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Abnormal [ 18 F]fluorodeoxyglucose accumulation to tori tubarius in IgG4-related disease

Annals of Nuclear Medicine(2021)

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Abstract
Objectives Tubarial glands (TGs) are recently refocused gland tissues localized near the tori tubarius in the nasopharynx and their clinical relevance is not clear yet. IgG4-related disease (IgG4-RD) is a progressive fibrosing condition and salivary glands are well-affected lesions. The aim of the present study is to examine [ 18 F]fluorodeoxyglucose ([ 18 F]FDG) accumulation to the tori tubarius in IgG4-related disease (IgG4-RD). Methods 48 patients with IgG4-RD who underwent positron emission tomography (PET) scanning with [ 18 F]FDG were included and semi-quantitative analysis of [ 18 F]FDG accumulation to tori tubarius was performed along with the clinical features and histopathological analysis. Results Of the 48 patients, abnormal [ 18 F]FDG accumulation (metabolic tumour volume ≥ 1) to tori tubarius was observed in 15 (31.3%), all of whom had lesions in other head and neck glands. IgG4-RD patients with abnormal [ 18 F]FDG accumulation to tori tubarius showed swollen nasopharyngeal walls around tori tubarius and forceps biopsy of the lesion revealed acinar cells and IgG4-positive plasma cells histologically. Abnormal [ 18 F]FDG accumulation (maximum standard uptake value, metabolic tumour volume and total lesion glycolysis) to tori tubarius correlated with higher IgG4 and lower IgA serum concentrations. Conclusions Abnormal [ 18 F]FDG accumulation to tori tubarius can be observed in patients with IgG4-RD and the abnormal [ 18 F]FDG accumulation to tori tubarius can be a clue of TG involvement in IgG4-RD.
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Positron emission tomography with [ 18 F]fluorodeoxyglucose
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