Evaluating salivary gland function using quantitative salivary gland scintigraphy in postoperative differentiated thyroid cancer patients after 131I therapy
10.3760/cma.j.cn321828-20240810-00289
- VernacularTitle:核素唾液腺显像定量法评估分化型甲状腺癌患者术后 131I治疗对唾液腺功能的影响
- Author:
Liangjun XIE
1
;
Yansong LIN
;
Muhua CHENG
Author Information
1. 中山大学附属第三医院核医学科，广州 510630
- Publication Type:Journal Article
- Keywords:
Thyroid neoplasms;
Radiotherapy;
Iodine radioisotopes;
Salivary glands;
Radionuclide imaging
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2025;45(7):416-420
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the impact of 131I therapy on salivary gland function in postoperative patients with differentiated thyroid cancer (DTC) using quantitative salivary gland scintigraphy (SGS). Methods:Sixty-four patients (23 males, 41 females, age (39.6±13.0) years) were recruited from the Third Affiliated Hospital, Sun Yat-Sen University, all of whom had undergone surgery for DTC between May 2014 and December 2023. SGS was conducted 3 d prior to and 3-6 months following 131I therapy. Salivary gland function parameters, including the uptake index (UI) and excretion fraction (EF) for both (right (R) and left (L)) parotid (P) and submandibular (S) glands (L-pUI, R-pUI, L-sUI, R-sUI, L-pEF, R-pEF, L-sEF, R-sEF), were measured. Patients were divided into two groups (group A: dose of first-time therapy (D f) ≤ 3700MBq; group B: D f>3700MBq) to analyze the characteristics of changes in salivary gland function between the two groups. The relationship between cumulative dose (D c) and salivary gland hypofunction was assessed. Data were analyzed using paired t test, Wilcoxon signed rank test, and χ2 test. The optimal threshold of D c for salivary gland hypofunction was determined through ROC curve analysis. Results:After the first therapy, L-pUI, R-pUI, L-sUI, and R-sUI significantly decreased compared with baseline values in group B ( n=38; t values: from -3.77 to -2.96, all P<0.01). In contrast, there were no significant differences in any salivary gland function parameters between pre-therapy and post-therapy assessments in group A ( n=26; t values: from -1.18 to 0.95, all P>0.05). Fifteen patients underwent therapy twice. After the second therapy, L-pUI, R-pUI, L-sUI, R-sUI, L-pEF, and R-pEF significantly decreased compared to baseline values ( t values: from -6.77 to -3.50, all P<0.01), and with a more pronounced reduction observed in L-pUI and R-pUI compared to the first therapy ( Z values: from -2.10 and -2.67, both P<0.05). The incidence of salivary gland hypofunction after the second therapy was higher than that after the first therapy (10/15 vs 21.9%(14/64); χ2=11.53, P=0.001). The incidence of salivary gland hypofunction was found to be related to D c ( χ2=24.35, P<0.001). Based on ROC curve analyses, patients were likely to experience salivary gland hypofunction when D c exceeded 5550MBq (AUC=0.80(95% CI: 0.69-0.89), P<0.001), with the sensitivity of 13/19, specificity of 91.1%(41/45), positive predictive value of 13/17, and negative predictive value of 87.2%(41/47). Conclusion:Some patients with DTC experience a decline in salivary gland function in the short term (3-6months) after undergoing postoperative therapy with 131I, and the degree and incidence of this decline display in a D c-related manner.
