111In-octreotide imaging in patients with long-standing Graves' ophthalmopathy

The aim of this study was to examine patients with long-standing Graves' ophthalmopathy using 111In-octreotide scintigraphy. Sixteen patients with inactive ophthalmopathy of up to 114 months duration and 14 normals were investigated for 48 h following an injection of 200 MBq 111In-octreotide. No significant tracer accumulation in the orbital region could be identified in any of the patients with long-standing Graves' ophthalmopathy. The orbit to brain (O/B) ratios after 24 and 48 h were 2.39 +/- 0.36 and 2.15 +/- 0.44 versus 2.17 +/- 0.33 and 2.20 +/- 0.37 for the patients and normals, respectively (N.S.). 111In-octreotide accumulation in ophthalmopathy described in the literature may thus be a passing event limited to its active stage, which is consistent with the concept of imaging a lymphocytic infiltration. In this study, the lack of accumulation of 111In-octreotide in the orbital region during the inactive stage demonstrates an absence of somatostatin receptors in orbital tissue itself. Thus, in patients with inactive Graves' ophthalmopathy, there is no basis for a diagnostic approach with somatostatin.