Ultrasonography of major salivary glands could be an alternative tool to sialoscintigraphy in the American-European classification criteria for primary Sjogren's syndrome

Milić, Vera; Petrović, Radmila; Boričić, Ivan; Radunović, Goran; Marinković-Erić, Jelena; Jeremic, Predrag; Damjanov, Nemanja

doi:10.1093/rheumatology/ker431

Cited by 85 publications

(59 citation statements)

References 17 publications

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“…Furthermore, Giuseppetti et al (2005) reported that contrastenhanced ultrasound can provide additional information in morphologic and functional parotid imaging. Most of the previous studies on salivary gland ultrasound in SS deal with the contribution of B-mode sonography to diagnosis and focus on different scoring systems or the potential to replace the aforementioned established modalities, which are part of different classification criteria (Cornec et al 2013(Cornec et al , 2014Hocevar et al 2005;Kawamura et al 1990;Milic et al 2012;Niemela et al 2004;Takashima et al 1992;Wernicke et al 2008;Yonetsu et al 2002). Meanwhile, there are various validated scoring systems for B-mode sonography, with just marginal differences regarding the evaluation of salivary gland echostructure, which seems to be the most characteristic alteration.…”

Section: Discussionmentioning

confidence: 99%

Sonoelastographic Modalities in the Evaluation of Salivary Gland Characteristics in Sjögren's Syndrome

Hofauer

Mansour

Heiser

et al. 2016

Ultrasound in Medicine & Biology

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Section: Discussionmentioning

confidence: 99%

Sonoelastographic Modalities in the Evaluation of Salivary Gland Characteristics in Sjögren's Syndrome

Hofauer

Mansour

Heiser

et al. 2016

Ultrasound in Medicine & Biology

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“…It has recently been suggested that more emphasis should be given to tests that in addition to identifying true cases and excluding unaffected individuals, can be done at early stages, multiple times, and with minimal distress to the participant 29. In the future, we may see salivary gland ultrasonography playing this role in SS 30. But with the current sets of criteria, there is an interesting difference in terms of accessibility; while the ACR criteria require evaluation by a practitioner specialising in eyes and by a practitioner who can perform a lip biopsy, both the Schirmer's and the WUSF tests can be performed in a standard medical office without the need for sophisticated equipment or medical specialists.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the American-European Consensus Group Sjögren's syndrome classification criteria to newly proposed American College of Rheumatology criteria in a large, carefully characterised sicca cohort

et al. 2013

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Objective To compare the performance of the American-European Consensus Group (AECG) and the newly proposed American College of Rheumatology (ACR) classification criteria for Sjögren's syndrome in a well-characterized sicca cohort, given ongoing efforts to resolve discrepancies and weaknesses in the systems. Methods In a multidisciplinary clinic for the evaluation of sicca, we assessed features of salivary and lacrimal gland dysfunction and autoimmunity as defined by tests of both AECG and ACR criteria in 646 participants. Global gene expression profiles were compared in a subset of 180 participants. Results Application of the AECG and ACR criteria resulted in classification of 279 and 268 participants with SS, respectively. Both criteria were met by 244 participants (81%). In 26 of the 35 AECG+/ACR- participants, the minor salivary gland biopsy focal score was ≥1 (74%), while 9 had positive anti-Ro/La (26%). There were 24 AECG-/ACR+ who met ACR criteria mainly due to differences in the scoring of corneal staining. All patients with SS, regardless of classification, had similar gene expression profiles, which were distinct from the healthy controls. Conclusion The two sets of classification criteria yield concordant results in the majority of cases and gene expression profiling suggests that patients meeting either set of criteria are more similar to other SS participants than to healthy controls. Thus, there is no clear evidence for increased value of the new ACR criteria over the old AECG criteria from the clinical or biological perspective. It is our contention, supported by this report, that improvements in diagnostic acumen will require a more fundamental understanding of the pathogenic mechanisms than is at present available.

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“…A number of publications have presented convincing data on the usefulness of SGUS for diagnosis of primary SS (7)(8)(9)(10)(11). Various scoring systems evaluating size of the glands, parenchymal echogenicity and inhomogeneity, clearness of the borders, and vascularity were proposed (7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

Primary Sjögren's Syndrome: Diagnostic and Prognostic Value of Salivary Gland Ultrasonography Using a Simplified Scoring System

Theander

Mandl

2014

Arthritis Care & Research

152

124

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Objective. To determine the usefulness and prognostic value of a simplified salivary gland ultrasonography (SGUS) scoring system in primary Sjögren's syndrome (SS). Methods. Patients with primary SS (n ‫؍‬ 105) and controls (n ‫؍‬ 57) were evaluated using a simplified SGUS scoring system. Parenchymal homogeneity in salivary glands was graded from 0 to 3, with grades 0 (normal) and 1 (mild inhomogeneity) being interpreted as normal or unspecific, and grades 2 (several rounded) and 3 (numerous or confluent hypoechoic lesions) as primary SS typical. Associations between SGUS and clinical, histologic, and laboratory disease characteristics were analyzed. Results. The characteristic hypoechoic lesions (score 2 or 3) were found in 52% of primary SS patients and in 1 (1.8%) of controls (P < 0.001). Specificity and positive predictive value of abnormal SGUS for primary SS were both 98%, sensitivity and negative predictive values were 52% and 53%, respectively. Age or disease duration did not influence the SGUS result. Dryness did not differ between normal or abnormal SGUS. However, patients with pathologic SGUS had significantly more often signs and symptoms of systemic complications, higher disease activity, and more frequently markers of lymphoma development, such as salivary gland swelling, skin vasculitis, germinal center-like structures in salivary gland biopsy findings, and CD4؉ T cell lymphopenia. Conclusion. SGUS using a simplified score for assessment of parenchyma dyshomogeneity is highly specific for primary SS and offers the advantage of identifying patients with severe disease or at risk of lymphoma. However, early disease may be missed. SGUS is easy and rapidly performed and may be considered as an item in future modified classification criteria.

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Ultrasonography of major salivary glands could be an alternative tool to sialoscintigraphy in the American-European classification criteria for primary Sjogren's syndrome

Abstract: US finding of major salivary gland involvement could replace sSC in AEC for the diagnosis of pSS.

Cited by 85 publications

References 17 publications

Sonoelastographic Modalities in the Evaluation of Salivary Gland Characteristics in Sjögren's Syndrome

Sonoelastographic Modalities in the Evaluation of Salivary Gland Characteristics in Sjögren's Syndrome

Comparison of the American-European Consensus Group Sjögren's syndrome classification criteria to newly proposed American College of Rheumatology criteria in a large, carefully characterised sicca cohort

Primary Sjögren's Syndrome: Diagnostic and Prognostic Value of Salivary Gland Ultrasonography Using a Simplified Scoring System

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