{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T16:47:43Z","timestamp":1790182063305,"version":"4.1.0"},"reference-count":35,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T00:00:00Z","timestamp":1761264000000},"content-version":"unspecified","delay-in-days":23,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003130","name":"Fonds Wetenschappelijk Onderzoek","doi-asserted-by":"publisher","award":["11J6925N"],"award-info":[{"award-number":["11J6925N"]}],"id":[{"id":"10.13039\/501100003130","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2025,7,8]]},"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Disappointing outcomes in Sj\u00f6gren\u2019s 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In the Belgian Sj\u00f6gren\u2019s 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&gt;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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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&lt;0.01) and not with traditional outcome measures (European Alliance of Associations for Rheumatology Sj\u00f6gren\u2019s Syndrome Patient-Reported Index dryness and European Alliance of Associations for Rheumatology Sj\u00f6gren\u2019s Syndrome Disease Activity Index).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rmdopen-2025-005560","type":"journal-article","created":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T07:25:45Z","timestamp":1761290745000},"page":"e005560","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Ultrasound-guided core needle biopsy of the parotid gland in Sj\u00f6gren\u2019s disease: a promising tool towards precision medicine"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9895-7780","authenticated-orcid":false,"given":"Helena","family":"Achten","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium"},{"name":"Department of Rheumatology, Ghent University Hospital, Ghent, Flanders, Belgium"},{"name":"VIB-UGent, 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