO4-) injection. 99mTcO4- salivary gland scintigraphy was performed with regions of interest delineated for bilateral parotid and submandibular glands. Time-activity curves were generated over 2.5 h, and radioactivity counts and accumulation ratios were calculated at defined intervals.
RESULTS: Baseline parotid and submandibular radioactivity counts did not differ significantly across groups (parotid: P > 0.05; submandibular: P > 0.05). Both acid stimulation protocols induced significant reductions in glandular radioactivity compared with control at all dynamic acquisition intervals (P < 0.001). Cumulative tracer accumulation was significantly lower in the early repeated stimulation group versus the control and single-stimulation groups (P < 0.001). At the same time, no significant difference was observed between control and single-stimulation groups.
CONCLUSION: Early repeated acid stimulation markedly decreases 99mTcO4- uptake and retention in salivary glands, outperforming delayed single stimulation.
IMPLICATIONS FOR PRACTICE: Implementing early repeated acid stimulation during 131I therapy may help prevent salivary gland injury and preserve gland function in DTC patients.