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. 2024 Jun 19;77(7):464-470.
doi: 10.1136/jcp-2023-208810.

Histopathology reporting of temporal artery biopsy specimens for giant cell arteritis: results of a modified Delphi study

Dilek Taze  1   2 , Arundhati Chakrabarty  3   4 , Ranjana Venkateswaran  5 , Collette Hartley  4 , Charlotte Harden  4 , Ann Wendy Morgan  3   4 , Sarah Louise Mackie  4   5 , Kathryn Jane Griffin  3   2
Affiliations

Histopathology reporting of temporal artery biopsy specimens for giant cell arteritis: results of a modified Delphi study

Dilek Taze et al. J Clin Pathol. .

Abstract

The temporal artery biopsy (TAB) is regarded as the gold-standard test in the diagnosis of giant cell arteritis (GCA). There is a lack of agreement among experienced pathologists regarding the diagnostic features and classification of inflammation observed in TAB sections in the diagnosis of GCA.

Aims: The aim of this research study was to establish consensus on the key parameters which should be included in a standardised reporting proforma for TAB specimens. We specifically investigated factors pertaining to clinical information, specimen handling and microscopic pathological features.

Methods: A modified Delphi process, comprising three survey rounds and three virtual consensus group meetings, was undertaken by 13 UK-based pathology or ophthalmology consultants, with a 100% response rate across the three rounds. Initial statements were formulated after a literature review and participants were asked to rate their agreement using a nine-point Likert scale. Consensus was defined a priori as an agreement of ≥70% and individual feedback was provided after each round, together with data on the distribution of group responses.

Results: Overall, 67 statements reached consensus and 17 statements did not. The participants agreed on the core microscopic features to be included in a pathology report and felt that a proforma would facilitate consistent reporting practices.

Conclusions: Our work revealed uncertainty surrounding the correlation between clinical parameters (eg, laboratory markers of inflammation and steroid therapy duration) and microscopic findings, and we propose areas for future research.

Keywords: DIAGNOSIS; INFLAMMATION; NEUROPATHOLOGY; Pathology, Surgical; VASCULITIS.

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Conflict of interest statement

Competing interests: SLM reports consultancy on behalf of her institution for Roche/Chugai, Sanofi, AbbVie and AstraZeneca; speaker fees received by her institution from Pfizer, Chugai and Vifor; and support from Roche to attend EULAR2019 and Pfizer to attend ACR2021.

Figures

Figure 1
Figure 1
Example whole slide images used in the Delphi study.
Figure 2
Figure 2
Flow chart illustrating the modified Delphi process.
Figure 3
Figure 3
Level of agreement with the statements that did not reach consensus. GCA, giant cell arteritis; WSI, whole slide images; CPC, clinicopathological correlation.
See this image and copyright information in PMC

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