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Amin SN, Patterson KT, Cvancara DJ, Dahl JP. Pediatric Salivary Gland Pathology. Oral Maxillofac Surg Clin North Am 2024; 36:317-332. [PMID: 38724422 DOI: 10.1016/j.coms.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2024]
Abstract
Benign and malignant salivary gland disorders are uncommon in the pediatric population; however, these can be frequently seen in pediatric otolaryngology or oral and maxillofacial surgery practices. The astute clinician should be aware of the clinical presentation, diagnosis, and management options for common inflammatory, infectious, benign, and malignant disorders of salivary glands.
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Affiliation(s)
- Shaunak N Amin
- Department of Otolaryngology-Head and Neck Surgery, University of Washington, Box 356515 Health Sciences Building, Suite BB1165, Seattle, WA 98195-65, USA
| | - Kristopher T Patterson
- School of Medicine, University of Washington, Box 356515 Health Sciences Building, Suite BB1165, Seattle, WA 98195-65, USA
| | - David J Cvancara
- School of Medicine, University of Washington, Box 356515 Health Sciences Building, Suite BB1165, Seattle, WA 98195-65, USA
| | - John P Dahl
- Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, WA, USA; Division of Pediatric Otolaryngology-Head and Neck Surgery, Seattle Children's Hospital, Seattle, WA, USA.
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2
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Kim JW, Jin R, Han JH, Kang JH, Jung JY, Suh CH, An YS, Kim HA. Correlations between salivary gland scintigraphy and histopathologic data of salivary glands in patients with primary Sjogren's syndrome. Clin Rheumatol 2022; 41:3083-3093. [PMID: 35771363 DOI: 10.1007/s10067-022-06269-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 06/17/2022] [Accepted: 06/26/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Our aim was to evaluate the association between salivary gland scintigraphy and the clinical parameters, including histological characteristics of salivary glands, in patients with primary Sjogren's syndrome (pSS). METHODS Forty-one pSS patients were included in the study. The patients who had received salivary gland scintigraphy and minor salivary gland biopsy were retrospectively analyzed. Salivary gland scintigraphy was interpreted via semi-quantitative methods obtained by calculating the peak uptake and washout of each gland using regions of interest. All specimens were examined by pathologists for focus scores and leukocyte common antigen (LCA) to determine the degree of inflammatory infiltration. RESULTS The mean age of pSS patients was 46.4 years, 82.9% were female, and the mean duration of symptoms was 2.5 years. The focus score was negatively correlated to the mean peak uptake (r = ‒0.396; p = 0.019), mean uptake (r = ‒0.388; p = 0.021), and mean percentage washout (r = ‒0.391; p = 0.02). In addition, the focus score and number of LCA positive cells per mm2 were correlated with the clinical parameters including erythrocyte sedimentation rate, globulin, rheumatoid factor, unstimulated whole saliva, and stimulated whole saliva flow. The number of LCA positive cells per mm2 was negatively correlated to leukocytes and hemoglobin. CONCLUSION Although the diagnostic role of salivary gland biopsy is widely accepted and features in the classification criteria of Sjogren's syndrome, salivary gland scintigraphy may be an acceptable alternative method especially if a non-invasive test is required.
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Affiliation(s)
- Ji-Won Kim
- Department of Rheumatology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea
| | - Roh Jin
- Department of Pathology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea
| | - Jae Ho Han
- Department of Pathology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea
| | - Jeong-Hyun Kang
- Clinic of Oral Medicine and Orofacial Pain, Institute of Oral Health Science, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea
| | - Ju-Yang Jung
- Department of Rheumatology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea
| | - Chang-Hee Suh
- Department of Rheumatology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea
| | - Young-Sil An
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea.
| | - Hyoun-Ah Kim
- Department of Rheumatology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea.
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Pang XA, Wei ZX, Li JH, Pang XQ. Salivary gland function in women with Hashimoto's thyroiditis without xerostomia and the correlation with auto-thyroid antibodies. Nuklearmedizin 2020; 60:47-54. [PMID: 33124031 DOI: 10.1055/a-1204-9748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Hashimoto's thyroiditis (HT) may cause salivary dysfunction in patients resulting in xerostomia, but little is known about changes in salivary function in patients with no obvious dry mouth symptoms. In this study we assessed salivary function in women with HT, who had not experienced xerostomia and, for the first time, evaluated the effects of thyroid auto-antibodies on this function.: METHODS: Sixty consecutive subjects were included, comprising 32 women (mean age, 36 ± 12 years) diagnosed with HT accompanied by differentiated thyroid cancer (DTC) in the study group (HT group), along with a control group (DTC group) of 28 women (mean age, 40 ± 12 years) diagnosed with DTC only. Salivary gland scintigraphy was used to assess salivary function with the semi-quantitative parameters of maximum absorption ratio and maximum secretion ratio, the decrease of which indicate impaired salivary function. Moreover, the HT and DTC groups were divided into four subgroups (Anti- HT, Anti+ HT, Anti- DTC, and Anti+ DTC), based on the presence of anti-thyroid peroxidase antibody (TPOAb) and anti-thyroglobulin antibody (TgAb). Finally, salivary gland semi-quantitative parameters were correlated with levels of thyroid-stimulating hormone (TSH), TGAb, and TPOAb in the HT and DTC groups. RESULTS None of the semi-quantitative parameters examined in parotid or submandibular glands differed significantly between the HT and DTC groups. However, the maximum secretion ratio for the parotid and submandibular glands were significantly different in the subgroup comparison (p < 0.05). Furthermore, the TgAb, TPOAb, and TSH values correlated significantly with salivary excretive function (p ≤ 0.05). CONCLUSION Women with HT without xerostomia may not have salivary functional impairment during hypothyroidism. Serum thyroid autoantibody and TSH levels may mainly influence salivary excretive function but not uptake function.
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Affiliation(s)
- Xiao-An Pang
- Department of Nuclear medicine, First Affiliated Hospital of Guangxi Medical University
| | - Zhi-Xiao Wei
- Department of Nuclear medicine, First Affiliated Hospital of Guangxi Medical University
| | - Jun-Hong Li
- Department of Nuclear medicine, First Affiliated Hospital of Guangxi Medical University
| | - Xiao-Qi Pang
- Department of Radiology, First Affiliated Hospital of Guangxi Medical University
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4
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García-González M, González-Soto MJ, Gómez Rodríguez-Bethencourt MÁ, Ferraz-Amaro I. The validity of salivary gland scintigraphy in Sjögren's syndrome diagnosis: comparison of visual and excretion fraction analyses. Clin Rheumatol 2020; 40:1923-1931. [PMID: 33074391 DOI: 10.1007/s10067-020-05462-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 10/05/2020] [Accepted: 10/11/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The diagnostic validity of salivary gland scintigraphy in Sjögren's syndrome (SS) has not been conclusively defined. Whether a quantitative (excretion fraction) interpretation of scintigraphy is superior to a qualitative one (visual analysis) remains a matter of debate. We sought to determine whether the diagnostic discrimination of excretion fraction is higher compared to that obtained by visual analysis. METHODS Diagnostic test validity study that encompassed 137 suspected SS subjects who underwent scintigraphy for diagnostic purposes. Patients were diagnosed as SS and non-SS according to the rheumatologist's clinical judgment, and by using the American-European Consensus Group (AECG) and American College of Rheumatology (ACR) classification criteria. Visual analysis (normal vs. abnormal and Schall's classification grade) and excretion fraction scores were calculated. The diagnostic discrimination of these methods was compared through the area under the curve (AUC) analysis. Scintigraphy associations with SS clinical and laboratory features were assessed through multivariable regression analysis. RESULTS Schall's classification AUC reached statistical significance in its diagnostic discrimination for SS clinical judgment (0.704 [95%CI 0.597-0.811]) and AECG criteria (0.764 [95%CI 0.641-0.886]). Similarly, submandibular excretion fraction was associated with SS diagnosis based on ACR (0.737 [95%CI 0.546-0.931]) and AECG criteria (0.715 [95%CI 0.597-0.833]). However, AUC comparisons between qualitative and quantitative methods did not yield statistically significant values. Both interpretation modalities were associated with SS serological features. Moreover, excretion fraction was also associated with salivary gland biopsy. CONCLUSIONS SS diagnostic discrimination of excretion fraction is not superior to that obtained by qualitative visual analysis. Both qualitative and quantitative scintigraphy methods are associated with SS clinical and laboratory characteristics.
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Affiliation(s)
| | | | | | - Iván Ferraz-Amaro
- Rheumatology Division, Hospital Universitario de Canarias, Tenerife, Spain
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5
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Chen YC, Han DY, Chang CC, Su CH, Hung SH, Hsu CH. The establishment and application of sialoscintigraphic reference values from patients with obstructive sialadenitis. Nucl Med Commun 2020; 41:308-313. [PMID: 32073551 DOI: 10.1097/mnm.0000000000001161] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AIM To evaluate feasibility of establishing a clinically applicable reference value through those unaffected salivary gland on sialoscintigraphic data obtained from patients presented with obstructive sialadenitis affected a single gland. MATERIALS AND METHODS Ninety-one patients suffered from single salivary gland swelling, pain/tenderness and received sialoscintigraphic examinations were retrospectively enrolled. The quantitative data parameters, including the uptake ratio, maximal accumulation, maximal excretion, time to maximal (Tmax) and time to minimal (Tmin) activity of the affected and unaffected glands, were calculated for analysis. Data were also obtained and recorded for comparison from 50 patients who fulfill the American-European criteria for the diagnosis of Sjogren's syndrome. RESULTS The maximal excretion appeared to be the best indicator for distinguishing affected and unaffected glands of obstructive diseases, for parotid and submandibular glands (P = 0.0002 and P < 0.0001, respectively). The area under the receiver-operating characteristic curve (AUC) is 0.82 for submandibular glands. In patients with Sjogren's syndrome, the maximal excretion and Tmin were the best parameters, for parotid (P = 0.002 and P < 0.0001, respectively) and submandibular glands (P < 0.0001 and P = 0.002, respectively). Uptake ratio was a good parameter for submandibular gland (P < 0.0001). The AUC of maximal excretion and uptake ratio for submandibular glands is 0.81 and 0.77, respectively. CONCLUSION Quantitative data obtained from the unaffected glands of patients with obstructive sialadenitis could be used as reference values for the functional evaluation of salivary gland disorders with maximal excretion as one of the reliable parameters.
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Affiliation(s)
| | | | - Chi-Ching Chang
- Division of Rheumatology, Immunology and Allergy, Department of Internal Medicine, Taipei Medical University Hospital
| | - Chin-Hui Su
- Department of Otolaryngology, Mackay Memorial Hospital
| | - Shih-Han Hung
- Department of Otolaryngology, Taipei Medical University Wan-Fang Hospital.,International Master/PhD Program in Medicine, College of Medicine, Taipei Medical University
| | - Chung-Huei Hsu
- Nuclear Medicine.,Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan
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Son SH, Lee CH, Jung JH, Kim DH, Hong CM, Jeong JH, Jeong SY, Lee SW, Lee J, Ahn BC. The Preventive Effect of Parotid Gland Massage on Salivary Gland Dysfunction During High-Dose Radioactive Iodine Therapy for Differentiated Thyroid Cancer: A Randomized Clinical Trial. Clin Nucl Med 2019; 44:625-633. [PMID: 31274608 DOI: 10.1097/rlu.0000000000002602] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate the preventive effect of parotid gland (PG) massage for PG damage during the I therapy, we prospectively investigated the serum amylase value and salivary gland scintigraphy (SGS) after I therapy. MATERIALS AND METHODS One hundred patients with thyroidectomized differentiated thyroid cancer who underwent high-dose I therapy were enrolled in the clinical trial and randomized into 2 groups (PG massage group and nonmassage group). The serum amylase value was obtained before and 24 hours after I therapy, and the SGSs were also taken just before and at 8 months after the I therapy. Change in serum amylase value and SGS was compared between PG massage and nonmassage groups. RESULTS The difference value of serum amylase was significantly lower in PG massage group than in nonmassage group (P = 0.0052). Worsening of PG function on SGS was observed in 43 (45.3%) of the 95 patients. The incidence rate of PG abnormality on F/U SGS was significantly lower in PG massage group than in nonmassage group (odds ratio, 0.3704; P = 0.0195). In the multiple regression analysis, PG massage significantly affected the abnormality on the 8-month F/U SGS (rpartial = -0.2741, P = 0.0090) after adjusting for clinical variables (age, sex, TNM stage, TSH preparation methods for the I therapy, and I dose). CONCLUSIONS PG gland massage significantly reduced the incidence rates of salivary gland dysfunction on the 8-month F/U SGS and the level of the serological marker of salivary gland destruction after I therapy. Therefore, PG gland massage could alleviate salivary gland damage related to I therapy.
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Affiliation(s)
- Seung Hyun Son
- From the Department of Nuclear Medicine, School of Medicine, Kyungpook National University.,Department of Nuclear Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Chang-Hee Lee
- From the Department of Nuclear Medicine, School of Medicine, Kyungpook National University.,Department of Nuclear Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Ji-Hoon Jung
- From the Department of Nuclear Medicine, School of Medicine, Kyungpook National University.,Department of Nuclear Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Do-Hoon Kim
- From the Department of Nuclear Medicine, School of Medicine, Kyungpook National University.,Department of Nuclear Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Chae Moon Hong
- From the Department of Nuclear Medicine, School of Medicine, Kyungpook National University.,Department of Nuclear Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Ju Hye Jeong
- From the Department of Nuclear Medicine, School of Medicine, Kyungpook National University.,Department of Nuclear Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Shin Young Jeong
- From the Department of Nuclear Medicine, School of Medicine, Kyungpook National University.,Department of Nuclear Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Sang-Woo Lee
- From the Department of Nuclear Medicine, School of Medicine, Kyungpook National University.,Department of Nuclear Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Jaetae Lee
- From the Department of Nuclear Medicine, School of Medicine, Kyungpook National University.,Department of Nuclear Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Byeong-Cheol Ahn
- From the Department of Nuclear Medicine, School of Medicine, Kyungpook National University.,Department of Nuclear Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
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7
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Validation of quantitative salivary gland scintigraphy in relation to the American–European concensus criteria for Sjögren’s syndrome. Nucl Med Commun 2019; 40:343-348. [DOI: 10.1097/mnm.0000000000000983] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Nadal M, Levy M, Bakhsh A, Joly A, Maruani A, Vaillant L, Erra B, Samimi M. Salivary scintigraphy for Sjögren's syndrome in patients with xerostomia: A retrospective study. Oral Dis 2018; 24:552-560. [DOI: 10.1111/odi.12802] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 09/27/2017] [Accepted: 10/18/2017] [Indexed: 01/03/2023]
Affiliation(s)
- M Nadal
- Department of Dermatology; University François Rabelais of Tours; University Hospital of Tours; Tours France
| | - M Levy
- Department of Dermatology; University François Rabelais of Tours; University Hospital of Tours; Tours France
| | - A Bakhsh
- Department of Nuclear Medicine Imaging; University Hospital of Tours; Tours France
- Medical Imaging Department; KAMC-HC; Mecca Saudi Arabia
| | - A Joly
- Department of Stomatology and Maxillofacial Surgery; University François Rabelais of Tours; University Hospital of Tours; Tours France
| | - A Maruani
- Department of Dermatology; University François Rabelais of Tours; University Hospital of Tours; Tours France
- UMR INSERM 1246; SPHERE; Universities of Tours and Nantes; France
| | - L Vaillant
- Department of Dermatology; University François Rabelais of Tours; University Hospital of Tours; Tours France
- INSERM U930; University François Rabelais; Tours France
| | - B Erra
- Department of Nuclear Medicine Imaging; University Hospital of Tours; Tours France
| | - M Samimi
- Department of Dermatology; University François Rabelais of Tours; University Hospital of Tours; Tours France
- Laboratoire “Biologie des Polyomavirus” ISP 1282; UMR INRA-University of Tours; Tours France
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Shen J, Xu XQ, Su GY, Hu H, Shi HB, Liu W, Wu FY. Intravoxel incoherent motion magnetic resonance imaging of the normal-appearing parotid glands in patients with differentiated thyroid cancer after radioiodine therapy. Acta Radiol 2018; 59:204-211. [PMID: 28530137 DOI: 10.1177/0284185117709037] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background Radiation damage to the salivary gland is a common complication of radioiodine therapy (RIT) in the patients with differentiated thyroid cancer (DTC). Purpose To investigate the feasibility of using intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) to detect radiation-induced changes of normal-appearing parotid glands in the patients after RIT for DTC. Material and Methods We prospectively enrolled 20 patients with RIT-induced sialoadenitis and 20 healthy control (HC) participants. The patients were divided into intermediate and late groups, and a questionnaire was used to assess the related symptoms. IVIM MRI was scanned using nine b-values (0, 50, 100, 150, 200, 400, 600, 800, and 1000 s/mm2). Quantitative parameters (pseudodiffusion coefficient, D*; perfusion fraction, f; tissue diffusivity, D) were obtained using a biexponential model and compared among different groups using one-way analysis of variance (ANOVA) test. Correlations between significant parameters and symptom score were assessed using Spearman's correlation analysis. Results The f and D value differed significantly (f, P = 0.016; D, P = 0.006) among different groups. Post hoc analysis showed that f and D value of intermediate group were significantly higher than those of HC group (f, P = 0.012; D, P = 0.004), while no significant differences between late group and HC group (f, P = 0.852; D, P = 0.707). Significant positive correlation was found between f value and the total symptom score of the patients in intermediate group ( P = 0.028, r = 0.762). Conclusion The IVIM MRI might be feasible to detect the radiation-induced changes of parotid glands in the patients after RIT for DTC.
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Affiliation(s)
- Jie Shen
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Xiao-Quan Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Guo-Yi Su
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Hao Hu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Hai-Bin Shi
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Wei Liu
- Department of nuclear medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Fei-Yun Wu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
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Angusti T, Pilati E, Parente A, Carignola R, Manfredi M, Cauda S, Pizzigati E, Dubreuil J, Giammarile F, Podio V, Skanjeti A. Semi-quantitative analysis of salivary gland scintigraphy in Sjögren’s syndrome diagnosis: a first-line tool. Clin Oral Investig 2017; 21:2389-2395. [DOI: 10.1007/s00784-016-2034-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 12/08/2016] [Indexed: 11/29/2022]
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Infante J, García L, Rayo J, Serrano J, Domínguez M, Moreno M. Aportación diagnóstica del análisis cuantitativo de la gammagrafía salival en pacientes con sospecha de síndrome de Sjögren. Rev Esp Med Nucl Imagen Mol 2016; 35:145-51. [DOI: 10.1016/j.remn.2015.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 09/17/2015] [Accepted: 09/21/2015] [Indexed: 11/29/2022]
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12
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Infante J, García L, Rayo J, Serrano J, Domínguez M, Moreno M. Diagnostic contribution of quantitative analysis of salivary scintigraphy in patients with suspected Sjögren's syndrome. Rev Esp Med Nucl Imagen Mol 2016. [DOI: 10.1016/j.remnie.2016.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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13
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The Diagnostic Value of Technetium 99m Pertechnetate Salivary Gland Scintigraphy in Patients With Certain Salivary Gland Diseases. J Oral Maxillofac Surg 2015; 73:443-50. [DOI: 10.1016/j.joms.2014.09.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 09/16/2014] [Accepted: 09/18/2014] [Indexed: 12/14/2022]
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14
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Controversies in the Management of Pediatric Sialorrhea. CURRENT OTORHINOLARYNGOLOGY REPORTS 2015. [DOI: 10.1007/s40136-014-0073-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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15
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Afzelius P, Nielsen MY, Ewertsen C, Bloch KP. Imaging of the major salivary glands. Clin Physiol Funct Imaging 2014; 36:1-10. [DOI: 10.1111/cpf.12199] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 09/18/2014] [Indexed: 02/04/2023]
Affiliation(s)
- Pia Afzelius
- Department of Diagnostic Imaging; North Zealand Hospital; Copenhagen Denmark
| | - Ming-Yuan Nielsen
- Department of Diagnostic Imaging; North Zealand Hospital; Copenhagen Denmark
| | - Caroline Ewertsen
- Department of Radiology, Rigshospitalet; Copenhagen University Hospital; Copenhagen Denmark
| | - Klaus Poulsen Bloch
- Department of Diagnostic Imaging; North Zealand Hospital; Copenhagen Denmark
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16
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Jeong SY, Kim HW, Lee SW, Ahn BC, Lee J. Salivary gland function 5 years after radioactive iodine ablation in patients with differentiated thyroid cancer: direct comparison of pre- and postablation scintigraphies and their relation to xerostomia symptoms. Thyroid 2013; 23:609-16. [PMID: 23153322 PMCID: PMC3643252 DOI: 10.1089/thy.2012.0106] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Chronic sialadenitis is one of the most frequent chronic complications after radioactive iodine (RAI) therapy for thyroid cancer. To evaluate the long-term effects of RAI ablation on salivary gland function, we investigated scintigraphic changes in salivary glands by direct comparison of two salivary gland scintigraphies (SGSs) taken before and at 5 years after an RAI ablation. METHODS SGS was performed just before RAI ablation (pre-SGS) and ∼5 years after RAI ablation (F/U SGS) in 213 subjects who underwent thyroidectomy for thyroid cancer. The uptake score (U score) was graded, and the ejection fraction (EF) was quantified for the parotid and submandibular glands at pre-SGS and F/U SGS. Changes in salivary gland function were graded as mild, moderate, or severe according to the differences in U score and EF between the two SGSs. Xerostomia was assessed and compared with the SGS findings. RESULTS Worsening of the U score was observed in 182 of 852 salivary glands (total: 21.3%; mild: 4.2%, moderate: 7.4%, severe: 9.7%), and 47.4% of the patients had a worsening U score for at least one of four salivary glands. A decrease in EF was observed in 173 of 852 salivary glands (total: 20.3%; mild: 5.4%, moderate: 6.8%, severe: 8.1%), and 43.7% of the patients experienced a decrease in the EF of at least one of the four salivary glands. Bilateral parotid gland dysfunction was the most commonly observed condition. Thirty-five (16.4%) patients complained of xerostomia at 5 years after RAI ablation. Scintigraphic changes in salivary gland function and xerostomia were more common in patients receiving 5.55 GBq, compared with 3.7 GBq. Xerostomia was more common in patients with submandibular gland dysfunction than those with parotid gland dysfunction (68.8% vs. 33.3%, p<0.05). The number of dysfunctional salivary glands was correlated with xerostomia (p<0.01). CONCLUSION About 20% of the salivary glands were dysfunctional on SGS 5 years after a single RAI ablation, especially in patients who received higher doses of RAI. While parotid glands are more susceptible to (131)I-related damage, xerostomia was more associated with submandibular gland dysfunction and the prevalence of dysfunctional salivary glands.
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Affiliation(s)
- Shin Young Jeong
- Department of Nuclear Medicine, Kyungpook National University School of Medicine/Hospital , Daegu, Korea
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Semi-quantitative evaluation of salivary gland function in Sjögren's syndrome using salivary gland scintigraphy. Clin Rheumatol 2012; 31:1699-705. [PMID: 22941258 DOI: 10.1007/s10067-012-2076-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2011] [Revised: 08/15/2012] [Accepted: 08/19/2012] [Indexed: 10/27/2022]
Abstract
This retrospective study is designed to evaluate the diagnostic value of semi-quantitative parameters of salivary gland scintigraphy (SGS) in Sjögren's syndrome (SS) and explore the relationship between SGS parameters and salivary gland histopathologic manifestations. SGS and labial salivary gland biopsy were performed on 95 SS patients and 36 healthy age-matched and sex-matched volunteers. Uptake ratios at 15 min (UR(15)) and stimulated excretion fraction (EF) of each parotid and submandibular gland were calculated automatically from SGS; histopathologic grades were classified based on focal lymphocytic infiltration, and biopsy focus scores were calculated simultaneously. As a result, the UR(15) and EF of each salivary gland in SS patients were significantly lower than that in controls. Multivariate logistic regression equation was: logit p = 6.965 - 1.680 × UR(15) of left submandibular gland - 0.040 × EF of left parotid gland - 0.050 × EF of right submandibular gland. The receiver operating characteristic (ROC) curve validated high efficiency of this model with the area under curve of 0.911. And logistic regression analysis on combined original and validation cohorts confirmed its diagnostic value. Moreover, the EF of right parotid gland and both submandibular glands was correlated with histopathologic changes. Consequently, the semi-quantitative parameters of SGS may be helpful for diagnosing SS; UR(15) of left submandibular gland, EF of left parotid gland, and EF of right submandibular gland are more powerful predictor of SS. Besides, SGS parameters reflect the degree of salivary gland involvement, severe patients with low parameters would have high histopathologic grades and biopsy focus scores.
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Sun Z, Zhang Z, Fu K, Zhao Y, Liu D, Ma X. Diagnostic accuracy of parotid CT for identifying Sjögren's syndrome. Eur J Radiol 2012; 81:2702-9. [PMID: 22285605 DOI: 10.1016/j.ejrad.2011.12.034] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2011] [Revised: 12/10/2011] [Accepted: 12/13/2011] [Indexed: 10/14/2022]
Abstract
PURPOSE To evaluate the diagnostic accuracy of computed tomography (CT) of the parotid gland for Sjögren's syndrome in comparison with conventional X-ray sialography. METHODS CT scans and X-ray sialography were performed in 34 patients with confirmed Sjögren's syndrome and 22 symptomatic controls without the disease. CT data from 57 asymptomatic controls were included for quantitative analysis. The CT findings of heterogeneity, abnormal diffuse fat tissue deposition, diffuse punctate calcification, swelling or atrophy, nodularity or cystic changes of the parotid gland were analyzed by two independent blinded readers. The correlation between CT and X-ray sialography findings was evaluated. Diagnostic performance and receiver operating characteristics curves were calculated. RESULTS On CT, heterogeneity of the parotid gland was seen in 30/31 (reader 1/reader 2) Sjögren's syndrome patients by the two readers (sensitivity 88.2%/91.2%; specificity 100%/90.9%). Abnormal diffuse fat tissue deposition was seen in 28/28 SS patients by the readers (sensitivity 82.3%/82.3%; specificity 100%/90.9%). Diffuse punctate calcification was seen in 10/12 Sjögren's syndrome patients (sensitivity 29.4%/35.2%; specificity 100%/100%). Stagings of CT findings correlate positively with sialography. The areas under the receiver operating characteristics curves were 0.887 (P=0.000) and 0.908 (P=0.000) for the maximum and standard deviation (SD) of the CT value. CONCLUSIONS Parotid CT is accurate and reliable in the diagnosis of Sjögren's syndrome. Heterogeneity, abnormal diffuse fat tissue deposition, and diffuse punctate calcification are specific for Sjögren's syndrome. CT attenuation analysis is helpful in diagnosis.
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Affiliation(s)
- Zhipeng Sun
- Department of Oral and Maxillofacial Radiology, School and Hospital of Stomatology, Peking University, No.22, South Zhong Guan Cun Ave., Haidian District, Beijing 100081, China.
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Quantitative and visual evaluation of salivary and thyroid glands in patients with primary Sjögren's syndrome using salivary gland scintigraphy: relationship with clinicopathological features of salivary, lacrimal and thyroid glands. Nucl Med Commun 2010. [DOI: 10.1097/mnm.0b013e328339bdf6] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Vinagre F, Santos MJ, Prata A, da Silva JC, Santos AI. Assessment of salivary gland function in Sjögren's syndrome: the role of salivary gland scintigraphy. Autoimmun Rev 2009; 8:672-6. [PMID: 19245858 DOI: 10.1016/j.autrev.2009.02.027] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2009] [Accepted: 02/09/2009] [Indexed: 11/19/2022]
Abstract
Salivary gland scintigraphy (SGS) is a non invasive method of salivary gland function assessment. This technique is easy to perform, reproducible and well tolerated by patients. Additionally, an abnormal salivary gland scintigraphy result is accepted by the American-European consensus group as a criterion for the diagnosis of Sjögren's syndrome. Scintigraphic evaluation of salivary gland function also plays an important role in therapeutic decision and patient follow-up. Schall's categorical classification is usually considered the standard method for salivary scintigraphy interpretation, though subjective and with limited capacity to discriminate borderline results. In order to improve the diagnostic accuracy of SGS, there has been an increasing interest in the quantification of glandular function. However, the debate on the most reliable and suitable parameters for the diagnosis of SS persists.
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Affiliation(s)
- F Vinagre
- Rheumatology Department, Hospital Garcia de Orta, Almada, Portugal.
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Pipitone N, Salvarani C. Role of imaging in vasculitis and connective tissue diseases. Best Pract Res Clin Rheumatol 2009; 22:1075-91. [PMID: 19041078 DOI: 10.1016/j.berh.2008.09.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Imaging techniques play a pivotal role in securing the diagnosis of large vessel vasculitis, and in demonstrating internal organ involvement in connective tissue diseases. In large vessel vasculitis, angiography is useful in demonstrating vessel stenoses or aneurysms. However, angiography is unable to reveal initial lesions such as vessel wall oedema and thickening, and is thus not useful to make an early diagnosis. In contrast, colour Doppler ultrasonography, computerized tomography angiography, and magnetic resonance imaging/angiography are able to delineate both the vessel wall and the lumen. Therefore, they may show vessel wall alterations when the lumen is still unaffected on angiography. 18fluorodeoxyglucose positron emission tomography does not visualize the vessel wall, but is very sensitive in revealing inflamed vessels. All of these investigations have also been used to follow up patients over time and to monitor response to treatment. In connective tissue diseases, imaging techniques are particularly useful to study internal organs, especially the brain and lung. Magnetic resonance imaging is the investigation of choice to detect and monitor brain disease, while computerized tomography is the best procedure for lung disease. However, since most imaging findings are not entirely specific for any given condition, it is important to interpret the results of imaging in the broader clinical context.
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Affiliation(s)
- Nicolò Pipitone
- Department of Rheumatology, Arcispedale Santa Maria Nuova, Viale Risorgimento, 80 42100 Reggio Emilia, Italy
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[Interdisciplinary point of contact between rheumatology and pneumology]. Z Rheumatol 2008; 67:407-10, 412-4. [PMID: 18704464 DOI: 10.1007/s00393-008-0346-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The lungs are involved in many inflammatory rheumatic diseases. We will focus on the most common clinical problems. In systemic sclerosis interstitial lung disease resulting in fibrosis and pulmonary arterial hypertension (PAH) resulting in right heart failure are the leading complications requiring close cooperation between specialists in rheumatology and pulmonology. In Sjogren's syndrome interstitial pneumonia, pleural and bronchial inflammation and rarely PAH will be the main pulmonary complications. Hypereosinophilic syndrome, eosinophilic pneumonia, and Churg-Strauss syndrome are conditions that show marked eosinophilia and can clinically be confused with asthma and allergic bronchopulmonary aspergillosis. These conditions mandate thorough investigation of the lungs including bronchoscopy and possibly open lung biopsy. Finally, patients for whom treatment with tumour necrosis factor blocking agents is planned should undergo interdisciplinary management to prevent tuberculosis activation or infection.
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Role of Nuclear Scintigraphy in the Characterization and Management of the Salivary Component of Sjögren's Syndrome. Rheum Dis Clin North Am 2008; 34:973-86, ix. [DOI: 10.1016/j.rdc.2008.08.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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