{
  "abstract": "Background Disappointing outcomes in Sjögren’s disease (SjD) trials underscore the need for reliable, sensitive endpoints. Histological assessment holds promise, but a minimally invasive, repeatable method for salivary gland tissue sampling is lacking.Objectives To evaluate the feasibility, safety and tissue adequacy of ultrasound-guided core needle biopsy (US-guided CNB) of the parotid gland and explore its role for facilitating histology-driven stratification and precision medicine.Methods In the Belgian Sjögren’s Syndrome Transition Trial, 66 patients (64 without gland swelling) underwent US-guided CNB. US was evaluated using OMERACT (Outcome Measures in Rheumatology Clinical Trials). and Hocevar scoring. Histopathology included assessment of focus score, B cell predominance (CD20>CD3), follicular dendritic cell networks (CD21), plasma cells (CD138), lymphoepithelial lesions (CK7/CK14) and FcRL4+ B cells. Pain was assessed using a visual analogue scale (VAS) from 0 to 10. Findings were matched with clinical data.Results Mean VAS pain scores were 2.7 (SD=2.77) during biopsy and 1.9 (SD=2.33) in the 3 days before the follow-up call at day 14. No major complications occurred, and 82% of patients were willing to repeat the procedure. Adequate tissue was retrieved in 62/66 cases. Patients showed histological heterogeneity and were, as proof of concept, stratified into mild, moderate and severe histological involvement. Histological severity correlated with ultrasound scores (p<0.01) and not with traditional outcome measures (European Alliance of Associations for Rheumatology Sjögren’s Syndrome Patient-Reported Index dryness and European Alliance of Associations for Rheumatology Sjögren’s Syndrome Disease Activity Index).Conclusion US-guided CNB is safe, well-tolerated and yields adequate tissue. Beyond diagnostics, it might facilitate histology-driven patient stratification and advance precision medicine for SjD.",
  "authors": [
    {
      "affiliations": [
        "Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium",
        "Department of Rheumatology, Ghent University Hospital, Ghent, Flanders, Belgium",
        "VIB-UGent, Zwijnaarde, Belgium"
      ],
      "name": "Helena Achten"
    },
    {
      "affiliations": [
        "Department of Radiology, Ghent University Hospital, Ghent, Belgium"
      ],
      "name": "Eva Genbrugge"
    },
    {
      "affiliations": [
        "Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium",
        "Department of Rheumatology, Ghent University Hospital, Ghent, Flanders, Belgium"
      ],
      "name": "Liselotte Deroo"
    },
    {
      "affiliations": [
        "Department of Pathology, Ghent University Hospital, Ghent, Belgium",
        "Department of Diagnostic Sciences, Ghent University, Ghent, Flanders, Belgium"
      ],
      "name": "David Creytens"
    },
    {
      "affiliations": [
        "Department of Pathology, Ghent University Hospital, Ghent, Belgium"
      ],
      "name": "Amber Vanhaecke"
    },
    {
      "affiliations": [
        "VIB-UGent, Zwijnaarde, Belgium"
      ],
      "name": "Joke Deprez"
    },
    {
      "affiliations": [
        "VIB-UGent, Zwijnaarde, Belgium"
      ],
      "name": "Emilie Dumas"
    },
    {
      "affiliations": [
        "Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium",
        "Department of Rheumatology, Ghent University Hospital, Ghent, Flanders, Belgium",
        "VIB-UGent, Zwijnaarde, Belgium"
      ],
      "name": "Sophie Vanhoof"
    },
    {
      "affiliations": [
        "Department of Rheumatology, Ghent University Hospital, Ghent, Flanders, Belgium"
      ],
      "name": "Kristel De Boeck"
    },
    {
      "affiliations": [
        "Department of Radiology, Ghent University Hospital, Ghent, Belgium"
      ],
      "name": "Wouter Bauters"
    },
    {
      "affiliations": [
        "Department of Head and Neck Surgery, Ghent University Hospital, Ghent, Belgium"
      ],
      "name": "Frederick Dochy"
    },
    {
      "affiliations": [
        "Department of Ophthalmology, Ghent University Hospital, Ghent, Belgium"
      ],
      "name": "Dimitri Roels"
    },
    {
      "affiliations": [
        "Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium",
        "Department of Rheumatology, Ghent University Hospital, Ghent, Flanders, Belgium",
        "VIB-UGent, Zwijnaarde, Belgium"
      ],
      "name": "Dirk Elewaut"
    },
    {
      "affiliations": [
        "Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium",
        "Department of Rheumatology, Ghent University Hospital, Ghent, Flanders, Belgium",
        "VIB-UGent, Zwijnaarde, Belgium",
        "Department of Rheumatology, AZ Sint-Jan, Bruges, Belgium"
      ],
      "name": "Isabelle Peene"
    }
  ],
  "title": "Ultrasound-guided core needle biopsy of the parotid gland in Sjögren’s disease: a promising tool towards precision medicine",
  "uid": "952dee25-db89-57e2-88c1-fc421cbed6da"
}