Temporal artery Doppler ultrasound in patients with giant cell arteritis: State of the art and systematic review of the literature

2021 ◽  
Author(s):  
Tomás Urrego-Callejas ◽  
Daniel Jaramillo-Arroyave ◽  
Adriana-Lucía Vanegas-García ◽  
Carlos Horacio Muñoz-Vahos ◽  
Maribel Plaza Tenorio
Keyword(s):  
Systematic Review ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Doppler Ultrasound ◽  
State Of The Art ◽  
Temporal Artery ◽  
Review Of The Literature

Diagnostic performance of temporal artery ultrasound for the diagnosis of giant cell arteritis: a systematic review and meta-analysis of the literature

2019 ◽  
Vol 18 (1) ◽  
pp. 56-61 ◽  
Author(s):  
Marina Rinagel ◽  
Emmanuel Chatelus ◽  
Sandrine Jousse-Joulin ◽  
Jean Sibilia ◽  
Jacques-Eric Gottenberg ◽  
...  
Keyword(s):  
Systematic Review ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Diagnostic Performance ◽  
Meta Analysis ◽  
Temporal Artery

scholarly journals A comparative study of Doppler ultrasound against temporal artery biopsy in the diagnosis of giant cell arteritis

2020 ◽  
Vol 16 (5) ◽  
pp. 313-318
Author(s):  
Sara Alicia González Porto ◽  
María Teresa Silva Díaz ◽  
Ana Reguera Arias ◽  
Jorge Pombo Otero ◽  
Alba González Rodríguez ◽  
...  
Keyword(s):  
Comparative Study ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Doppler Ultrasound ◽  
Temporal Artery ◽  
Temporal Artery Biopsy

scholarly journals P006 The potential of colour Doppler ultrasound in reducing temporal artery biopsies in suspected giant cell arteritis

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Arslan A Sidhu ◽  
Anupama Nandagudi ◽  
Anurag Bharadwaj
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Doppler Ultrasound ◽  
Clinical Assessment ◽  
Temporal Artery ◽  
British Society ◽  
Colour Doppler ◽  
Clinical Probability ◽  
Colour Doppler Ultrasound ◽  
Low Probability

Abstract Background/Aims  Giant cell arteritis (GCA) is an emergency. The initial treatment with high dose glucocorticoids (GC) is often started on clinical suspicion without waiting for temporal artery biopsy (TAB) results. Colour Doppler ultrasound (CDUS) is a simple, non-invasive test which is readily available. However, like any other ultrasound, it is operator dependent. Non-compressible ‘halo sign’ is the most specific abnormality on CDUS. British society for Rheumatology (BSR) guidelines advises to avoid TAB in patients with low clinical probability and negative CDUS as well as in high clinical probability and positive CDUS. Methods  We adopted the quality improvement methodology for assessment. Retrospective data of suspected GCA patients was collected over the last two years. CDUS was introduced to investigative plan midway, after eleven months. Two rheumatology consultants were trained in CDUS. Results were compared before and after the introduction of ultrasound as a diagnostic tool. In collecting the data, our main focus for documentation was based on clinical symptoms, CDUS and TAB results. Patient were divided into high, medium and low probability groups based on clinical assessment by a rheumatologist. Final diagnosis was decided on the basis of clinical assessment at 6 months. Results  It was a retrospective review from January 2018 to November 2019, 101 patients were referred with suspected GCA. Median age was 72 years (50 - 91 years) with male to female ratio of 1:3. Thirty five patients were referred in the first 11 months and 28.6% were diagnosed with GCA. CDUS and TAB was done in 20% and 49% of patients respectively. Sixty six patients were referred in the next 12 months after CDUS was introduced and 21.2% were diagnosed as GCA. CDUS and TAB were done in 82% and 38% of the patients respectively. We reviewed all TABs in the second phase of QIP (38%). As per current BSR guideline, 8 TABs could have been avoided in patients with positive CDUS and high probability of GCA or negative CDUS and low probability of GCA. Even if we deduct these 8 TABs from total of 25, 26% of our suspected GCA referrals would still require TAB for diagnostic workup. Conclusion  After the routine introduction of CDUS, the percentage of patients requiring TAB has declined. Approximately one fourth patients would still require TAB as per BSR guidelines. To improve the clinical relevance of biopsies further we recommended; the routine use of GCA probability score, improve CDUS skills and arrange availability of urgent slots in clinic for CDUS. We also noticed that the number of patients referred has almost doubled. This might be due to better education and awareness at the primary and secondary care level which was done as part of the project. Disclosure  A.A. Sidhu: None. A. Nandagudi: None. A. Bharadwaj: None.

scholarly journals Systematic Review of the Yield of Temporal Artery Biopsy for Suspected Giant Cell Arteritis

2018 ◽  
Vol 43 (1) ◽  
pp. 18-25 ◽  
Author(s):  
Edsel B. Ing ◽  
Dan Ni Wang ◽  
Abirami Kirubarajan ◽  
Etienne Benard-Seguin ◽  
Jingyi Ma ◽  
...  
Keyword(s):  
Systematic Review ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Temporal Artery ◽  
Temporal Artery Biopsy

scholarly journals Practice Preferences: Temporal Artery Biopsy versus Doppler Ultrasound in the Work-Up of Giant Cell Arteritis

2019 ◽  
Vol 44 (3) ◽  
pp. 174-181 ◽  
Author(s):  
Edsel Ing ◽  
Qinyuan (Alis) Xu ◽  
Jean Chuo ◽  
Femida Kherani ◽  
Klara Landau
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Doppler Ultrasound ◽  
Temporal Artery ◽  
Temporal Artery Biopsy ◽  
Work Up

scholarly journals OP0150 WHAT IS THE ROLE OF TEMPORAL ARTERY BIOPSY IN GIANT CELL ARTERITIS FAST-TRACK PATHWAYS WHEN TEMPORAL ARTERY ULTRASOUND IS NEGATIVE?

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 95.3-95
Author(s):  
A. Sachdev ◽  
S. Dubey ◽  
C. Tiivas ◽  
M. George ◽  
P. Mehta
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Sensitivity And Specificity ◽  
Fast Track ◽  
Temporal Artery ◽  
Clinical Findings ◽  
Specimen Size ◽  
Temporal Artery Biopsy ◽  
Duration Of Treatment ◽  
Relevant Role

Background:A number of centres are now running fast track pathways for diagnosis and management of Giant cell arteritis with ultrasound as the first port of call for diagnosis1. Temporal artery biopsies (TABs) have become the second line of investigation, and it is unclear how useful TAB is in this setting.Objectives:This study looked at accuracy of Temporal artery biopsy (TAB) in patients with suspected Giant Cell arteritis (GCA) with negative/inconclusive ultrasound (U/S) and how duration of treatment on steroids prior to these investigations and arterial specimen size affected it.Methods:Prospective study of all patients with suspected GCA referred for TAB when U/S was negative or inconclusive, as part of the local fast-track pathway (Coventry). Database included clinical findings, serological work up, U/S and TAB results and treatment. Sensitivity and specificity of U/S and TAB was calculated and compared based on duration of treatment with steroids.Results:One hundred and nine patients were referred for TAB via Coventry fast-track-pathway. The sensitivity of U/S in this cohort of patients was 9.08% and specificity was 93.33%. After 3 days of steroid this was 0% and 100% respectively. For TAB when done within 10 days of starting steroids, this was 65% and 87.5% respectively. After 20 days of steroids this was 0 % and 100%. The sensitivity and specificity was 20% and 85% when arterial specimen size was 11-15mm and 47% and 100% when specimen size was 16 mm or more. Sensitivity and specificity of U/S of 644 suspected GCA patients was 48% and 98%.Conclusion:Our study demonstrates that TAB plays a relevant role in GCA fast-track-pathways, when U/S is negative/inconclusive. TAB was more sensitive than U/S in this cohort of patients, but overall sensitivity of U/S was higher when calculated for all patients suspected with GCA. Both remain useful tests if performed early. TAB specimen size should ideally be 16mm or more and done within 10 days of starting steroids.References:[1]Jonathan Pinnell, Carl Tiivas, Kaushik Chaudhuri, Purnima Mehta, Shirish Dubey, O38 The diagnostic performance of ultrasound Doppler in a fast-track pathway for giant cell arteritis,Rheumatology, Volume 58, Issue Supplement_3, April 2019, kez105.036,https://doi.org/10.1093/rheumatology/kez105.036Disclosure of Interests:None declared

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