AIM: To investigate the value of maximum standardized uptake value(SUVmax), extraocular muscle(EOM)diameter, and thyroid stimulating hormone receptor antibody(TRAb)in evaluating inflammatory activity in thyroid-associated ophthalmopathy(TAO).METHODS: TAO patients underwent orbital 99mTc-DTPA SPECT/CT imaging at the Affiliated Hospital of Panzhihua University between January 2023 and December 2024 were retrospectively enrolled. According to the clinical activity score(CAS), patients were classified into an active group and an inactive group. SUVmax and EOM were independently measured by three nuclear medicine physicians, and the mean values were used for analysis. Serum TRAb levels from TAO patients were measured using a fully automated electrochemiluminescence immunoassay analyzer. Nonparametric tests were used to compare differences between the two groups. Spearman correlation analysis was performed to assess the correlations of CAS with SUVmax, EOM, and TRAb. Using CAS as the reference standard, receiver operating characteristic(ROC)curves were plotted to evaluate the diagnostic performance of SUVmax, EOM, and TRAb, as well as their combination. Intraclass correlation coefficient(ICC)was used for reliability analysis to evaluate the consistency of SUVmax and EOM among the 3 measurers.RESULTS: A total of 99 patients(198 eyes)with TAO were enrolled in this study, including 38 males and 61 females, aged 16-74(46.92±11.84)y. The active group comprised 46 patients(92 eyes), aged 16-71(48.40±12.02)y, with 25 males and 21 females. The inactive group included 53 patients(106 eyes), aged 17-74(45.46±11.59)y, consisting of 13 males and 40 females. There were no statistically significant differences between the two groups in terms of gender and age(P>0.05). Statistically significant differences were observed in SUVmax, EOM, and TRAb. Compared with the inactive group, the active group showed higher SUVmax, EOM, and TRAb levels(all P<0.01). Correlation analysis showed that CAS was positively correlated with SUVmax, EOM, and TRAb(r=0.734, 0.622, and 0.404, respectively, all P<0.01). ROC curves were plotted using CAS as the reference standard, and the AUCs for SUVmax, EOM, TRAb, and their combined diagnosis were 0.874, 0.797, 0.715, and 0.892, respectively. The ICC of SUVmax and EOM were 0.925(95%CI: 0.901-0.948, P<0.001)and 0.943(95%CI: 0.907-0.964, P<0.001)respectively.CONCLUSION: Beyond CAS, there is a need to identify objective imaging and serological biomarkers. Measurements of SUVmax and EOM provide visualized and quantifiable tools for assessing TAO activity, and their combination with TRAb can further improve the accuracy of activity assessment.

Objective To investigate the clinical significance of dynamic change of serum IL‐17A/IL‐23 in131 I treatment of Graves hyperthyroidism by dynamically detecting the serum IL‐23/Th17 axis related factor levels before and after 131 I treatment of Graves hyperthyroidism .Methods 30 untreated inpatients with Graves disease(GD) in our hospital were selected as the T0 group , those treated by 1- ,3- ,6-month 131 I treatment were taken as the group T1 ,T3 and T6 .Contemporeneous 30 individuals under‐going healthy physical examination were selected as the normal control (NC) group .The various groups had no statistical differences in the aspects of the age ,gender and disease course ,and had the comparability (P>0 .05) .Serum concentration of IL‐17A and IL‐23 was measured by the enzyme‐linked immunosorbent assay (ELISA) technique .FT3 ,FT4 and TSH were detected by combing with clinic .Results The levels of serum IL‐17A and IL‐23 before131I treatment were significantly higher than those in the NC group(P<0 .05);with the treatment proceeding ,which at ,1 ,3 ,6 months were gradually decreased ,the differences were statistically signifi‐cant but(P<0 .05);after 6 -month 131 I treatment in the GD patients ,the effects of IL‐17A and IL‐23 double negative in the T6 group were better than those of single negative ,and better than those of double positive ,the differences were statistically (Fisher value=13 .273 ,P<0 .05) .Conclusion Dynamically monitoring the serum IL‐23/Th17 axis related factor levels has the significance for guiding treatment ,judging the curative effect and predicting recurrence .