A New Scoring System for Ultrasonographic Evaluation of Salivary Gland in Sjogren: Multireader Reliability

Sandrine Jousse-Joulin¹, Malin V. Jonsson², Nicoletta Luciano³, Elke Theander⁴, Vera Milic⁵, Alojzija Hocevar⁶, Jacqueline Brown⁷, Andrew Carr⁸, Divi Cornec⁹, Marina Carotti¹⁰, Benjamin A. Fisher¹¹, Joel Fradin¹², John Rout¹³, Alain Saraux¹⁴, Alja Stel¹⁵, Arjan Vissink¹⁶, Simon Bowman¹⁷, Alan N. Baer¹⁸, Matija Tomšič⁶, Wan-Fai Ng¹⁹, Chiara Baldini³ and Valerie Devauchelle²⁰, ¹Rheumatology, CHu La cavle Blanche, Brest, France, ²Department of Clinical Dentistry, Section for Oral and Maxillofacial Radiology,, University of Bergen, Bergen, Norway, ³Rheumatology Unit, University of Pisa, Italy, Pisa, Italy, ⁴Skåne University Hospital Malmö, Lund University, Malmo, Sweden, ⁵rheumatology, belgrade university, belgrade, Serbia, ⁶Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia, ⁷dental division, Tower Wing Guy's hospital, london, United Kingdom, ⁸departement of radiology, University of Newcastle, New castle, United Kingdom, ⁹Department of rheumatology, Brest Occidentale University, Brest, France, ¹⁰Istituto di Radiologia, Ospedali Riuniti di Ancona, Ancona, Italy, ¹¹Kennedy Institute of Rheumatology, Imperial College London, London, United Kingdom, ¹²Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, ¹³Birmingham Dental Hospital, Birmingham, United Kingdom, ¹⁴Rheumatology Department, CHU de la Cavale Blanche, Brest Cedex, France, ¹⁵Hanzeplein 1, University Medical Center Groningen, University of Groningen, Groningen, Netherlands, ¹⁶Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, Netherlands, ¹⁷Rheumatology Dept, University Hospital Birmingham, Birmingham, United Kingdom, ¹⁸Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, ¹⁹Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom, ²⁰Service de Rhumatologie, CHU Brest, Brest, France

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: radiology, salivary gland and ultrasonography, Sjogren's syndrome

Session Information

Date: Tuesday, November 10, 2015

Title: Sjögren's Syndrome: Translational Insights into Sjögren's Syndrome

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: A new consensual scoring system for Ultrasonography (US) of the salivary gland in pSS is required and endorsed by an international group of experts (US-pSS Study group).

The objectives were to define and validate relevant ultrasonographic components of the salivary glands in Sjogren.

Methods: A consensus exercise about definitions of the different ultrasonographic components of the salivary glands was done and discussed between experts on the field of US pSS during 2 annual meetings. Using these preliminary definitions, a reliability exercice was done on static images (60 images of both parotid and submandibular glands were read twice). Then an interreliability exercise was performed by a group of 5 experts with acquisition on 20 pSS patients. On this basis, we selected the most relevant US components, to build the new US-pSS score

Results: Eight different components evaluating the abnormal parenchyma of salivary glands were defined (echogenicity, homogenicity, presence or absence of hyperechoic bands, number of hypoechoic ares, and location of hypoechoic areas, lymph nodes, presence or absence of calcifications, visualisation of posterior border) in Sjögren. Concerning reliabilities, the web exercise demonstrated good inter and intra observers agreements applying these definitions on US parotid gland and submandibular glands (table 1) particularly in taking homogeneity as the principal important item in this definition. In contrast posterior border or presence of calcification had low agreement. The inter reliability exercice on pSS patients showed good kappa values concerning parotids glands but very low for submandibular glands

Conclusion: This is the first consensus-based US definitions on salivary glands and its elementary components. These results of the reliability exercice on static images showed good results and permit to apply these preliminary definitions on pSS patients with good results in parotids glands. With these results, a new US score could be assessed and used in routine practice

Disclosure: S. Jousse-Joulin, None; M. V. Jonsson, None; N. Luciano, None; E. Theander, Roche, 5; V. Milic, None; A. Hocevar, None; J. Brown, None; A. Carr, None; D. Cornec, None; M. Carotti, None; B. A. Fisher, None; J. Fradin, None; J. Rout, None; A. Saraux, None; A. Stel, None; A. Vissink, None; S. Bowman, Cellgene, 5,Glenmark, 5,GlaxoSmithKline, 5,Eli Lilly and Company, 5,Novartis Pharmaceutical Corporation, 5,Roche Pharmaceuticals, 5,Takeda, 5,UCB, 5; A. N. Baer, Glenmark Pharmaceuticals, 9; M. Tomšič, None; W. F. Ng, None; C. Baldini, None; V. Devauchelle, None.

To cite this abstract in AMA style:

Jousse-Joulin S, Jonsson MV, Luciano N, Theander E, Milic V, Hocevar A, Brown J, Carr A, Cornec D, Carotti M, Fisher BA, Fradin J, Rout J, Saraux A, Stel A, Vissink A, Bowman S, Baer AN, Tomšič M, Ng WF, Baldini C, Devauchelle V. A New Scoring System for Ultrasonographic Evaluation of Salivary Gland in Sjogren: Multireader Reliability [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/a-new-scoring-system-for-ultrasonographic-evaluation-of-salivary-gland-in-sjogren-multireader-reliability/. Accessed .

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