Ultrasonography-led multimodal diagnostic pathway for giant cell arteritis

Mukhtyar, Chetan B., Beadsmoore, Clare, Ducker, Georgina, Fordham, Sarah, Sisson, Katherine and Jones, Colin (2025) Ultrasonography-led multimodal diagnostic pathway for giant cell arteritis. Rheumatology, 64 (4). pp. 2077-2082. ISSN 1462-0324

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Abstract

Objectives This study aims to establish the sensitivity and negative predictive value of a multimodal pathway incorporating ultrasonography, 18-fluorodeoxyglucose labelled PET-CT and temporal artery biopsy for the diagnosis of giant cell arteritis. Methods In total, 1000 consecutive referrals for a new diagnosis of giant cell arteritis were analysed. All patients had a protocolized examination. Patients with a negative ultrasonography and a CRP of ≥20 mg/L received an extended ultrasound examination. If that was negative, and there was no other explanation for their presentation, a second test in the form of either a temporal artery biopsy or an 18-fluorodeoxyglucose labelled PET-CT was offered. We calculated the sensitivity and negative predictive value of the interventions for diagnosing giant cell arteritis. Results 279/1000 patients had positive ultrasonography for giant cell arteritis. 202 had bilateral superficial temporal arterial involvement. Ultrasonography of the axillary artery and other head/neck arteries increased the yield by 53 and 24 patients, respectively. 181 patients were referred for a second test. 24/139 temporal artery biopsies and 7/42 18-fluorodeoxyglucose labelled PET-CT scans were positive. The sensitivity and negative predictive value rise from 62.3% and 84.7%, respectively, for imaging superficial temporal arteries alone, to 95.7% and 98.0%, respectively, for extended ultrasonography plus a second test. Conclusion This is the first real-world evidence of the utility of ultrasonography for the diagnosis of giant cell arteritis as part of a multimodal diagnostic pathway.

Item Type:	Article
Uncontrolled Keywords:	gca,pet,temporal artery biopsy,ultrasonography,pharmacology (medical),rheumatology ,/dk/atira/pure/subjectarea/asjc/2700/2736
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Related URLs:	http://www.scopus.com/inward/record.url?...
Depositing User:	LivePure Connector
Date Deposited:	04 Apr 2025 15:30
Last Modified:	23 Apr 2025 11:30
URI:	https://ueaeprints.uea.ac.uk/id/eprint/98966
DOI:	10.1093/rheumatology/keae493

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