This version (2025/01/21 10:35) was approved by manos.papadopoulos.The Previously approved version (2021/08/23 13:55) is available.Diff

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Northern Lincolnshire and Goole NHS Foundation Trust - Nuclear Medicine

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SOP CodeTitleReview Date
REF016Salivary Gland Imaging2028-01-21


Authorised By Authorising Role Authorisation Signature
(only on master paper copy) 		Date Authorised
Prof G Avery ARSAC Licence Holder 2025-01-21

REF016 - Salivary Gland Imaging Referral Criteria

See REF000 - Referring to Nuclear Medicine (NLAG) for details on how to refer.

Description

Technetium-99m pertechnetate is taken up by salivary glands and secreted by the ductal epithelium. A salivary gland scan can provide physiological information about the ability of the salivary glands to accumulate the radiopharmaceutical and about the drainage of saliva[1]

Rapid sequential images should show progressive concentration of activity within the salivary glands and the mouth. The thyroid is also visualised and the intensity of activity is generally similar to that in the salivary glands. During imaging, the salivary glands are stimulated to drain by giving the patient lemon juice. When the salivary ducts are patent, this causes prompt salivation and drainage of the glands into the mouth.

In the normal subject, the four salivary glands all accumulate the radiopharmaceutical at the same rate and drain rapidly following stimulation. When a duct is obstructed, the uptake by the gland may be normal or slower than normal and there is no fall of activity following stimulation.

ARSAC Licence Holders
Prof Ged Avery
Dr Najeeb Ahmed
NuclidePharmaceutical FormLocal DRL (MBq)
Tc99mPertechnetate35
Typical Radiation Dose (mSv) 0.44mSv (for 35 MBq)

Staff Entitled to Refer

  • The referrer may be any clinician holding a current valid medical qualification and currently employed in Secondary Care.
  • Referrals from Primary Care will be accepted if the investigation has been suggested by a Consultant Radiologist in a report from a previous investigation or following discussion with a Consultant Radiologist or Secondary Care Specialist. Details of such suggestions or discussions should be included on the request form.

Supplementary Drugs

  • Sodium chloride for parenteral use (0.9% w/v).

Contraindications

Patient Demographics Pregnancy
Allergies Allergy to lemon juice

Patient Preparation

  • Patients must fast for at least 2 hours prior to the investigation. They may NOT be given perchlorate[1].
  • Anticholinergic medication should be stopped during 24 h prior to the examination[1].
  • The patient should not take any thyroid blocking agents for up to 48 hours prior to scanning.

Clinical Indications

Obstruction of the salivary glands without an obvious cause
Traumatic abnormalities and fistulas
Following surgery (e.g. stenosis operations, symptoms following subtotal parotidectomy, transposition of the duct orifice or surgical denervation to prevent drooling)
Following irradiation or high dose 131I therapy
Salivary gland aplasia
Sjogren’s syndrome
Warthin’s tumour
As an alternative to sialography e.g. in patients with a sensitivity to radiographic contrast agent or in failure to cannulate the duct
[1] MWJ Versleijen, Antoni van Leeuwenhoek. Salivary Gland Scintigraphy
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