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Quantitative texture analysis of parotid gland ultrasound images yield higher correlation with scintigraphy than semiquantitative scoring in primary sjögren's syndrome patients

1 Department of Internal Medicine, Division of Allergy, Immunology and Rheumatology, National Taiwan University Hospital; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
2 Department of Internal Medicine, National Taiwan University Hospital, Yunlin, Taiwan
3 Department of Internal Medicine, Division of Allergy, Immunology and Rheumatology, National Taiwan University Hospital, Taipei, Taiwan

Correspondence Address:
Ko-Jen Li,
No. 7, Chung Shan S. Road, Taipei 10002
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Source of Support: None, Conflict of Interest: None

Background: Ultrasound (US) can detect salivary gland abnormalities in primary Sjögren's syndrome (SS). This study aimed to compare the correlation among the semiquantitative US scores, texture features, and the quantitative salivary gland scintigraphy (SGS) results. Methods: This retrospective study included 11 patients who were diagnosed with primary SS and underwent US examinations of the parotid glands and SGS simultaneously. We evaluated SGS quantitatively based on the calculation of maximum accumulation ratio (MAR) and stimulated excretion fraction (EF). The US findings were accessed through the semiquantitative Outcome Measures in Rheumatology scoring system and by gray-level co-occurrence matrix (GLCM) texture analysis. Spearman's rank correlation tests were performed. Results: A significant moderate negative correlation was noted between the semiquantitative US score and MAR (rho = −0.57, P = 0.006), but not with EF (rho = −0.11, P = 0.613). The GLCM texture metrics, including contrast, dissimilarity, and homogeneity, were all determined to be significantly associated with both MAR and EF. The GLCM contrast correlated moderately to MAR (rho = −0.66, P = 0.001). The GLCM homogeneity highly correlated to EF (rho = 0.74, P < 0.001). The contrast and homogeneity can still discriminate the changes in MAR and EF in the subgroups with the same semiquantitative US scores. Conclusion: US findings on parotid gland can correlate with SGS results when analyzed based on GLCM texture features. With the GLCM texture metrics, US appears to be an excellent imaging tool for the assessment of the parotid glands in primary SS patients.

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