Detection of the involvement of salivary glands in autoimmune diseases of thyroid gland by using TC-99M MİBİ scintigraphy

The aim of this study was to determine the involvement in the salivary glands of the patients with Graves? Disease and Hashimoto Thyroiditis by detecting the changes of Tc-99m MIBI uptake.Nineteen patients with Graves? Disease (6 men, 13 women; mean age: 34.47±11.76 years), 28 Hashimoto disease patients (5 men, 23 women; mean age: 44,5±10.94 years), and 11 euthyroid controls (4 men, 7 women; mean age: 53.9±11.56 years) were included in the study. Medical history from all patients were obtained and their neck examination were carried out . None of the patients had complaint such as pain, xerostomia and lack of taste. Thyroid function test results and treatment conditions were determined (patients were not receiving treatment), and neck ultrasonography were performed. None of the patients had thyroid nodule. Tc-99m MIBI scintigraphy was applied to all groups. 370MBq (10 mCi) Tc-99m MIBI was given intravenously. For imaging double headed gamma camera (Infinia, GE Medical Systems, Tirat Hacermel, Israel) and parallel hole, low energy, high resolution (LEHR) collimator was used. Full and empty injectors were scanned in 2 zoom for 2 seconds before and after injection. Static images were taken in the 20., 60., 120.,minutes by positioning salivary glands in the center of the collimator.Uptake values of parotid and submandibular glands were calculated by drawing elliptical ROIs and using the formula for uptake calculation.As a result, in all three groups, in parotis glands, a statistical significant difference between Tc-99m MIBI uptake in the 20th, 60th, 120th minutes was not detected (p>0.05).In Graves?Disease, Hashimoto Thyroiditis and Control Group ; a statistical significant difference between Tc-99m MIBI involvement rate in the 20th, 60th, 120 th. minutes was detected in submandibular glands (p<0.05).In the Hashimoto Thyroiditis group, in submandibular glands, 20th min. (Mean±SD: 0.03 ± 0.01), 60th min. (mean±SD: 0.03 ± 0.01) ve120th min. (Mean±SD: 0.03 ± 0.01) of Tc-99m MIBI uptake values were significantly higher than the control group (20th.min mean±SD: 0.01 ± 0.005; 60th min. mean±SD: 0.01 ± 0,007; 120th.min mean±SD: 0.02 ± 0.006) (p <0.05).In Graves? Disease the uptake values of Tc-99m MIBI in submandibular glands were significantly higher than the control group at 20th min. (p=0.045). Although no statistical significant difference was detected at 60th and 120th minutes, the uptake values of Tc-99m MIBI were higher than the control group.We observed changes in Tc-99m-MIBI uptake in submandibular glands in Graves?Disease and Hashimoto Thyroiditis group which differ from the control group is thought to be related to the histopathological changes such as autoimmunity, high mitochondria number, and inflammatory reaction. Our findings suggest that Tc-99m MIBI scintigraphy could be used in the early detection of autoimmune diseases that affect salivary glands.