High-Resolution Magnetic Resonance Imaging of Scalp Arteries for the Diagnosis of Giant Cell Arteritis: Results of a Prospective Cohort Study.

OBJECTIVE: To examine the concordance between high-resolution magnetic resonance imaging (MRI) of the scalp arteries and temporal artery biopsy for the diagnosis of giant cell arteritis (GCA). METHODS: We conducted a prospective cohort study of patients with suspected GCA. Participants underwent high-field 3T MRI of the scalp arteries followed by temporal artery biopsy. Arterial wall thickness and enhancement on multiplanar postcontrast T1-weighted spin-echo images were graded according to a published severity scale (range 0-3). MRI findings were compared with temporal artery biopsy results and the American College of Rheumatology (ACR) criteria for GCA. RESULTS: One hundred seventy-one patients were included in the study. Temporal artery biopsy findings were positive in 31 patients (18.1%), and MRI findings were abnormal in 60 patients (35.1%). ACR criteria were met in 137 patients (80.1%). With temporal artery biopsy as the reference test, MRI had a sensitivity of 93.6% (95% confidence interval [95% CI] 78.6-99.2) and a specificity of 77.9% (95% CI 70.1-84.4). The corresponding negative predictive value of MRI was 98.2% (95% CI 93.6-99.8) and positive predictive value was 48.3% (95% CI 35.2-61.6). CONCLUSION: In patients with suspected GCA, normal findings on scalp artery MRI are very strongly associated with negative temporal artery biopsy findings. This suggests that MRI could be used as the initial diagnostic procedure in GCA, with temporal artery biopsy being reserved for patients with abnormal MRI findings.

Peer Review in Radiology: A Resident and Fellow Perspective.

PURPOSE: The purpose of this study was to explore Canadian radiology residents' and fellows' understanding, attitudes, opinions, and preferences toward peer review. METHODS: An Internet-based anonymous questionnaire designed to understand one's familiarity, attitudes, opinions, and preferences toward peer review was distributed to radiology residents and fellows across Canada. Data were analyzed using descriptive statistics, and answers were stratified by level of training. RESULTS: A total of 136 trainees responded to the survey with 92 completed survey responses available for descriptive statistics. Approximately half of respondents are familiar with peer review (49%), and 39% of trainees are involved in peer review. Most respondents (92%) expressed an interest in learning more about peer review; believe that it should be incorporated into the residency training curriculum (86%), be mandatory (72%), and that current participation will increase odds of future participation (91%). Most trainees (80%) are comfortable advising one another about errors, but less comfortable advising staff (21%). CONCLUSIONS: Residents and fellows welcome the opportunity to learn more about peer review and believe it should be incorporated into the residency training curriculum. Understanding the attitudes and perceptions held by trainees regarding peer review is important, as a means to optimize education and maximize current and future participation in peer review.