Semi-quantitative analysis of salivary gland scintigraphy in Sjögren’s syndrome diagnosis: a first-line tool

Tiziana Angusti, Emanuela Pilati, Antonella Parente, Renato Carignola, Matteo Manfredi, Simona Cauda, Elena Pizzigati, Julien Dubreuil, Francesco Giammarile, Valerio Podio, Andrea Skanjeti

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)2389-2395
Number of pages7
JournalClinical Oral Investigations
Volume21
Issue number7
DOIs
Publication statusPublished - Sep 1 2017

Keywords

  • Differential diagnosis
  • Quantitative analysis
  • Salivary gland dynamic scintigraphy
  • Sicca syndrome
  • Sjögren’s syndrome

ASJC Scopus subject areas

  • Dentistry(all)

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