Salivary Gland Scintigraphy in Patients with Sjogren’s Syndrome: A local Experience with Dual-tracer

OBJECTIVES To review the findings of the patients with Sjögren's syndrome (SS) having technetium99-m-pertechnetate (99mTc-pertechnetate) and gallium67- citrate (Ga-67) salivary gland scintigraphy in the past eight years. METHODS The patients with SS, who were referred to our department for salivary gland scintigraphy during January -2008December 2015 were studied using both 99mTc-pertechnetate and Ga-67 citrate scintigraphy. RESULTS Eighteen patients were included in the study, 17 of whom had positive findings on 99mTc-pertechnetate salivary gland scintigraphy. One patient had negative parotid glands findings on 99mTc-pertechnetate, but positive findings in Ga-67 study. Four patients had asymmetric involvement of the parotid glands, and one patient had asymmetric involvement of the submandibular glands in 99mTc-pertechnetate salivary gland scintigraphy. On the other hand, one patient had only submandibular gland involvement in the 99mTc-pertechnetate scan. Nine patients (18/9) had positive parotid gland findings on Ga-67 study. The involvements of the parotid glands were all symmetrical, except for one patient. No abnormal gallium uptake in the submandibular glands in our patients was noted. CONCLUSION 99mTc-pertechnetate salivary gland scintigraphy is sufficient for the assessment in the majority of patients with SS. Ga-67 scintigraphy may be a useful supplementary test, especially if the result of 99mTc-pertechnetate scintigraphy is not conclusive.