Comparison of temporal artery ultrasound versus biopsy in the diagnosis of giant cell arteritis
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Comparison of temporal artery ultrasound versus biopsy in the diagnosis of giant cell arteritis. / Hansen, Michael Stormly; Terslev, Lene; Jensen, Mads Radmer; Brittain, Jane Maestri; Døhn, Uffe Møller; Faber, Carsten; Heegaard, Steffen; Klefter, Oliver Niels; Kønig, Elisabeth Bay; Subhi, Yousif; Wiencke, Anne Katrine; Hamann, Steffen.
I: Eye, Bind 37, 2023, s. 344–349.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Comparison of temporal artery ultrasound versus biopsy in the diagnosis of giant cell arteritis
AU - Hansen, Michael Stormly
AU - Terslev, Lene
AU - Jensen, Mads Radmer
AU - Brittain, Jane Maestri
AU - Døhn, Uffe Møller
AU - Faber, Carsten
AU - Heegaard, Steffen
AU - Klefter, Oliver Niels
AU - Kønig, Elisabeth Bay
AU - Subhi, Yousif
AU - Wiencke, Anne Katrine
AU - Hamann, Steffen
N1 - Publisher Copyright: © 2022, The Author(s), under exclusive licence to The Royal College of Ophthalmologists.
PY - 2023
Y1 - 2023
N2 - Background/objectives: Giant cell arteritis (GCA) is a medical and ophthalmological emergency due to risk of stroke and sudden irreversible loss of vision. Fast and accurate diagnosis is important to prevent complications and long-term high dose glucocorticoids toxicity. Temporal artery biopsy is gold standard for diagnosing GCA. However, temporal artery ultrasound is a fast and non-invasive procedure which may provide a supplement or an alternative to biopsy. This study assesses the diagnostic performance of ultrasound and biopsy in the diagnosis of GCA. Subjects/methods: Examination results of patients suspected of having GCA in the period from August 2018 to June 2019 were reviewed. Patients underwent clinical examination and blood tests. Within a few days of starting glucocorticoid treatment, temporal ultrasound and unilateral biopsy were performed. Experienced physicians established the final clinical diagnosis at 6-months follow-up. Results: Seventy-eight patients underwent both ultrasound and biopsy. Thirty-five (45%) received the final clinical diagnosis of GCA. Compared with the final clinical diagnosis, biopsy had a sensitivity of 69% (51–83%) and a specificity of 100% (92–100%), and ultrasound a sensitivity of 63% (45–79%) and a specificity of 79% (64–94%). Area under the receiver operating characteristics curves were 0.84 and 0.71 for biopsy and ultrasound respectively (p = 0.048). False negative rate of ultrasound was 4 out of 78 (5%). Conclusion: Sensitivity of ultrasound is almost on par with that of biopsy although the overall diagnostic accuracy of ultrasound was slightly lower. We find that ultrasound is a reliable tool for first line diagnosis of GCA.
AB - Background/objectives: Giant cell arteritis (GCA) is a medical and ophthalmological emergency due to risk of stroke and sudden irreversible loss of vision. Fast and accurate diagnosis is important to prevent complications and long-term high dose glucocorticoids toxicity. Temporal artery biopsy is gold standard for diagnosing GCA. However, temporal artery ultrasound is a fast and non-invasive procedure which may provide a supplement or an alternative to biopsy. This study assesses the diagnostic performance of ultrasound and biopsy in the diagnosis of GCA. Subjects/methods: Examination results of patients suspected of having GCA in the period from August 2018 to June 2019 were reviewed. Patients underwent clinical examination and blood tests. Within a few days of starting glucocorticoid treatment, temporal ultrasound and unilateral biopsy were performed. Experienced physicians established the final clinical diagnosis at 6-months follow-up. Results: Seventy-eight patients underwent both ultrasound and biopsy. Thirty-five (45%) received the final clinical diagnosis of GCA. Compared with the final clinical diagnosis, biopsy had a sensitivity of 69% (51–83%) and a specificity of 100% (92–100%), and ultrasound a sensitivity of 63% (45–79%) and a specificity of 79% (64–94%). Area under the receiver operating characteristics curves were 0.84 and 0.71 for biopsy and ultrasound respectively (p = 0.048). False negative rate of ultrasound was 4 out of 78 (5%). Conclusion: Sensitivity of ultrasound is almost on par with that of biopsy although the overall diagnostic accuracy of ultrasound was slightly lower. We find that ultrasound is a reliable tool for first line diagnosis of GCA.
U2 - 10.1038/s41433-022-01947-1
DO - 10.1038/s41433-022-01947-1
M3 - Journal article
C2 - 35094027
AN - SCOPUS:85123838504
VL - 37
SP - 344
EP - 349
JO - Eye
JF - Eye
SN - 0950-222X
ER -
ID: 313614205