Department of Nuclear Medicine, East-West Neo Medical Center, The Comparison with Salivary image and Saliva Clerance Rate in Salivary Scintigraphy Department of Nuclear Medicine, East-West Neo Medical Center, Kyung Hee University Kim Young-Bin

SALIVARY GLAND • Secretion 1,000 ~ 1,500 cc/day Digestion of starch & Softening of food Moisture conservation of the membrane’s oral cavity Prevention of bacteria’s reproduction. • Sialolithiasis, xerostomia, halitosis, Sjogren’s syndrome.

SALIVARY EXAM Advantage Disadvantage Noninvasive Sonography Noninvasive Easy detection sialolithiasis Sialography No quantification of function No quantification of obstruction Easy detection sialolithiasis CT, MRI High geometric resolution Salivary Scan Quantification of function Quantification of obstruction No morphological presentation

OBJECT Salivary Diagnosis in Clinic : Static Image & Dynaminc Image Relationship Advantage Previous study : Salivary clearance rate

TARGET 37 patients ( male 9, female 27 ) June 2007 ~ June 2008 halitosis patients 21 xerostomia patients 7 radioisotope therapy patients 9 6hr NPO before testing Tc-99m pertechnetate 185 MBq (5 mCi ) IV

Philips Gamma Camera Forte A-Z MACHINE CAPTUS 3000, CAPINTEC Philips Gamma Camera Forte A-Z

After stimulation phase PROCESS 5 MIN Concentration phase 15 MIN Secretory phase Stimulation 40 MIN After stimulation phase

STIMULATION Saliva & blood collection process flow 12 min Stimulation [ 2 min] Saliva collection [ 10 min ] Stimulate [ 1 min ] 5 min saliva collection Spit out [ 1 min ] Thyroid uptake - captus 3000 - After 2Hrs Blood sampling 1cc Saliva sampling 1cc 5 min - Blood 5 ml extraction Saliva & blood collection process flow KYUNG HEE UNIVERSITY EAST-WEST NEO MEDICAL CENTER

METHOD Secretory image count Secretion rate (%) = - 1 Concentration image count Secretory image count Drainage rate (%) = - 1 After stimulation count Saliva radioactivity (cpm/ml) ×Saliva volume (ml) Saliva clearance rate(ml/min) = Blood radioactivity (cpm/ml) ×Saliva gathering time (min)

METHOD Normal : Mildly 5 Group 1 : Moderate 17 Group 2 : Severe function of parotid or submandibular gland 9 Group 3 : Non function 5

Salivary clearance rate RESULT Salivary clearance rate (ml/min) patient

RESULT Secretion rate (%) patient

RESULT Drainage rate (%) patient

Saliva clearance rate (ml/min) RESULT Normal Group 1 Group 2 Group 3 Saliva clearance rate (ml/min) 18.4 16.1 10.0 2.3 Secretion rate (%) 21.6 17.6 8.8 4.4 Drainage rate (%) 24.6 24.0 13.9 5.8 Group 2 & 3 p < 0.05 Significant difference Group 1 p > 0.05 Insignificant difference Saliva clearance rate Group 2 & 3 p < 0.05 Significant difference Group 1 p > 0.05 Insignificant difference Secretion & Drainage rate

CONCLUSION Salivary clearance rate increade Salivary image Saliva Clearance rate Nonfunction patient decrease Secretion & Drainage rate increase Accordance Salivary images Saliva clearance rate Severe function of Pa. or Su. Abnormal secretion & Drainage velocity Noticeable difference Make up for error

Department of Nuclear Medicine, East-West Neo Medical Center, Thank You ♡ Department of Nuclear Medicine, East-West Neo Medical Center, Kyung Hee University