Shear wave elastography of the salivary glands in the diagnosis of Sjögren disease: a systematic review and meta-analysis

Objective Sjögren disease (SD) is characterized by lymphocytic infiltration and fibrosis of the salivary glands. Shear wave elastography (SWE), an ultrasound-based modality that quantifies tissue stiffness, may assist in SD diagnosis. This study aimed to systematically review and meta-analyze the diagnostic performance of SWE in evaluating major salivary glands in individuals with SD, based on studies applying the 2016 ACR/EULAR classification criteria. Methods Six electronic databases and gray literature sources were searched. Cross-sectional and diagnostic accuracy studies were included. Risk of bias was appraised using the Joanna Briggs Institute tool. Quantitative synthesis was performed using random-effects meta-analyses. Results Eleven studies comprising 1,029 participants (530 with SD; 499 controls; 90.67% female) were included. Meta-analyses revealed that SWE values were significantly higher in SD patients than in controls, with pooled mean differences of 0.78 m/s (95% CI: 0.54–1.02) and 12.37 kPa (95% CI: 8.65–16.10) in the parotid gland, and 0.48 m/s (95% CI: 0.33–0.63) and 9.09 kPa (95% CI: 4.88–13.31) in the submandibular gland. Parotid SWE values expressed in kPa showed the highest diagnostic accuracy (AUC=82.9%), followed by values in m/s (AUC=73.1%). Conclusions SWE effectively differentiates SD from healthy individuals, particularly when applied to the parotid gland. Standardization of SWE protocols may enhance diagnostic accuracy and foster clinical integration. Advances in knowledge This is the first meta-analysis focused exclusively on studies adopting the 2016 ACR/EULAR criteria for SD.