Application Of The Value Of Somatostatin Receptor Imaging In The Treatment Of Idiopathic Orbital Inflammatory Pseudotumor

Objective:To analyze the value of treatment of Octreotide in Idiopathic Orbital Inflammatory Pseudotumor with orbital scintigraphy.On the other hand to compare the efficacy and safety of subcutaneous octreotide with those of oral prednisone in treating Idiopathic Orbital Inflammatory Pseudotumor..Methods:We studied a group of 16 patients with Idiopathic Orbital Inflammatory Pseudotumor and 5 volunteers(control group) without eye disease.All patients were divided into 2 groups by medicine imaging.SPECT studied of skull were completed within 1hour after iv.740Mbq 99mTc-octreotide.The region of interest(ROI) of right orbit(R),left(L)and occiput(O)were drawn.The uptake ratios(UR)were calculated in(R+L)/20.The statistic analyses included ANOVA and rank correlation using SPSS10.0.Those high uptake ratios patients were randomly divided into 2 groups.Patients(n=6) of octreotide group were treated with octreotide 100ug sc.q8h for 12 weeks.The other 6 patients in predisone group were treated with oral predisone for 12 weeks.60mg for the first 2weeks,40mg for 2 weeks,30mg for 4weeks,and 20mg for 4 weeks.Clinical efficiency of treatment was evaluated before and after treatment by calculating uptake ratio.Results;The orbit appeared as a "cold area" in control group. The orbit uptake of the first group had a visual orbital accumulation of 99Tc-octreotide,but little in the second group.(UR[1]=1.54±0.21 UR[2]=1.16±0.11 and UR[CG]=1.11±0.04).There was a significant difference between the first group and the second group(P＜0.05).A successful outcome was observed in 6 octreotide-treated and 6 predisone-treated patients(belong to the first group).Responders to treatment in both groups showed improvements in soft-tissue,involvement,proptosis.Side effects were more frequent and severe in predisone than in octreotide.Conclusions:(1)99mTc-OCT Scintigraphy may be useful to estimate a positive response activity of Idiopathic Orbital Inflammatory Pseudotumor.(2)Subcutaneous octreotide and oral predisone appear to be equally effective in patients with high uptake rate.In view of its better tolerability,octreotide shoud be considered the alternative treatment.