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A direct comparison in diagnostic performance of CDUS, FDG-PET/CT and MRI in patients suspected of giant cell arteritis.
van Nieuwland, Marieke; Colin, Edgar M; Vermeer, Marloes; Wagenaar, Nils R L; Vijlbrief, Onno D; van Zandwijk, Jordy K; Slart, Riemer H J A; Koffijberg, Hendrik; Jebbink, Erik Groot; van der Geest, Kornelis S M; Brouwer, Elisabeth; Boumans, Dennis; Alves, Celina.
Afiliação
  • van Nieuwland M; Department of Rheumatology and Clinical Immunology, Hospital Group Twente (Ziekenhuisgroep Twente), Almelo, the Netherlands.
  • Colin EM; Department of Rheumatology and Clinical Immunology, Hospital Group Twente (Ziekenhuisgroep Twente), Almelo, the Netherlands.
  • Vermeer M; ZGT Academy, Hospital Group Twente (Ziekenhuisgroep Twente), Almelo, the Netherlands.
  • Wagenaar NRL; Department of Nuclear Medicine, Hospital Group Twente (Ziekenhuisgroep Twente), Almelo, the Netherlands.
  • Vijlbrief OD; Department of Radiology, Hospital Group Twente (Ziekenhuisgroep Twente), Almelo, the Netherlands.
  • van Zandwijk JK; Magnetic Detection & Imaging, University of Twente, The Netherlands. Department of Vascular Surgery, Medisch Spectrum Twente, The Netherlands.
  • Slart RHJA; Medical Imaging Centre, Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, the Netherlands; Biomedical Photonic Imaging Group, Faculty of Science and Technology, University of Twente, Enschede, the Netherlands.
  • Koffijberg H; Health Technology & Services Research, TechMed Centre, University of Twente, Enschede, The Netherlands.
  • Jebbink EG; Multi-Modality Medical Imaging Group, TechMed Centre, University of Twente, Enschede, The Netherlands.
  • van der Geest KSM; Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
  • Brouwer E; Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
  • Boumans D; Department of Rheumatology and Clinical Immunology, Hospital Group Twente (Ziekenhuisgroep Twente), Almelo, the Netherlands.
  • Alves C; Department of Rheumatology and Clinical Immunology, Hospital Group Twente (Ziekenhuisgroep Twente), Almelo, the Netherlands.
Article em En | MEDLINE | ID: mdl-38597882
ABSTRACT

OBJECTIVES:

This study directly compares diagnostic performance of Colour Duplex Ultrasound (CDUS), Fluor-18-deoxyglucose Positron Emission Tomography Computed Tomography (FDG-PET/CT) and Magnetic Resonance Imaging (MRI) in patients suspected of giant cell arteritis (GCA).

METHODS:

Patients with suspected GCA were included in a nested-case control pilot study. CDUS, whole body FDG-PET/CT and cranial MRI were performed within 5 working days after initial clinical evaluation. Clinical diagnosis after six months follow-up by experienced rheumatologists in the field of GCA, blinded for imaging, was used as reference standard. Diagnostic performance of the imaging modalities was determined. Stratification for GCA subtype was performed and imaging results were evaluated in different risk stratification groups.

RESULTS:

In total, 23 patients with GCA and 19 patients suspected of but not diagnosed with GCA were included. Sensitivity was 69.6% (95%CI 50.4%-88.8%) for CDUS, 52.2% (95%CI 31.4%-73.0%) for FDG-PET/CT and 56.5% (95%CI 35.8%-77.2%) for MRI. Specificity was 100% for CDUS, FDG-PET/CT and MRI. FDG-PET/CT was negative for GCA in all isolated cranial GCA patients (n = 8), while MRI was negative in all isolated extracranial GCA patients (n = 4). In 4 GCA patients with false-negative (n = 2; intermediate and high risk) or inconclusive (n = 2; low and intermediate risk) CDUS results, further imaging confirmed diagnosis.

CONCLUSIONS:

Sensitivity of CDUS was highest, while specificity was excellent in all imaging modalities. Nevertheless, confidence intervals of all imaging modalities were overlapping. Following EULAR recommendations, CDUS can be used as a first test to diagnose GCA. With insufficient evidence for GCA, further testing considering GCA subtype is warranted.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Rheumatology (Oxford) Assunto da revista: REUMATOLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Holanda

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Rheumatology (Oxford) Assunto da revista: REUMATOLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Holanda