Automatic quantitative kinetic analysis in salivary gland scintigraphy

Salivary gland scintigraphy (SGS) is a valuable imaging modality for assessing major salivary gland function, particularly in patients with Sjögren syndrome, and postradiotherapy conditions. Despite the existence of multiple quantitative analysis methods, clinical practice remains dominated by qualitative interpretation due to the lack of standardization, time-consuming procedures, and absence of user-friendly tools. In this study, we present a fully automated method for quantitative SGS analysis based on kinetic modeling of time-activity curves, implemented without altering standard imaging protocols, using a software we developed in-house on a Xeleris (GE HealthCare) workstation. The curves were segmented into uptake, excretion, and postexcretion phases, each fitted to specific kinetic models. From the fitted parameters, we derived functional variables, including vascular flow, active uptake, uptake velocity, total accumulation, absolute excretion, excretion fraction, and excretion rate. This approach enables rapid and reproducible extraction of functional data, with processing time under 5 s per study. We demonstrate its clinical utility through two case studies, highlighting how kinetic parameters reflect salivary gland function and its longitudinal changes. Our method bridges the gap between complex quantitative analysis and practical clinical application, offering a robust tool for monitoring disease progression and treatment response, potentially improving diagnostic reliability and research scalability.