Salivary gland scintigraphy in Sjögren's syndrome. Comparison of the diagnostic performance of visual and semiquantitative analysis.

Abstract

The aim of this study was to compare the diagnostic utility of visual versus

semi-quantitative analysis of salivary gland scintigraphy in the diagnosis of

Sjogren's syndrome (SS). PATIENTS, METHODS: 99mTc-pertechnetate salivary gland

scintigraphy was performed in 145 patients (133 women, 12 men) with clinically

suspicious SS. The images were interpreted with visual and semiquantitative

methods and the diagnostic performances for SS were compared using uptake and

excretory functional parameters. RESULTS: In total, 76 patients (52.4%) were

finally diagnosed with SS. The sensitivity, specificity, positive predictive

value, negative predictive value, and accuracy of visual analysis for the

diagnosis of SS were 88.2%, 48.6%, 65.1%, 79.1%, and 69.2%, respectively.

Semiquantitative values, the area under the ROC curve for uptake ratio and

percentage excretion in the right salivary glands were signi fi cantly greater

than 0.5 (p < 0.05). However, the percentage excretion in the left salivary

glands did not show a statistically significant diagnostic ability for SS. The

diagnostic ability of visual assessment was greater than that of the

semiquantitative method in terms of evaluating uptake and excretory function in

the submandibular glands. CONCLUSION: Visual analysis of salivary gland

scintigraphy showed greater diagnostic utility than semiquantitative assessment

in the diagnosis of SS, especially in the submandibular glands.