Salivary Gland Ultrasound in Primary Sjögren's Syndrome: Current and Future Perspectives

Overview

Journal Open Access Rheumatol

Publisher Dove Medical Press

Specialty Rheumatology

Date 2022 Sep 8

PMID 36072437

Authors

Michele Lorenzon

Erica Spina

Francesco Tulipano Di Franco

Ivan Giovannini

Salvatore De Vita

Alen Zabotti

Affiliations

Soon will be listed here.

Abstract

Salivary gland ultrasound (SGUS) is the imaging modality of choice for the assessment of parotid and submandibular gland parenchyma. Being highly effective, non-invasive and easy to perform, SGUS has become increasingly popular among specialists in assessing salivary gland (SG) abnormalities, including those commonly found in primary Sjögren's syndrome (pSS). SGUS may be useful in the assessment of pSS and its complications, the most serious being the development of non-Hodgkin's lymphoma (NHL). SGUS may also be useful in the characterization and differential diagnosis of diffuse and focal abnormalities commonly associated with pSS, and may act as a guide for core-needle biopsy (CNB), an established, safe, and feasible technique, which provides enough viable tissue for the diagnosis and assessment of lymphoproliferative diseases of the SG. The combination of SGUS with other tools, such as sonoelastography and artificial intelligence (AI), could further improve the usefulness of SGUS in the management of pSS. In this perspective, we summarize current and future applications of SGUS in pSS.

Citing Articles

Clinical value of salivary gland ultrasonography in evaluating secretory function, disease activity, and lymphoma risk factors in primary Sjögren's syndrome.

Yang J, Park Y, Lee J, Kim W, Park S, Kwok S Clin Rheumatol. 2025; .

PMID: 40035924 DOI: 10.1007/s10067-025-07369-0.

Salivary Flow Rate in Patients with Sjögren's Syndrome: Correlations with Salivary Gland Ultrasound Findings and Biomarkers of Disease Activity.

Caraba A, Roman D, Crisan V, Iurciuc S, Iurciuc M Int J Mol Sci. 2025; 26(1.

PMID: 39795957 PMC: 11720050. DOI: 10.3390/ijms26010101.

Practical Use of Ultrasound in Modern Rheumatology-From A to Z.

Sapundzhieva T, Sapundzhiev L, Batalov A Life (Basel). 2024; 14(9).

PMID: 39337990 PMC: 11433054. DOI: 10.3390/life14091208.

Update on the pathophysiology and treatment of primary Sjögren syndrome.

Baldini C, Fulvio G, La Rocca G, Ferro F Nat Rev Rheumatol. 2024; 20(8):473-491.

PMID: 38982205 DOI: 10.1038/s41584-024-01135-3.

Performance of salivary glands ultrasonography, shear wave elastography and their combined use for the diagnosis of primary and secondary Sjögren's syndrome.

Cheng L, Yang Y, Ma A J Appl Clin Med Phys. 2024; 25(8):e14441.

PMID: 38980059 PMC: 11302824. DOI: 10.1002/acm2.14441.

References

Kise Y, Shimizu M, Ikeda H, Fujii T, Kuwada C, Nishiyama M . Usefulness of a deep learning system for diagnosing Sjögren's syndrome using ultrasonography images. Dentomaxillofac Radiol. 2019; 49(3):20190348. PMC: 7068075. DOI: 10.1259/dmfr.20190348. View

Pfeiffer J, Ridder G . Diagnostic value of ultrasound-guided core needle biopsy in patients with salivary gland masses. Int J Oral Maxillofac Surg. 2011; 41(4):437-43. DOI: 10.1016/j.ijom.2011.12.005. View

Pijpe J, Kalk W, van der Wal J, Vissink A, Kluin P, Roodenburg J . Parotid gland biopsy compared with labial biopsy in the diagnosis of patients with primary Sjogren's syndrome. Rheumatology (Oxford). 2006; 46(2):335-41. DOI: 10.1093/rheumatology/kel266. View

Vitali C, Carotti M, Salaffi F . Is it the time to adopt salivary gland ultrasonography as an alternative diagnostic tool for the classification of patients with Sjögren's syndrome? Comment on the article by Cornec et al. Arthritis Rheum. 2013; 65(7):1950. DOI: 10.1002/art.37945. View

Fana V, Dohn U, Krabbe S, Terslev L . Application of the OMERACT Grey-scale Ultrasound Scoring System for salivary glands in a single-centre cohort of patients with suspected Sjögren's syndrome. RMD Open. 2021; 7(2). PMC: 8061801. DOI: 10.1136/rmdopen-2020-001516. View

Hardee P, Carter J, Piper K, Ng S . Metachronous bilateral primary adenocarcinoma of the submandibular glands. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001; 91(4):455-61. DOI: 10.1067/moe.2001.113547. View

Roesink J, Moerland M, Hoekstra A, van Rijk P, Terhaard C . Scintigraphic assessment of early and late parotid gland function after radiotherapy for head-and-neck cancer: a prospective study of dose-volume response relationships. Int J Radiat Oncol Biol Phys. 2004; 58(5):1451-60. DOI: 10.1016/j.ijrobp.2003.09.021. View

Ramos-Casals M, Brito-Zeron P, Garcia-Carrasco M, Font J . Sarcoidosis or Sjögren syndrome? Clues to defining mimicry or coexistence in 59 cases. Medicine (Baltimore). 2004; 83(2):85-95. DOI: 10.1097/01.md.0000121237.98962.1e. View

De Vita S, Boiocchi M, Sorrentino D, Carbone A, Avellini C, Dolcetti R . Characterization of prelymphomatous stages of B cell lymphoproliferation in Sjögren's syndrome. Arthritis Rheum. 1997; 40(2):318-31. DOI: 10.1002/art.1780400217. View

10.

Abraham M, Khosroshahi A . Diagnostic and treatment workup for IgG4-related disease. Expert Rev Clin Immunol. 2017; 13(9):867-875. PMC: 5896560. DOI: 10.1080/1744666X.2017.1354698. View

11.

Eom H, Lee J, Ko M, Choi Y, Yoon R, Cho K . Comparison of fine-needle aspiration and core needle biopsy under ultrasonographic guidance for detecting malignancy and for the tissue-specific diagnosis of salivary gland tumors. AJNR Am J Neuroradiol. 2015; 36(6):1188-93. PMC: 8013020. DOI: 10.3174/ajnr.A4247. View

12.

Jousse-Joulin S, Coiffier G . Current status of imaging of Sjogren's syndrome. Best Pract Res Clin Rheumatol. 2020; 34(6):101592. DOI: 10.1016/j.berh.2020.101592. View

13.

Nocturne G, Pontarini E, Bombardieri M, Mariette X . Lymphomas complicating primary Sjögren's syndrome: from autoimmunity to lymphoma. Rheumatology (Oxford). 2019; 60(8):3513-3521. PMC: 8328496. DOI: 10.1093/rheumatology/kez052. View

14.

Bialek E, Jakubowski W, Karpinska G . Role of ultrasonography in diagnosis and differentiation of pleomorphic adenomas: work in progress. Arch Otolaryngol Head Neck Surg. 2003; 129(9):929-33. DOI: 10.1001/archotol.129.9.929. View

15.

Raderer M, Kiesewetter B, Ferreri A . Clinicopathologic characteristics and treatment of marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma). CA Cancer J Clin. 2016; 66(2):153-71. DOI: 10.3322/caac.21330. View

16.

Fragkioudaki S, Mavragani C, Moutsopoulos H . Predicting the risk for lymphoma development in Sjogren syndrome: An easy tool for clinical use. Medicine (Baltimore). 2016; 95(25):e3766. PMC: 4998301. DOI: 10.1097/MD.0000000000003766. View

17.

Badarinza M, Serban O, Maghear L, Bocsa C, Micu M, Damian L . Shear wave elastography as a new method to identify parotid lymphoma in primary Sjögren Syndrome patients: an observational study. Rheumatol Int. 2020; 40(8):1275-1281. DOI: 10.1007/s00296-020-04548-x. View

18.

Cornec D, Saraux A, Jousse-Joulin S, Pers J, Boisrame-Gastrin S, Renaudineau Y . The Differential Diagnosis of Dry Eyes, Dry Mouth, and Parotidomegaly: A Comprehensive Review. Clin Rev Allergy Immunol. 2014; 49(3):278-87. DOI: 10.1007/s12016-014-8431-1. View

19.

Bialek E, Jakubowski W, Zajkowski P, Szopinski K, Osmolski A . US of the major salivary glands: anatomy and spatial relationships, pathologic conditions, and pitfalls. Radiographics. 2006; 26(3):745-63. DOI: 10.1148/rg.263055024. View

20.

van Ginkel M, Glaudemans A, van der Vegt B, Mossel E, Kroese F, Bootsma H . Imaging in Primary Sjögren's Syndrome. J Clin Med. 2020; 9(8). PMC: 7463854. DOI: 10.3390/jcm9082492. View