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

Luz Kelly Anzola; Sara Ramirez; Sergio Moreno; Camilo Vargas; Sebastian Rojas; José Nelson Rivera

doi:10.3390/jcm14124141

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

J Clin Med. 2025 Jun 11;14(12):4141. doi: 10.3390/jcm14124141.

Authors

Luz Kelly Anzola^{1

2}, Sara Ramirez³, Sergio Moreno⁴, Camilo Vargas⁵, Sebastian Rojas³, José Nelson Rivera⁶

Affiliations

¹ Nuclear Medicine Unit, Clinica Reina Sofia, Bogotá 110121, Colombia.
² Nuclear Medicine Unit, Clinica Universitaria Colombia, Bogotá 110931, Colombia.
³ Fundación Universitaria Sanitas, Bogotá 110131, Colombia.
⁴ Clinical Research Institute, Universidad Nacional de Colombia, Bogotá 111321, Colombia.
⁵ Medicina Nuclear Sanitas Palermo, Bogotá 111311, Colombia.
⁶ Internal Medicine Department, Clinica Reina Sofia, Bogotá 110121, Colombia.

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.

Keywords: 99mTc-HYNIC-TOC scintigraphy; ASIA syndrome; autoimmune inflammation; explantation; silicone breast implants; somatostatin receptor imaging.