Development of a new ultrasound scoring system to evaluate glandular inflammation in Sjögren's syndrome: an OMERACT reliability exercise

Alojzija Hočevar, George A Bruyn, Lene Terslev, Juan Jose De Agustin, Daryl MacCarter, Stavros Chrysidis, Paz Collado, Christian Dejaco, Viktoria Fana, Gerogios Filippou, Stephanie Finzel, Frederique Gandjbakhch, Petra Hanova, Daniel Hammenfors, Cristina Hernandez-Diaz, Annamaria Iagnocco, Mohamed Atia Mortada, Nevsun Inanc, Esperanza Naredo, Sarah OhrndorfNejc Perko, Wolfgang A Schmidt, Giorgio Tamborrini, Matija Tomšič, Isabelle Chary-Valckenaere, Alen Zabotti, Helen I Keen, Carlos Pineda, Maria-Antonietta D'Agostino, Sandrine Jousse-Joulin


OBJECTIVE: The aim of this exercise from the OMERACT Ultrasound subgroup on Sjögren's syndrome was to develop and assess the reliability of a consensus-based semiquantitative colour Doppler US scoring system for pathologic salivary gland vascularization in patients with primary Sjögren's syndrome (pSS).

METHODS: Using the Delphi method, a colour Doppler semiquantitative scoring system for vascularization of bilateral parotid and submandibular glands was developed and tested in static images and on patients (9 pSS patients and 9 sonographers). Intra-reader and inter-reader reliability of grading the salivary glands were computed by weighted Cohen and Light's kappa analysis, respectively.

RESULTS: The consensus-based semiquantitative score was: grade 0, no visible vascular signals; grade 1, focal, dispersed vascular signals; grade 2, diffuse vascular signals detected in <50% of the gland; grade 3, diffuse vascular signals in >50% of the gland. In static images, the intra- and inter-reader reliability showed excellent kappa values (95% CI) of 0.90 (0.87, 0.93) and 0.80 (0.74, 0.84), respectively, for all four salivary glands together. In patients, the intra- and inter-reader reliability for all four salivary glands together was kappa = 0.84 (0.73, 0.92) and 0.70 (0.64, 0.76), respectively.

CONCLUSION: The consensus-based colour Doppler US scoring for the evaluation of salivary gland vascularization in pSS showed a good inter-reader reliability and excellent intra-reader reliability in static images and in patients. The clinical application of the developed scoring system should be tested in clinical settings.

TidsskriftRheumatology (Oxford, England)
Udgave nummer8
Sider (fra-til)3341-3350
Antal sider10
StatusUdgivet - 3 aug. 2022


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