Comparison of Ultra High‐resolution Ultrasound (UHFUS) of Labial Salivary Glands and Conventional Salivary Gland Ultrasonography in Primary Sjögren’s Syndrome Assessment

Chiara Baldini¹, Francesco Ferro ¹, Nicoletta Luciano ¹, Saverio Vitali ², Rossana Izzetti ³, Silvia Fonzetti ⁴, Veronica Iodice ², Marta Mosca ⁵, Valentina Donati ⁶ and Davide Caramella ², ¹Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy, Pisa, Italy, ²Department of Diagnostic and Interventional Radiology, University of Pisa, Pisa, Italy, ³Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa,, Pisa, Italy, ⁴University of Pisa, Pisa, Italy, ⁵Rheumatology Unit, Department of clinical and experimental medicine, University of Pisa, Pisa, Italy, ⁶University of Pisa, Pisa

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: Sjogren's syndrome, ultrasonography and salivary gland

Session Information

Date: Monday, November 11, 2019

Title: Sjögrenʼs Syndrome – Basic & Clinical Science Poster II

Session Type: Poster Session (Monday)

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

Background/Purpose: Labial salivary gland (LSG) biopsy remains a key tool for the diagnosis of primary Sjögren’s syndrome (pSS). Nowadays, however, interest is growing in non‐invasive methods able to supplement more invasive diagnostic procedures. Last‐generation ultra high‐resolution ultrasound (UHFUS) transducers, which can produce frequencies up to 70 MHz and achieve tissue resolution up to 30 μm, have recently opened up new possibilities for the study of a variety of superficial targets. In this work, we investigated the diagnostic accuracy of UHFUS in detecting LSGs involvement in patients with suspected SS and compared UHFUS findings with both LSG histopathology and conventional SGUS.

Methods: We enrolled consecutive patients undergoing a complete diagnostic work-up for suspected pSS, including conventional SGUS and LSG biopsy. The same expert pathologist assessed LSG focus score (FS) also reporting number of foci, presence of ectopic germinal centers (GCs) and percentage of total area infiltrated. UHFUS of LSG was performed by specialized radiologists scanning first the central compartment of the inferior lip, and then both peripheral compartments. The following parameters were evaluated: distribution of the glands, parenchymal inhomogeneity (score 0-3, from normal to evident), fibrosis and eco color-Doppler vascular pattern and grade of vascular intensity.

Results: We included 75 patients with suspected pSS. At the end of the work-up, pSS diagnosis was confirmed in 42/75 (56%) cases. With respect to no-SS sicca controls, pSS patients presented higher UHFUS inhomogeneity scores in both central (p=0.001) and peripheral labial compartments (p=0.001) as well as higher degree of central (p=0.003) and peripheral fibrosis (p=0.002). Considering a score ≥2 in parenchymal inhomogeneity as suggestive for pSS, UHFUS appeared less specific than conventional SGUS (UHFUS Sp=72% vs SGUS Sp=93%) but more sensitive (UHFUS Se=79% vs SGUS Se = 53%). Moreover, in comparison with conventional SGUS, the correlation coefficients between UHFUS inhomogeneity and LSG FS (UHFUS r=0.503** vs SGUS r=0.290*), number of foci (UHFUS r=0.493** vs SGUS r=0.307*), number of ectopic GCs (UHFUS r=0.315** vs SGUS r=0.173), and percentage of total area infiltrated (UHFUS r=0.506** vs SGUS r=0.332) were significantly higher.

Conclusion: The use of UHFUS of LSG in pSS appeared feasible and sensitive potentially offering unique advantages over the conventional imaging modalities in pSS assessment.

Disclosure: C. Baldini, None; F. Ferro, None; N. Luciano, None; S. Vitali, None; R. Izzetti, None; S. Fonzetti, None; V. Iodice, None; M. Mosca, None; V. Donati, None; D. Caramella, None.

To cite this abstract in AMA style:

Baldini C, Ferro F, Luciano N, Vitali S, Izzetti R, Fonzetti S, Iodice V, Mosca M, Donati V, Caramella D. Comparison of Ultra High‐resolution Ultrasound (UHFUS) of Labial Salivary Glands and Conventional Salivary Gland Ultrasonography in Primary Sjögren’s Syndrome Assessment [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/comparison-of-ultra-high%e2%80%90resolution-ultrasound-uhfus-of-labial-salivary-glands-and-conventional-salivary-gland-ultrasonography-in-primary-sjogrens-syndrome-assessment/. Accessed .

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