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Hočevar A, Bruyn GA, Terslev L, et al. Development of a new ultrasound scoring system to evaluate glandular inflammation in Sjögren's syndrome: an OMERACT reliability exercise. Rheumatology (Oxford). 2021;doi: 10.1093/rheumatology/keab876.
Hočevar, A., Bruyn, G. A., Terslev, L., De Agustin, J. J., MacCarter, D., Chrysidis, S., Collado, P., Dejaco, C., Fana, V., Filippou, G., Finzel, S., Gandjbakhch, F., Hanova, P., Hammenfors, D., Hernandez-Diaz, C., Iagnocco, A., Mortada, M. A., Inanc, N., Naredo, E., Ohrndorf, S., Perko, N., Schmidt, W. A., Tamborrini, G., Tomšič, M., Chary-Valckenaere, I., Zabotti, A., Keen, H. I., Pineda, C., D'Agostino, M. A., & Jousse-Joulin, S. (2021). Development of a new ultrasound scoring system to evaluate glandular inflammation in Sjögren's syndrome: an OMERACT reliability exercise. Rheumatology (Oxford, England), . https://doi.org/10.1093/rheumatology/keab876
Hočevar, Alojzija, et al. "Development of a new ultrasound scoring system to evaluate glandular inflammation in Sjögren's syndrome: an OMERACT reliability exercise." Rheumatology (Oxford, England) vol. (2021). doi: https://doi.org/10.1093/rheumatology/keab876
Hočevar A, Bruyn GA, Terslev L, De Agustin JJ, MacCarter D, Chrysidis S, Collado P, Dejaco C, Fana V, Filippou G, Finzel S, Gandjbakhch F, Hanova P, Hammenfors D, Hernandez-Diaz C, Iagnocco A, Mortada MA, Inanc N, Naredo E, Ohrndorf S, Perko N, Schmidt WA, Tamborrini G, Tomšič M, Chary-Valckenaere I, Zabotti A, Keen HI, Pineda C, D'Agostino MA, Jousse-Joulin S. Development of a new ultrasound scoring system to evaluate glandular inflammation in Sjögren's syndrome: an OMERACT reliability exercise. Rheumatology (Oxford). 2021 Nov 25; doi: 10.1093/rheumatology/keab876. Epub 2021 Nov 25. PMID: 34849616.
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Rheumatology (Oxford). 2021 Nov 25; doi: 10.1093/rheumatology/keab876. Epub 2021 Nov 25.

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

Rheumatology (Oxford, England)

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 Ohrndorf, Nejc 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

Affiliations

  1. Department of Rheumatology, University Medical Centre, Ljubljana, Slovenia.
  2. Department of Rheumatology, MC Groep Hospitals, Lelystad, The Netherlands.
  3. Centre for Rheumatology and Spinal Diseases, Rigshospitalet, Copenhagen, Denmark.
  4. Department of Rheumatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
  5. Rheumatology Department, North Valley Hospital, Whitefish, Montana, USA.
  6. Department of Rheumatology, Hospital of Southwest Jutland, Esbjerg, Denmark.
  7. Universitario Severo Ochoa, Madrid, Spain.
  8. Department of Rheumatology, Medical University Graz, Austria and Department of Rheumatology, Hospital of Bruneck (ASAA-SABES), Italy.
  9. Centre for Rheumatology and Spinal Diseases, Rigshospitalet, Copenhagen, Denemark.
  10. Section of Rheumatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
  11. Department of Rheumatology and Clinical Immunology, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  12. Sorbonne Université, Paris, France; Pitié Salpêtrière hospital, APHP, Rheumatology department, Paris, France.
  13. Institute of Rheumatology, Prague, Czech Republic.
  14. Department of Rheumatology, Haukeland University Hospital, Bergen, Norway.
  15. Musculoskeletal Ultrasound Laboratory, Instituto Nacional de Rehabilitacion, Mexico City, Mexico.
  16. Academic Rheumatology Centre, Università degli Studi di Torino, Turin, Italy.
  17. Rheumatology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
  18. Division of Rheumatology, Marmara University, School of Medicine, Istanbul, Turkey.
  19. Rheumatology Department, Joint and Bone Research Unit, Hospital Universitario Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain.
  20. Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, Berlin, Germany.
  21. Faculty of electrical engineering, University of Ljubljana, Ljubljana, Slovenia.
  22. Medical Centre for Rheumatology Berlin-Buch, Immanuel Krankenhaus Berlin, Berlin, Germany.
  23. UZR-Ultraschallzentrum Rheumatologie, Basel, Switzerland.
  24. Department of Rheumatology, University Hospital of Nancy, Nancy, France.
  25. Department of Medical and Biological Sciences, Rheumatology Institute, University Hospital Santa Maria della Misericordia, Udine, Italy.
  26. Rheumatology Department, Royal Perth Hospital, Perth, WA, Australia.
  27. Division of Musculoskeletal and Rheumatic Diseases, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, Mexico.
  28. Department of Rheumatology, Università Cattolica del Sacro Cuore, Policlinico Universitario Agostino Gemelli, Rome, Italy and, Paris Saclay University of Versailles Saint Quentin en Yvelines, UMRII73, France.
  29. Rheumatology Department, Chu de Brest, University of Brest, INSERM, Brest, France.

PMID: 34849616 DOI: 10.1093/rheumatology/keab876

Abstract

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

METHODS: Using the Delphi method a CD 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 (κ) 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 κ values (95% confidence interval) = 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 κ  = 0.84 (0.73-0.92) and 0.70 (0.64-0.76), respectively.

CONCLUSION: The consensus-based CD ultrasound 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.

© The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: [email protected].

Keywords: colour Doppler ultrasound; primary Sjögren’s syndrome; salivary gland vascularization; scoring system

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