Gallium-67 SPECT scintigraphy may be useful in diagnosis of temporal arteritis

Background: Temporal arteritis (TA) is a common syndrome in the elderly, consisting of persistent pain in the temporal area of the skull, jaw claudication, sudden visual loss, high erythrocyte sedimentation rate, and tenderness on palpation in the temporal area. The diagnosis of this condition is relatively straightforward when the typical symptoms and a positive temporal artery biopsy are present. However, only half of the patients have a positive temporal artery biopsy. Other diagnostic procedures, such as colour Doppler sonography or superficial carotid artery angiography which have been proved to be useful for the diagnosis of TA, do not discriminate between inflammatory and non-inflammatory temporal artery disease and may be helpful only in experienced hands. Gallium-67 (⁶⁷Ga) planar scan was reported to be useful in the diagnosis of the disease. Quantitative ⁶⁷Ga single photon emission computed tomography (SPECT) may raise the accuracy of the diagnosis. Objective: To investigate the effectiveness and usefulness of ⁶⁷Ga SPECT scintigraphy in the diagnosis of TA. Methods: Nine patients (five male, four female) and six controls were included in the study. All of them received 8-10 mCi ⁶⁷Ga intravenously 48 hours before the scan.⁶⁷Ga uptake ratios were calculated on transaxial and coronal slices. Results: All patients showed increased uptake in the temporal area of the skull compared with controls. Conclusion: The data suggest that ⁶⁷Ga skull SPECT may be useful in the diagnosis of TA, especially if the uptake ratio in the area of interest is calculated. Further studies are needed to confirm these data.