TY - JOUR
T1 - Semi-quantitative analysis of salivary gland scintigraphy in Sjögren’s syndrome diagnosis
T2 - a first-line tool
AU - Angusti, Tiziana
AU - Pilati, Emanuela
AU - Parente, Antonella
AU - Carignola, Renato
AU - Manfredi, Matteo
AU - Cauda, Simona
AU - Pizzigati, Elena
AU - Dubreuil, Julien
AU - Giammarile, Francesco
AU - Podio, Valerio
AU - Skanjeti, Andrea
PY - 2017/9/1
Y1 - 2017/9/1
N2 - Objective: The aim of this study was the assessment of semi-quantified salivary gland dynamic scintigraphy (SGdS) parameters independently and in an integrated way in order to predict primary Sjögren’s syndrome (pSS). Materials and methods: Forty-six consecutive patients (41 females; age 61 ± 11 years) with sicca syndrome were studied by SGdS after injection of 200 MBq of pertechnetate. In sixteen patients, pSS was diagnosed, according to American-European Consensus Group criteria (AECGc). Semi-quantitative parameters (uptake (UP) and excretion fraction (EF)) were obtained for each gland. ROC curves were used to determine the best cut-off value. The area under the curve (AUC) was used to estimate the accuracy of each semi-quantitative analysis. To assess the correlation between scintigraphic results and disease severity, semi-quantitative parameters were plotted versus Sjögren’s syndrome disease activity index (ESSDAI). A nomogram was built to perform an integrated evaluation of all the scintigraphic semi-quantitative data. Results: Both UP and EF of salivary glands were significantly lower in pSS patients compared to those in non-pSS (p < 0.001). ROC curve showed significantly large AUC for both the parameters (p < 0.05). Parotid UP and submandibular EF, assessed by univariated and multivariate logistic regression, showed a significant and independent correlation with pSS diagnosis (p value <0.05). No correlation was found between SGdS semi-quantitative parameters and ESSDAI. The proposed nomogram accuracy was 87%. Conclusion: SGdS is an accurate and reproducible tool for the diagnosis of pSS. ESSDAI was not shown to be correlated with SGdS data. Clinical relevance: SGdS should be the first-line imaging technique in patients with suspected pSS.
AB - Objective: The aim of this study was the assessment of semi-quantified salivary gland dynamic scintigraphy (SGdS) parameters independently and in an integrated way in order to predict primary Sjögren’s syndrome (pSS). Materials and methods: Forty-six consecutive patients (41 females; age 61 ± 11 years) with sicca syndrome were studied by SGdS after injection of 200 MBq of pertechnetate. In sixteen patients, pSS was diagnosed, according to American-European Consensus Group criteria (AECGc). Semi-quantitative parameters (uptake (UP) and excretion fraction (EF)) were obtained for each gland. ROC curves were used to determine the best cut-off value. The area under the curve (AUC) was used to estimate the accuracy of each semi-quantitative analysis. To assess the correlation between scintigraphic results and disease severity, semi-quantitative parameters were plotted versus Sjögren’s syndrome disease activity index (ESSDAI). A nomogram was built to perform an integrated evaluation of all the scintigraphic semi-quantitative data. Results: Both UP and EF of salivary glands were significantly lower in pSS patients compared to those in non-pSS (p < 0.001). ROC curve showed significantly large AUC for both the parameters (p < 0.05). Parotid UP and submandibular EF, assessed by univariated and multivariate logistic regression, showed a significant and independent correlation with pSS diagnosis (p value <0.05). No correlation was found between SGdS semi-quantitative parameters and ESSDAI. The proposed nomogram accuracy was 87%. Conclusion: SGdS is an accurate and reproducible tool for the diagnosis of pSS. ESSDAI was not shown to be correlated with SGdS data. Clinical relevance: SGdS should be the first-line imaging technique in patients with suspected pSS.
KW - Differential diagnosis
KW - Quantitative analysis
KW - Salivary gland dynamic scintigraphy
KW - Sicca syndrome
KW - Sjögren’s syndrome
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U2 - 10.1007/s00784-016-2034-6
DO - 10.1007/s00784-016-2034-6
M3 - Article
AN - SCOPUS:85008227618
VL - 21
SP - 2389
EP - 2395
JO - Clinical Oral Investigations
JF - Clinical Oral Investigations
SN - 1432-6981
IS - 7
ER -