ArticleRheumatology international2026
Imaging correlates of disease activity and patient-reported symptoms in primary Sjögren's disease: an ultrasonographic and scintigraphic study.
Article in Rheumatology international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
To examine whether salivary gland ultrasonography (SGUS) and scintigraphy (SGS) reflect systemic disease activity (ESSDAI) and patient-reported index (ESSPRI) in primary Sjögren's disease (PSD). We retrospectively enrolled 118 patients undergoing SGUS and SGS during diagnostic workup of dryness symptoms, which ultimately led to labial biopsy-confirmed PSD. SGUS was scored using the Outcome Measures in Rheumatology Clinical Trials (OMERACT) system (range 0-12). SGS analysis relied on time-activity curve-derived parotid and submandibular uptake ratios and excretion fractions. Unstimulated salivary flow rate (USFR) was also assessed. Associations were evaluated using correlation and logistic regression. OMERACT scores showed a weak but significant correlation with ESSDAI (ρ = 0.329, p < 0.001), whereas SGS parameters were not associated with ESSDAI or ESSPRI (all p > 0.05). ESSDAI and ESSPRI were weakly correlated (ρ = 0.252, p = 0.006). OMERACT scores differed significantly across ESSDAI categories (p = 0.001), whereas SGS parameters did not. In multivariable analysis, anti-SSA/Ro positivity (p = 0.006) and higher OMERACT scores (p < 0.001) independently predicted moderate-to-high ESSDAI (ESSDAI ≥ 5). No imaging parameter predicted high ESSPRI (ESSPRI ≥ 5) (all p > 0.05); however, USFR was strongly associated with symptom burden (p < 0.001). The final models showed good discrimination (AUC 0.76 for ESSDAI and 0.74 for ESSPRI). SGUS reflects systemic disease activity, whereas SGS has limited clinical value. Patient-reported burden is more closely related to objective salivary hypofunction than to imaging findings. Integrating structural imaging, functional assessment, and patient-reported symptoms in PSD provides complementary information for disease assessment.
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