# Somatostatin Receptor Scintigraphy in Autoimmune Syndrome Induced by Silicone Breast Implants: Pre- and Postexplantation Findings

## TL;DR

This study uses a specific imaging technique to assess inflammation in patients with silicone breast implants and autoimmune symptoms, finding that removing implants reduces local inflammation but not systemic issues.

## Contribution

The study introduces 99mTc-HYNIC-TOC scintigraphy as a novel tool for evaluating inflammation in autoimmune syndrome linked to silicone implants.

## Key findings

- Scintigraphy showed significant uptake in organs like joints and salivary glands associated with autoimmune symptoms.
- Strong correlations were found between imaging results and symptoms such as knee pain and sicca syndrome.
- Explantation reduced inflammation in the implant area but not in other organs, indicating persistent systemic inflammation.

## Abstract

Background: Silicone breast implants have been linked to autoimmune/inflammatory syndrome induced by adjuvants (ASIA). This study evaluates the role of 99mTc-HYNIC-TOC somatostatin receptor scintigraphy in assessing somatostatin-mediated inflammation and the impact of explantation on inflammatory activity. Methods: Fifty patients with silicone breast implants and symptoms suggestive of ASIA were evaluated. Pre- and postexplantation imaging was performed using 99mTc-HYNIC-TOC scintigraphy. Matthews correlation coefficients quantified associations between clinical symptoms and imaging findings, and autoantibody profiles were analysed. Results: Scintigraphy identified a significant uptake in organs associated with autoimmune symptoms, particularly joints and salivary glands. Strong correlations were found between imaging findings and symptoms, including knee pain (MCC = 0.81) and sicca syndrome (MCC = 0.96). Explantation resolved abnormal uptake in the surgical bed, though variable uptake persisted in other organs, reflecting systemic inflammatory heterogeneity. Autoantibody analysis revealed positivity in 66% of patients, with antinuclear antibodies being most frequent (30%). Conclusions: 99mTc-HYNIC-TOC scintigraphy effectively evaluates organ-specific inflammation in ASIA. Explantation reduces localized inflammation but does not consistently address systemic autoimmune responses. Larger prospective studies are needed to validate these findings and improve management strategies for ASIA.