Diagnostic value of axillary artery ultrasound in patients with suspected giant cell arteritis

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An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis
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An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis

Published on: February 8, 2019

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Hilde Hop1, Douwe J Mulder1, Maria Sandovici2

  • 1Department of Internal Medicine, Division of Vascular Medicine.

Rheumatology (Oxford, England)
|April 3, 2020
PubMed

Insights

Colour duplex ultrasonography (CDU) of the axillary artery can detect Giant Cell Arteritis (GCA) involvement. Adding axillary artery assessment to temporal artery CDU significantly improves diagnostic performance for GCA.

Area of Science:

  • Vascular Imaging
  • Rheumatology
  • Diagnostic Accuracy

Background:

  • Giant Cell Arteritis (GCA) is a systemic vasculitis affecting large arteries.
  • Accurate diagnosis of GCA is crucial for timely treatment and prevention of complications.
  • Colour duplex ultrasonography (CDU) is a non-invasive imaging technique used in GCA diagnosis.

Purpose of the Study:

  • To compare colour duplex ultrasonography (CDU) findings with axillary 18F-fluorodeoxyglucose (FDG) PET/CT in patients suspected of GCA.
  • To evaluate the diagnostic performance of combining temporal and axillary artery CDU compared to temporal artery CDU alone.

Main Methods:

  • Retrospective inclusion of patients suspected of GCA.
  • CDU findings of halo or occlusion were considered positive.
  • Axillary artery involvement on FDG-PET/CT was defined by increased FDG uptake.
  • Clinical diagnosis after 6 months served as the reference standard, excluding CDU.

Main Results:

  • Of 113 patients, 41 were diagnosed with GCA. Twenty-eight underwent FDG-PET/CT, revealing extra-cranial GCA in 20, with 13 showing axillary involvement.
  • An axillary halo was detected in 8 of these 13 patients.
  • Temporal artery CDU sensitivity was 52% and specificity 93%. Adding axillary artery assessment improved sensitivity to 71% without altering specificity.

Conclusions:

  • Axillary halo or occlusion on CDU aligns with FDG-PET/CT findings, but a negative CDU does not exclude axillary artery involvement in GCA.
  • Incorporating axillary artery assessment into CDU protocols can significantly enhance diagnostic accuracy for GCA.
Abstract

Keywords:
diagnostic imaginggiant cell arteritisultrasound

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