The aim of this study was to test the impact of quantitative salivary gland scintigraphy in patients with suspected Sjögren's syndrome. Thirteen patients with suspected Sjögren's syndrome were investigated. During clinical work-up, three had severe and four had mild Sjögren's syndrome, while six were normal. Quantitative salivary gland scintigraphy was performed using a standardized method. The normal data-base consisted of 172 patients without any evidence of salivary gland malfunction. Visual and quantitative comparisons of the patients' scintigrams were made. In the patients with severe Sjögren's syndrome, uptake was 0.10 +/- 0.04% and 0.09 +/- 0.03% in the parotid and submandibular glands respectively, confirming the visual diagnosis. In the patients without Sjögren's syndrome, concordance between the visual and quantitative evaluations could also be shown. In contrast, among the patients with mild Sjögren's syndrome, uptake was diminished (P < 0.05), amounting to 0.21 +/- 0.05% and 0.16 +/- 0.02% in the parotid and submandibular glands respectively, while visual analysis indicated normal parenchymatous function. In conclusion, quantitative salivary gland scintigraphy is essential for the reliable detection of parenchymatous malfunction at an early stage of Sjögren's syndrome, which may be missed by visual analysis alone.