A Point-Scoring System for the Clinical Diagnosis of Sjögren's Syndrome Based on Quantified SPECT Imaging of Salivary Gland

Abstract

ObjectiveTo establish a point-scoring diagnostic system for Sjögren's syndrome (SS) based on quantified SPECT imaging of salivary gland, and evaluate its feasibility and performance compared with 2002 AECG criteria and 2012 ACR criteria.Methods213 patients with suspected SS enrolled in this study. The related clinical data of all patients were collected. All patients were evaluated and grouped on a clinical basis and posttreatment follow-up by rheumatology specialists as the unified standard (SS group with 149 cases and nSS group with 64 cases). From SPECT imaging of salivary gland, Tmax, UImax, Ts and EFs were derived for bilateral parotid and submandibular glands, and compared between the groups. A point-scoring diagnostic system for SS was established based on the quantified SPECT imaging of salivary gland. We estimated the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy for the new diagnostic system, compared with 2002 AECG criteria and 2012 ACR criteria.ResultsWhen 7.0 was used as the cut-off point, the sensitivity, specificity, PPV, NPV and accuracy for the new point-scoring system in diagnosing SS were 89.93% (134/149), 93.75% (60/64), 97.10% (134/138), 80.00% (60/75) and 91.08% (194/213), respectively. The new point-scoring diagnostic system based on quantified SPECT imaging of salivary gland keeps the specificity comparatively to 2002 AECG criteria and 2012 ACR criteria, but improves the sensitivity significantly (P<0.01).ConclusionThe new point-scoring diagnostic system for SS based on quantified SPECT imaging of salivary gland may be superior to 2002 AECG criteria and 2012 ACR criteria, with higher sensitivity and similar specificity in the diagnosis of SS. Additionally, it also has good feasibility in the clinical settings.

Potential Applications of 68Ga-PSMA-11 PET/CT in the Evaluation of Salivary Gland Uptake Function: Preliminary Observations and Comparison with 99mTcO4− Salivary Gland Scintigraphy

“…e general information and PET and SGS imaging results for all 15 patients are shown in Table 1. is study included 4 patients with Sjogren's syndrome (patients 1-4), 10 patients with head and neck tumors after radiotherapy and chemotherapy (patients [5][6][7][8][9][10][11][12][13][14], and 1 patient with surgery for parotid space-occupying lesions (patient 15).…”

“…In addition, the thyroid uptake of 99m TcO − 4 was significantly increased; this patient had a history of hyperthyroidism and took propylthiouracil for half a year. 6 Contrast Media & Molecular Imaging Figure 3: A 64-year-old male patient (patient 5) with nasopharyngeal carcinoma received radiotherapy and chemotherapy. e 68 Ga-PSMA-11 PET/CT MIP (a) and tomographic images (c-e) clearly show a slight uptake of 68 Ga-PSMA-11 in the right submandibular gland (small arrow; SUVmax, 2.6) but no significant uptake of imaging agents in the left submandibular gland (large arrow; SUVmax, 1.9).…”

“…SGS allows a noninvasive inspection of the condition and has the advantages of simplicity, safety, and relatively low cost [5]. SGS is a commonly used method for the clinical evaluation of salivary gland function and has high speci city and sensitivity [6]. SGS has been generally proposed to assess salivary gland function in different indications [7,8].…”

Quantitative Single-Photon Emission Computed Tomography/Computed Tomography for Evaluation of Salivary Gland Dysfunction in Sjögren’s Syndrome Patients

“…In fact, 3dimensional SPECT approach without CT has rarely been applied to the salivary gland imaging [32,33]. SPECT with integrated CT (hybrid SPECT/CT) has been anecdotally performed for the functional evaluation of salivary glands without true quantitative assessment [23,34]. In the current study using quantitative SPECT/CT technology, the uptake/excretion of Tc-99m pertechnetate was absolutely quantitated under base of %ID that had been corrected for attenuation, scatter, and variation of distance between detector and patient (resolution recovery).…”

Sialoszintigrafie

“…Typischerweise zeigt sich in der Szintigrafie eine reduzierte Akkumulation und verzögerte Clearance sowie eine verminderte Reaktion auf das Sialogogum. Zudem ist szintigrafisch eine Quantifizierung der Funktionseinschränkung möglich [14]; Scoring-Systeme sind in der Literatur beschrieben, finden bislang jedoch keine routinemäßige Anwendung bei der Beurteilung [9]. Auch das Heerfordt-Syndrom (Febris uveoparotidea im Rahmen eines Morbus Boeck) geht unter anderem einher mit einer chronischen Entzündung der Parotiden, die zum Leitsymptom der Xerostomie führt [3,24].…”