Visual and Quantitative Analysis by Gallium-67 Single-photon Emission Computed Tomography/Computed Tomography in the Management of Malignant Otitis Externa
SSM Wong, K Wang, EHY Yuen, JKT Wong, A King, AT Ahuja
Hong Kong J Radiol 2011;14:155-60
Objective: To evaluate the value of Gallium-67 single-photon emission computed tomography/computed tomography in the diagnosis and monitoring treatment response of malignant otitis externa.
Methods: Eight patients underwent 12 Gallium-67 single-photon emission computed tomography/computed tomography scintigraphy for eight suspected malignant otitis externa and were subsequently subjected to visual and quantitative analysis. Relevant patient clinical data and other investigation results were also retrieved for correlation.
Results: Gallium-67 single-photon emission computed tomography/computed tomography improved anatomical localisation of lesion uptake. All patients (7/7) with active malignant otitis externa achieved a statistically significant higher Gallium-67 uptake on the side of the lesion than the contralateral side (p < 0.05). All patients (5 out of 5) without active malignant otitis externa had no significant difference in Gallium-67 uptake between the two sides. Serum inflammatory markers (white cell count, erythrocyte sedimentation rate, and C-reactive protein) did not correlate with disease activity.
Conclusion: Gallium-67 single-photon emission computed tomography, when combined with computed tomography, improves anatomical localisation of lesional uptake. It is also accurate in reflecting active infection and hence can confirm or exclude active malignant otitis externa.
中文摘要
鎵67（Gallium-67）單光子發射電腦斷層攝影／電腦斷層攝影 （SPECT/CT）融合作惡性外耳道炎的目測及定量分析
王先民、王琪、袁學遠、黃嘉德、金雅桃、AT Ahuja
目的：評估對於惡性外耳道炎，以鎵67 SPECT/CT融合作診斷和觀察治療結果的效果。
方法：擬有惡性外耳道炎的八名病人接受12次以鎵67 SPECT/CT融合診斷，並進行目測及定量分 析。病人臨床資料及其他檢查結果用作相關研究。
結果：鎵67 SPECT/CT融合技術可改善病灶攝取的解剖定位。全部七名確診為惡性外耳道炎的患者 中，有病灶的一邊的鎵67攝取值比無病灶的一邊明顯為高（p < 0.05）。而全部五位未有活躍性惡性外耳道炎的患者中，有灶和無灶的一邊對於鎵67攝取值並無顯著分別。血清炎症標誌物（白細胞數 目、血沉速度和C反應蛋白）與病症的活躍程度並無相關。
結論：鎵67 SPECT並結合CT技術可改善病灶攝取的解剖定位。除此以外，也可以準確反映炎症的活 躍程度，遂能確診或排除活躍性惡性外耳道炎的可能性。