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Nuklearmedizin 2020; 59(05): 375-380
DOI: 10.1055/a-1152-2279
Original Article

Sialoscintigraphy – Shopworn or Bestselling? A Traditional Procedure with New Prominent Role in Theranostics and Immuno-Oncology

Sialoszintigrafie – Ladenhüter oder Bestseller? Eine herkömmliche Methode mit neuer wichtiger Funktion in der Theranostik und Immunonkologie
Barbara Kreppel
  Department of Nuclear Medicine, University Medical Center Bonn, Bonn, Germany
,
Florian C. Gaertner
  Department of Nuclear Medicine, University Medical Center Bonn, Bonn, Germany
,
Markus Essler
  Department of Nuclear Medicine, University Medical Center Bonn, Bonn, Germany
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Abstract

Sialoscintigraphy has been used in nuclear imaging for almost sixty years. It allows functional assessment and quantification of all large salivary glands. Physiological function of the salivary glands is essential for the preservation of the oral mucosa, the sense of taste and dental health. Impaired salivary gland function may lead to reduced or even absent salivation resulting in various complaints such as loss of taste reducing quality of life. During the recent years clinical relevance of assessment of salivary gland function has been rising. As novel radiopharmaceuticals such as 225Ac-PSMA or 177Lu-PSMA may cause damage to the salivary glands in a subset of patients, reliable methods for quantification of salivary gland function are vital for therapy planning and follow-up. Standardized protocols for the implementation and interpretation of this procedure are necessary to achieve comparable results from individual theranostic centers and to facilitate multicenter trials. Sialocintigraphy is also of clinical relevance for immunooncology. Treatments with checkpoint inhibitors such as Ipilimumab or Nivulomab frequently cause autoimmune disorders affecting the salivary glands that may lead to reduced production of saliva and finally loss of taste. Therefore, standardized procedure protocols for sialoscintigraphy are also important for general oncology.

Here we suggest a protocol for sialoscintigraphy that may be used as standard in centers for theranostics or immunooncology and discuss the potential future role of this traditional procedure.

Zusammenfassung

Die Sialoszintigrafie wird seit fast sechzig Jahren in der nuklearmedizinischen Bildgebung eingesetzt. Sie ermöglicht die funktionelle Beurteilung und Quantifizierung aller großen Speicheldrüsen. Die physiologische Funktion der Speicheldrüsen ist für die Erhaltung der Mundschleimhaut, des Geschmackssinns und der Zahngesundheit von wesentlicher Bedeutung. Eine beeinträchtigte Speicheldrüsenfunktion kann zu vermindertem oder sogar fehlendem Speichelfluss führen, was verschiedene Beschwerden wie z. B. den Verlust des Geschmacksempfindens zur Folge hat und somit die Lebensqualität verringert. In den letzten Jahren hat die klinische Relevanz der Beurteilung der Speicheldrüsenfunktion zugenommen. Da neuartige Radiopharmazeutika wie 225Ac-PSMA oder 177Lu-PSMA bei einer Untergruppe von Patienten Schäden an den Speicheldrüsen verursachen können, sind zuverlässige Methoden zur Quantifizierung der Speicheldrüsenfunktion für die Therapieplanung und das Follow-Up von entscheidender Bedeutung. Standardisierte Protokolle für die Durchführung und Interpretation dieser Methode sind notwendig, um vergleichbare Ergebnisse von einzelnen Theranostikzentren zu erzielen und um multizentrische Studien zu ermöglichen. Die Sialozintigrafie ist auch für die Immunonkologie von klinischer Bedeutung. Behandlungen mit Checkpoint-Inhibitoren wie Ipilimumab oder Nivulomab verursachen häufig Autoimmunerkrankungen mit Beeinträchtigung der Speicheldrüsen, was zu einer verminderten Speichelproduktion und schließlich zu einem Verlust des Geschmacksinns führen kann. Daher sind standardisierte Protokolle für die Sialoszintigrafie auch in der allgemeinen Onkologie wichtig.

Wir schlagen hier ein Protokoll für die Sialoszintigrafie vor, das als Richtlinie in Zentren für Theranostik oder Immunonkologie angewandt werden kann, und diskutieren die mögliche zukünftige Rolle dieser herkömmlichen Methode.

Key words

salivary glands - scintigraphy - examination protocol - quantification - indications - clinical relevance

Schlüsselwörter

Speicheldrüsen - Szintigrafie - Untersuchungsprotokoll - Quantifizierung - Indikationen - klinische Relevanz


Publication History

Received: 01 April 2020

Accepted: 03 April 2020

Article published online:
18 May 2020

© Georg Thieme Verlag KG
Stuttgart · New York

 

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