You are here

  • Home
  • Archive
  • Volume 3, Issue 1
  • Salivary gland ultrasound abnormalities in primary Sjögren’s syndrome: consensual US-SG core items definition and reliability

Article Text

Article menu

Download PDFPDF

Sjögren syndrome
Original article
Salivary gland ultrasound abnormalities in primary Sjögren’s syndrome: consensual US-SG core items definition and reliability
  1. Sandrine Jousse-Joulin1,
  2. Emmanuel Nowak2,
  3. Divi Cornec1,
  4. Jackie Brown3,
  5. Andrew Carr4,
  6. Marina Carotti5,
  7. Benjamin Fisher6,7,
  8. Joel Fradin8,
  9. Alojzija Hocevar9,
  10. Malin V Jonsson10,
  11. Nicoletta Luciano11,
  12. Vera Milic12,
  13. John Rout13,
  14. Elke Theander14,
  15. Aaltje Stel15,
  16. Hendrika Bootsma15,
  17. Arjan Vissink16,
  18. Chiara Baldini11,
  19. Alan Baer17,
  20. Wan Fai Ng18,
  21. Simon Bowman7,
  22. Zarrin Alavi2,
  23. Alain Saraux1 and
  24. Valérie Devauchelle-Pensec1
  25. On behalf of the US-pSS Study Group.
  1. 1Department of Rheumatology, Cavale Blanche Hospital and Brest Occidentale University, Brest, France
  2. 2INSERM CIC 1412, Brest Medical University Hospital, Brest, France
  3. 3Department of Dental and Maxillofacial Radiology, KCL Dental Institute, Guy’s Hospital, London, UK
  4. 4Dental Radiology, Dental Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, London, UK
  5. 5Department of Radiology, Polytechnic University of the Marche, Ancona, Italy
  6. 6Rheumatology Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
  7. 7Department of Rheumatology, University Hospitals, Birmingham NHS Trust, Birmingham, UK
  8. 8Department of Imaging, Johns Hopkins Bayview Medical Center, Baltimore, USA
  9. 9Department of Rheumatology, University Medical Centre, Ljubljana, Slovenia
  10. 10Department of Clinical Dentistry, Section for Oral and Maxillofacial Radiology, University of Bergen, Bergen, Norway
  11. 11Rheumatology Unit, University of Pisa, Pisa, Italy
  12. 12Institute of Rheumatology, School of Medicine, University of Belgrade, Belgrade, Serbia
  13. 13Department of Radiology, Birmingham Dental Hospital, St Chad’s Queensway, Birmingham, UK
  14. 14Department of Rheumatology, Skane University Hospital, Malmö, Sweden
  15. 15Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
  16. 16Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
  17. 17Department of Medicine (Rheumatology), Johns Hopkins University School of Medicine, Baltimore, USA
  18. 18Institute of Cellular Medicine, Newcastle University & NIHR Newcastle Biomedical Research Centre, Tyne, UK
  1. Correspondence to Dr Valérie Devauchelle-Pensec; valerie.devauchelle-pensec{at}chu-brest.fr

Abstract

Objectives Ultrasonography (US) is sensitive for detecting echostructural abnormalities of the major salivary glands (SGs) in primary Sjögren’s syndrome (pSS). Our objectives were to define selected US-SG echostructural abnormalities in pSS, set up a preliminary atlas of these definitions and evaluate the consensual definitions reliability in both static and acquisition US-SG images.

Methods International experts in SG US in pSS participated in consensus meetings to select and define echostructural abnormalities in pSS. The US reliability of detecting these abnormalities was assessed using a two-step method. First 12 experts used a web-based standardised form to evaluate 60 static US-SG images. Intra observer and interobserver reliabilities were expressed in κ values. Second, five experts, who participated all throughout the study, evaluated US-SG acquisition interobserver reliability in pSS patients.

Results Parotid glands (PGs) and submandibular glands (SMGs) intra observer US reliability on static images was substantial (κ > 0.60) for the two main reliable items (echogenicity and homogeneity) and for the advised pSS diagnosis. PG inter observer reliability was substantial for homogeneity. SMGs interobserver reliability was moderate for homogeneity (κ = 0.46) and fair for echogenicity (κ = 0.38). On acquisition images, PGs interobserver reliability was substantial (κ = 0.62) for echogenicity and moderate (κ = 0.52) for homogeneity. The advised pSS diagnosis reliability was substantial (κ = 0.66). SMGs interobserver reliability was fair (0.20< κ ≤ 0.40) for echogenicity and homogeneity and either slight or poor for all other US core items.

Conclusion This work identified two most reliable US-SG items (echogenicity and homogeneity) to be used by US-SG trained experts. US-PG interobserver reliability result for echogenicity is in line with diagnosis of pSS.

  • Ultrasound
  • Salivary glands
  • Primary Sjögren’s syndrome
  • Atlas
  • Classification criteria

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

https://doi.org/10.1136/rmdopen-2016-000364

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Contributors All authors have equally contributed to all steps of this study.

    • Competing interests None declared.

    • Ethics approval Brest University Hospital Ethics Committee approval: NCT 02358213.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement All data are available in this original article and upon a request from corresponding author.