SALIVARY gland ultrasound (SGUS) demonstrated meaningful diagnostic value for patients with highly suspected Sjögren’s Disease (SjD), particularly when combined with established serological or biopsy measures, according to findings from a prospective monocentric study.
In this trial, 171 patients with strong clinical suspicion of SjD underwent SGUS of both parotid and submandibular glands using the OMERACT scoring system. Among the cohort, 130 patients ultimately received a confirmed diagnosis. The OMERACT total score showed moderate accuracy for distinguishing SjD, yielding an area under the curve (AUC) of 0.78, sensitivity of 0.52, and specificity of 0.93.
For comparison, labial salivary gland biopsy (LSGB) provided the highest diagnostic efficacy (AUC 0.90), while anti-Ro/SSA antibody testing achieved an AUC of 0.79. Notably, integrating SGUS results with either biopsy or antibody testing further improved diagnostic performance, reaching a specificity of 1.00.
Both parotid and submandibular ultrasound grading demonstrated comparable diagnostic utility, though submandibular assessment produced higher sensitivity at the expense of reduced specificity. Importantly, a Grade 3 ultrasound score strongly predicted biopsy positivity (AUC 0.77) and correlated with reduced unstimulated salivary flow rates. Correlation coefficients were -0.45 for parotid and -0.51 for submandibular glands.
Although the overall discriminatory ability of SGUS was lower than biopsy, the modality offers a valuable adjunct in evaluating patients with suspected SjD. The findings suggest that SGUS, particularly Grade 3 changes, could be incorporated into future classification criteria and aid in identifying patients who may benefit from further diagnostic workup.
Reference:
Shi Z et al. The diagnostic value and clinical relevance of salivary gland ultrasound in patients with highly suspected Sjögren’s Disease: a prospective monocentric study. Arthritis Res Ther. 2025;27(1):175.
