Imaging‐based diagnosis and classification of radioactive iodine‐induced sialadenitis

• Published in: Oral diseases Vol. 30; no. 7; pp. 4303 - 4311
• Main Authors: Li, Xiao, Zheng, Dan‐Ni, Ling, Xiao‐Tong, Yang, Jing, Xie, Xiao‐Yan, Liu, Deng‐Gao, Yu, Guang‐Yan
• Format: Journal Article
• Language: English
• Published: Denmark Wiley Subscription Services, Inc 01.10.2024
• Subjects: Adenitis; Computed tomography; diagnostic imaging; Iodine; radioactive iodine‐induced sialadenitis (RAIS); sialography; spiral computed tomography; Statistical analysis; Ultrasonic imaging; ultrasonography; spiral computed tomography; sialography; ultrasonography; radioactive iodine-induced sialadenitis (RAIS); diagnostic imaging
• ISSN: 1354-523X; 1601-0825; 1601-0825
• DOI: 10.1111/odi.14840

Objectives To establish an inflammation grading system for radioactive iodine‐induced sialadenitis (RAIS) based on spiral computed tomography (CT), ultrasonography and sialography. Methods In all, 120 RAIS patients (18 males and 102 females) were retrospectively included. Spiral CT, ultrasonography and sialography appearances were analysed and categorized as follows: grade I, approximately normal or mild sialadenitis; grade II, moderate sialadenitis; and grade III, severe sialadenitis. Adenitis severity was analysed relative to sex, age, RAI treatment sessions and cumulative doses. Results Spiral CT showed heterogeneous (78.9%) and atrophic changes (36.8%) in the parotid glands (PGs) and duct ectasia (24.8%) in the submandibular glands (SMGs). Ultrasonography showed heterogeneous echogenicity (54.3%) and diminished gland size (30.2%) in PGs and duct ectasia in SMGs (34.7%). Sialography showed duct obliteration in 25.3% PGs and 3.2% SMGs. Statistical analysis showed good consistency among the three imaging grading results. The incidence and severity of PG lesions were significantly higher than that of SMGs (p < 0.001). As for PGs, adenitis severity was associated with both treatment sessions and cumulative doses; but in SMGs, disease severity was only related to treatment sessions. Conclusions A grading system for severity of RAIS was established based on spiral CT, ultrasonography and sialography appearances.