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SAT0384 Multireader Reliability Using Us in Salivary Glands: An International Web Exercice to Evaluate a New Us Scoring (NUSC) in Primary Sjogren Syndrome
  1. S. Jousse1,
  2. E. Nowak2,
  3. E. Theander3,
  4. A. Hocevar4,
  5. M. Jonsson5,
  6. V. Milic6,
  7. A. Visink7,
  8. A. Saraux8,
  9. S.J. Bowman9,
  10. V. Devauchelle-Pensec10,
  11. J. Rout11,
  12. J. Brown12,
  13. J. Fradin13,
  14. N. Luciano14,
  15. M. Carotti15,
  16. A. Carr16,
  17. B. Fisher17
  18. on behalf of US-pSS Study Group
  1. 1Rheumatology, Brest University Hospital
  2. 2CIC 0502, INSERM, Brest, France
  3. 3Department of Rheumatology, Malmö University Hospita, Malmo, Sweden
  4. 4Department of Rheumatology, University Medical Centre, Ljubljana, Slovenia
  5. 5Department of Clinical Dentistry – Section for Oral and Maxillofacial Radiology, University of Bergen, Bergen, Norway
  6. 6Institute of Rheumatology, School of Medicine, University of Belgrade, Belgrade, Serbia
  7. 7Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
  8. 8Department of Rheumatology, EA2216, INSERM ESPRI 29, Cavale Blanche hospital, Brest, France
  9. 9Rheumatology, New Queen Elizabeth Hospital Mindelsohn Way, Edgbaston, Birmingham, United Kingdom
  10. 10Rheumatology, EA2216, INSERM ESPRI 29, Cavale Blanche Hospital, Brest, France
  11. 11Radiology, Birmingham
  12. 12Department of Oral and Maxillofacial Surgery, Dental Institute, london, United Kingdom
  13. 13Radiology, Baltimore, United States
  14. 14Institute of Rheumatology, Pisa
  15. 15Radiology, Ancona, Italy
  16. 16Department of Oral and Maxillofacial Surgery, Dental Institute, Newcastle
  17. 17Institute of Rheumatology, Birmingham, United Kingdom


Background Ultrasonography (US) has been shown to be a sensitive tool to diagnose major salivary gland echotexture abnormalities in primary Sjögren's syndrome (pSS).

Objectives The purpose of this study was [1] to assess definitions of the different ultrasonographic components of the salivary glands and [2] to study the reliability of these definitions on static images with an international web exercice.

Methods [1]The consensus exercice about definitions was done and discussed between 12 experts on the field of US pSS during 3 annual meetings. All experts were part of the US-pSS study group. [2]Using these preliminary definitions, a reliability exercice was done on static images. A centre (Brest- France) was in charge to send to the participants different representative US images collection of the agreed elementary lesions.30 parotid glands images and 30 submandibular glands images were sent to the experts by mail.They were asked to score each components of each glands in standardized file. Two rounds of exercicewere performed in order to obtain intra and inter reliability. The first round was in January 2014 and the second round was in March 2014. Inter and intra-observer agreements were estimated using the kappa index considering binary variables (agreements are almost perfect k:0.81 to 1.0; substantial: 0.61 to 0.8, moderate: 0.41 to 0.6, fair: 0.21 to 0.4, poor: -1.0 to 0.2).

Results All experts were trained for US of salivary gland with at least 5 years of experience.

We obtained definitions about 8 different components evaluating the abnormal parenchyma (echogenicity, homogenicity, presence or absence of hyperechoic bands, number of hypoechoic ares, and location of hypoechoic areas, lymph nodes, presence or absence of calcifications, visualisation of posterior border) on salivary glands in pSS patients. Results of the reliability web exercise is shown on table 1. Without practical training session, we showed good results concerning the intra and inter observer reliabilities applying these definitions on US parotid gland and submandibular glands, particularly in taking homogeneity as the main important item in this definition. Reliabilities for calcifications and posterior band were low.

Conclusions This is the first consensus-based US definitions on salivary glands and its elementary components. These first results of the reliability exercice on static images without any training showed good results and permit to apply these preliminary definitions in routine practice and for further studies on pSS patients.

Disclosure of Interest None declared

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