Assessing the Vascularization of Salivary Glands in Patients with Sjögren's Syndrome - An OMERACT Ultrasound Group Reliability Exercise

Alojzija Hocevar¹, Sandrine Jousse-Joulin ², Nejc Perko ³, STEPHANIE FINZEL ⁴, PETRA HANOVA ⁵, ANNAMARIA IAGNOCCO ⁶, Nevsun Inanc ⁷, ESPERANZA NAREDO ⁸, WOLFGANG A. SCHMIDT ⁹, Lene Terslev ¹⁰, ALEN ZABOTTI ¹¹, Matija Tomšič ¹² and George A. W. Bruyn ¹³, ¹Department of Rheumatology, University Medical Center Ljubljana, Slovenia, LJUBLJANA, Slovenia, ²Rheumatology Department, Cavale Blanche Hospital and Brest Occidentale University, Brest, France, ³Faculty of electrical engineering, University of Ljubljana, LJUBLJANA, Slovenia, ⁴Department of Rheumatology and Clinical Immunology, University Medical Centre, FREIBURG, Germany, ⁵5Institute of Rheumatology and Department of Rheumatology, First Faculty of Medicine, Charles University, PRAGUE, Czech Republic, ⁶Academic Rheumatology Centre, Università degli Studi di Torino, TURIN, Italy, ⁷Marmara University, Faculty of Medicine, Division of Rheumatology, Istanbul, Turkey, ISTANBUL, Turkey, ⁸Rheumatology Department, Joint and Bone Research Unit. Hospital Universitario Fundación Jiménez Díaz, Universidad Autónoma, MADRID, Spain, ⁹Medical Center of Rheumatology, Immanuel Krankenhaus Berlin Buch, BERLIN, Germany, ¹⁰Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Copenhagen, Denmark, ¹¹Department of Medical and Biological Sciences, Rheumatology Clinic, University Hospital Santa Maria della Misericordia, UDINE, Italy, ¹²Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia, LJUBLJANA, Slovenia, ¹³Department of Rheumatology, MC Groep Hospitals., Lelystad, Netherlands

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: Doppler ultrasound and salivary gland, Sjogren's syndrome

Session Information

Date: Sunday, November 10, 2019

Session Title: Imaging Of Rheumatic Diseases Poster I

Session Type: Poster Session (Sunday)

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

Background/Purpose: The vascularization of salivary glands (SG) in Sjögren’s syndrome (SS) has not been extensively studied by imaging methods, and currently no agreement exists on how this should best be evaluated. Color Doppler (CD) ultrasonography (US) might represent a good tool for the assessment of vascularization in SS.

The aim of the exercise of the OMERACT Sjögren US subtask group was to test the reliability of SG vascularization assessment in SS patients using a consensual developed semiquantitative CD US scoring system.

Methods: Nine sonographers participated in the reliability exercise, evaluating the vascularization of bilateral parotid and submandibular glands in 9 SS patients using CD US with previously standardized and optimized Doppler settings. The participants were not allowed to modify the settings while scanning. The superficial lobe of parotid glands was scanned in both longitudinal and transverse plane, while submandibular glands were scanned in longitudinal plane only. A previously agreed four grade semiquantitative score was applied: Grade 0, no visible vascular signals; Grade 1, focal, dispersed vascular signals; Grade 2, diffuse vascular signals detected in less than 50% of the gland; Grade 3, diffuse vascular signals in more than 50% of the gland. Intrareader and interreader reliability of grading SG was determined by Light’s weighted kappa analysis.

Results: Light’s weighted kappa of intrareader and interreader reliability showed good to excellent agreement. Data are presented in Table 1.

Conclusion: The consensual CD US scoring for the evaluation of SG vascularization in SS showed a good interreader reliability and excellent intrareader reliability. Next step should be further testing for clinical application in a larger group of SS patients and controls. In addition, a potential correlation between SG structural changes seen on B-mode US and vascularization should be studied.

Table 1. The prevalence of grades, intrareader, and interreader reliability of the proposed CD US scoring for the assessment of SG vascularization.

Disclosure: A. Hocevar, None; S. Jousse-Joulin, None; N. Perko, None; S. FINZEL, None; P. HANOVA, None; A. IAGNOCCO, None; N. Inanc, None; E. NAREDO, None; W. SCHMIDT, None; L. Terslev, None; A. ZABOTTI, None; M. Tomšič, None; G. Bruyn, None.

To cite this abstract in AMA style:

Hocevar A, Jousse-Joulin S, Perko N, FINZEL S, HANOVA P, IAGNOCCO A, Inanc N, NAREDO E, SCHMIDT W, Terslev L, ZABOTTI A, Tomšič M, Bruyn G. Assessing the Vascularization of Salivary Glands in Patients with Sjögren’s Syndrome – An OMERACT Ultrasound Group Reliability Exercise [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/assessing-the-vascularization-of-salivary-glands-in-patients-with-sjogrens-syndrome-an-omeract-ultrasound-group-reliability-exercise/. Accessed November 28, 2020.

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