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Comparative Study
. 2025 Jul;52(9):3333-3341.
doi: 10.1007/s00259-025-07166-6. Epub 2025 Feb 26.

Direct comparison of the diagnostic accuracy of PET/CT, cranial MRI, ultrasound and temporal artery biopsy in giant cell arteritis

Lien Moreel  1   2 , Albrecht Betrains  3   4 , Lennert Boeckxstaens  5   6 , Griet Pieters  7 , Els Wuyts  7 , Birgit Weynand  6   8 , Inge Fourneau  9   10 , Koen Van Laere  5   6 , Philippe Demaerel  6   11 , Ellen De Langhe  12   13   14 , Steven Vanderschueren  3   4   14 , Daniel Blockmans  3   4   14
Affiliations
Comparative Study

Direct comparison of the diagnostic accuracy of PET/CT, cranial MRI, ultrasound and temporal artery biopsy in giant cell arteritis

Lien Moreel et al. Eur J Nucl Med Mol Imaging. 2025 Jul.

Abstract

Purpose: To evaluate the diagnostic accuracy of PET/CT, cranial MRI, ultrasound and temporal artery biopsy (TAB) in patients with suspected giant cell arteritis (GCA) in a direct comparison.

Methods: Consecutive patients with a suspicion of GCA and at least 2 diagnostic tests ≤ 7 days after initiation of glucocorticoids between June 2021 and June 2024, were included retrospectively. The gold standard for the diagnosis of GCA was the judgment of experienced clinicians after a follow-up of ≥ 6 months. Examinations were compared within subgroups undergoing the same tests.

Results: Sixty-one GCA patients and 50 patients with an alternative diagnosis were included. Combined cranial and large vessel PET/CT had the highest sensitivity (89% [95%CI 77-96%]) and specificity (98% [95%CI 88-100%]). Cranial PET/CT and TAB yielded a better sensitivity compared to temporal artery ultrasound (83% [95%CI 64-94%], 77% [95%CI 59-90%] and 55% [95%CI 36-74%], respectively, p = 0.023) without difference in specificity (100% [95%CI 100 - 84%], 95% [95%CI 76-100%] and 81% [95%CI 58-95%], respectively, p = 0.136). Cranial MRI had a sensitivity of 56% (95%CI 21-86%) and specificity of 82% (95%CI 48-98%). Large vessel PET/CT resulted in a better sensitivity compared to axillary artery ultrasound (68% [95%CI 45-86%] vs. 18% [95%CI 5-40%], p = 0.001) without difference in specificity (100% [95% CI 82-100%] vs. 90% [95%CI 67-99%], p = 0.50).

Conclusion: PET/CT had a better sensitivity than ultrasound and cranial MRI. TAB and cranial PET/CT had a similar diagnostic yield.

Clinical trial number: Not applicable.

Keywords: GCA; Giant cell arteritis; MRI; PET/CT; Temporal artery biopsy; Ultrasound.

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Conflict of interest statement

Declarations. Ethical approval: The study was conducted in accordance with the Declaration of Helsinki and approved by the ethical committee of UZ Leuven (S69201). Consent to participate: Informed consent was waived because of the retrospective nature of the study and the analysis used pseudonymized clinical data. Conflict of interest: LM has received research support from Roche and travel support from Abbvie; AB: none; LB: none; GP: none; EW: none; BW: none, IF: none KVL: none; PD: none; EDL has received consulting fees from Boehringer Ingelheim, GSK, Astra Zeneca and Otsuka, a speaking fee from Actelion and Novartis and travel support from Astra Zeneca and was a board member for AC Immune; SVDS: none; DB has received research support from Roche and consulting fees from Roche, GSK and Eli Lily and was a board member of Roche and GSK.

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References

    1. Dejaco C, Ramiro S, Bond M, Bosch P, Ponte C, Mackie SL, et al. EULAR recommendations for the use of imaging in large vessel vasculitis in clinical practice: 2023 update. Ann Rheum Dis. 2024;83:741–51. https://doi.org/10.1136/ard-2023-224543 . - DOI - PubMed
    1. Moreel L, Betrains A, Doumen M, Molenberghs G, Vanderschueren S, Blockmans D. Diagnostic yield of combined cranial and large vessel PET/CT, ultrasound and MRI in giant cell arteritis: a systematic review and meta-analysis. Autoimmun Rev. 2023;22:103355. https://doi.org/10.1016/j.autrev.2023.103355 . - DOI - PubMed
    1. Bosch P, Bond M, Dejaco C, Ponte C, MacKie SL, Falzon L, et al. Imaging in diagnosis, monitoring and outcome prediction of large vessel vasculitis: a systematic literature review and meta-analysis informing the 2023 update of the EULAR recommendations. RMD Open. 2023;9:e003379. https://doi.org/10.1136/rmdopen-2023-003379 . - DOI - PubMed - PMC
    1. Van Nieuwland M, Colin EM, Vermeer M, Wagenaar NR, Vijlbrief OD, van Zandwijk JK, et al. A direct comparison in diagnostic performance of CDUS, FDG-PET/CT and MRI in patients suspected of giant cell arteritis. Rheumatology. 2024;keae171. https://doi.org/10.1093/rheumatology/keae171 .
    1. Slart RHJA, Slart RHJA, Glaudemans AWJM, Chareonthaitawee P, Treglia G, Besson FL, et al. FDG-PET/CT(A) imaging in large vessel vasculitis and polymyalgia rheumatica: joint procedural recommendation of the EANM, SNMMI, and the PET Interest Group (PIG), and endorsed by the ASNC. Eur J Nucl Med Mol Imaging. 2018;45:1250–69. https://doi.org/10.1007/s00259-018-3973-8 . - DOI - PubMed - PMC

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