**Martha S. van Ginkel 1,\*, Andor W.J.M. Glaudemans 2, Bert van der Vegt 3, Esther Mossel 1, Frans G.M. Kroese 1, Hendrika Bootsma <sup>1</sup> and Arjan Vissink 4,\***


Received: 10 July 2020; Accepted: 30 July 2020; Published: 3 August 2020

**Abstract:** Primary Sjögren's syndrome (pSS) is a systemic autoimmune disease characterized by dysfunction and lymphocytic infiltration of the salivary and lacrimal glands. Besides the characteristic sicca complaints, pSS patients can present a spectrum of signs and symptoms, which challenges the diagnostic process. Various imaging techniques can be used to assist in the diagnostic work-up and follow-up of pSS patients. Developments in imaging techniques provide new opportunities and perspectives. In this descriptive review, we discuss imaging techniques that are used in pSS with a focus on the salivary glands. The emphasis is on the contribution of these techniques to the diagnosis of pSS, their potential in assessing disease activity and disease progression in pSS, and their contribution to diagnosing and staging of pSS-associated lymphomas. Imaging findings of the salivary glands will be linked to histopathological changes in the salivary glands of pSS patients.

**Keywords:** primary Sjögren's syndrome; imaging; salivary gland; sialography; salivary gland ultrasonography; magnetic resonance imaging; sialendoscopy; salivary gland scintigraphy; positron emission tomography
