title: Virtual Touch Quantification of the Salivary Glands for Diagnosis of Primary Sjögren Syndrome.
abstract: OBJECTIVE
  To investigate the value of salivary gland stiffness measured by Virtual Touch quantification (VTQ; Siemens Medical Solutions, Erlangen, Germany) for assessment of primary Sjögren syndrome.
  
  
  METHODS
  Fifty-four patients with primary Sjögren syndrome, 35 patients without primary Sjögren syndrome (patients with dry mouth and dry eye symptoms), and 52 healthy control volunteers were included in this study. Patients with primary Sjögren syndrome were classified as early or advanced stage by labial gland biopsies. All participants underwent B-mode sonography, on which the salivary glands (parotid and submandibular) were identified and VTQ measurements of shear wave velocity (SWV) were obtained. The diagnostic performance of SWV was evaluated by sensitivity and specificity at the optimum cutoff point and the area under the receiver operating characteristic curve.
  
  
  RESULTS
  For submandibular glands, the mean SWV ± SD values were 2.25 ± 0.34 m/s in patients with early-stage primary Sjögren, 1.84 ± 0.20 m/s in patients without primary Sjögren syndrome, and 1.82 ± 0.27 m/s in healthy controls (P< .001). With cutoff values of 2.15 and 2.10 m/s to separate patients with early-stage primary Sjögren syndrome from those without Sjögren syndrome and healthy controls, the sensitivity and specificity were 77.1% and 85.4% and 79.2% and 83.9%, respectively. For parotid glands, the SWV values were 2.78 ± 0.82 m/s in patients with early-stage primary Sjögren syndrome, 1.93 ± 0.33 m/s, in patients without primary Sjögren syndrome, and 1.85 ± 0.31 m/s in healthy controls (P < .001). With cutoff values of 2.18 and 2.10 m/s to separate patients with early-stage primary Sjögren syndrome from those without Sjögren syndrome and healthy controls, the sensitivity and specificity were 89.3 % and 75.3% and 91.4% and 80.0%.
  
  
  CONCLUSIONS
  The VTQ technique might be a useful noninvasive strategy for assessment of salivary glands in the early stage of primary Sjögren syndrome.
authors.affiliation: Department of Ultrasound, First Affiliated Hospital of Shantou University Medical College, Shantou, China csq1036587183@qq.com.
authors.forename: Shaoqi
authors.initials: S
authors.lastname: Chen
authors.affiliation: Department of Rheumatism, Central Hospital of Shantou, Shantou, China.
authors.forename: Yukai
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Community Monitoring, First Affiliated Hospital of Shantou University Medical College, Shantou, China.
authors.forename: Shaoxing
authors.initials: S
authors.lastname: Chen
authors.affiliation: Guangdong Province Key Laboratory of Medical Molecular Imaging, Shantou University, Shantou, China.
authors.forename: Qiulin
authors.initials: Q
authors.lastname: Wu
authors.affiliation: Department of Radiology, Mayo Clinic College of Medicine, Rochester, Minnesota USA.
authors.forename: Shigao
authors.initials: S
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D015203:Reproducibility of Results; D012469:Salivary Glands / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D012680:Sensitivity and Specificity; D012859:Sjogren's Syndrome / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D014463:Ultrasonography / Q000379:methods*; D014584:User-Computer Interface; D055815:Young Adult
keywords: Virtual Touch quantification; differentiation; head and neck ultrasound; primary Sjögren syndrome; salivary gland