Vasculitis & polymyalgia rheumatica
A direct comparison in diagnostic performance of colour duplex ultrasound (CDUS), FDG-PET/CT and magnetic resonance imaging (MRI) in patients suspected of giant cell arteritis
Authors' conclusion
Sensitivity of CDUS was highest, while specificity was excellent in all imaging modalities. Nevertheless, confidence intervals of all imaging modalities were overlapping.
Study context
- Population
- Patients suspected of giant cell arteritis (GCA); imaging within 5 working days after initial clinical evaluation23 GCA, 19 non-GCA
- Comparison
- CDUS vs FDG-PET/CT vs MRI, against clinical diagnosis after 6 months follow-up
- Outcome
- Diagnostic performance (sensitivity, specificity) vs clinical diagnosis by experienced rheumatologists blinded for imaging
- Follow-up
- Six months
Methodological detailsnested case-control, pilot study
- Nested case-control
- Pilot study
Performance
As reported in the abstract
Diagnostic performance for GCA
| Test or model | Sensitivity | Specificity |
|---|---|---|
| CDUS | 69.6% (95%CI 50.4%-88.8%)Sensitivity on a scale from 0 to 100 percent | 100% |
| FDG-PET/CT | 52.2% (95%CI 31.4%-73.0%)Sensitivity on a scale from 0 to 100 percent | 100% |
| MRI | 56.5% (95%CI 35.8%-77.2%)Sensitivity on a scale from 0 to 100 percent | 100% |
Sensitivity
CDUS69.6% (95%CI 50.4%-88.8%)
FDG-PET/CT52.2% (95%CI 31.4%-73.0%)
MRI56.5% (95%CI 35.8%-77.2%)
Sensitivity on a scale from 0 to 100 percentSpecificity
CDUS100%
FDG-PET/CT100%
MRI100%
Further findings
Results by GCA subtype
- FDG-PET/CT negative in all isolated cranial GCA patients (n = 8)
- MRI negative in all isolated extracranial GCA patients (n = 4)
GCA patients with false-negative (n = 2) or inconclusive (n = 2) CDUS
- Further imaging confirmed diagnosis in all four
Original publication
A direct comparison in diagnostic performance of CDUS, FDG-PET/CT and MRI in patients suspected of giant cell arteritis. Rheumatology (Oxford). Published 10 April 2024. doi:10.
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