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. 2023 Dec;42(12):3275-3281.
doi: 10.1007/s10067-023-06696-4. Epub 2023 Aug 8.

The impact of an ultrasound atlas for scoring salivary glands in primary Sjögren's syndrome: a pilot study

Nanna S Schmidt  1   2 , Viktoria Fana  3 , Mads Ammitzbøll Danielsen  3 , Hanne M Lindegaard  4   5 , Anne Voss  4   5 , Hans Christian Horn  4 , John B Knudsen  4 , Keld-Erik Byg  4   6 , Melanie Birger Morillon  4   7 , Søren Andreas Just  4   7 , Uffe M Døhn  3 , Lene Terslev  3   8
Affiliations

The impact of an ultrasound atlas for scoring salivary glands in primary Sjögren's syndrome: a pilot study

Nanna S Schmidt et al. Clin Rheumatol. 2023 Dec.

Abstract

The objective of this pilot study was to assess the impact of a salivary gland ultrasound (SGUS) atlas for scoring parenchymal changes in Sjögren's syndrome by assessing the reliability of the scoring system (0-3), without and with the use of the SGUS atlas. Ten participants with varying experience in SGUS contributed to the reliability exercise. Thirty SGUS images of the submandibular and parotid gland with abnormalities ranging from 0 to 3 were scored using the written definitions of the OMERACT SGUS scoring system and using the SGUS atlas based on the OMERACT scoring system. For intra-reader reliability, two rounds were performed without and with the atlas-in the 2nd round the 30 images were rearranged in random order by a physician not included in the scoring. Inter-reader reliability was also determined in both rounds. Without using the atlas, the SGUS OMERACT scoring system showed fair inter-reader reliability in round 1 (mean kappa 0.36; range 0.06-0.69) and moderate intra-reader reliability (mean kappa 0.55; range 0.28-0.81). With the atlas, inter-reader reliability improved in round 1 to moderate (mean kappa 0.52; range 0.31-0.77) and intra-reader reliability to good (mean kappa 0.69; range 0.46-0.86). Higher intra-reader reliability was noted in participants with previous SGUS experience. The SGUS atlas increased both intra- and inter-reader reliability for scoring gland pathology in participants with varying SGUS experience suggesting a possible future role in clinical practice and trials. Key Points • Ultrasonography can detect parenchymal changes in salivary glands in patients with Sjögren's disease. • An ultrasound atlas may improve reliability of scoring parenchymal changes in salivary glands.

Keywords: OMERACT; Reproducibility of results; Salivary glands; Sjögren’s syndrome; Ultrasonography.

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Figures

Fig. 1
Fig. 1
SGUS atlas. Ultrasound images examples of the four-grade semi-quantitative scoring system developed and validated by the OMERACT ultrasound working group: parotid gland (A) and submandibular gland (B) grade 0, normal parenchyma; grade 1, minimal change: mild inhomogeneity without anechoic/hypoechoic areas; grade 2, moderate change: moderate inhomogeneity with focal anechoic/hypoechoic areas; grade 3, severe change: diffuse inhomogeneity with anechoic/hypoechoic areas occupying the entire gland surface
See this image and copyright information in PMC

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