Highlights from the breakout session: imaging in disease assessment

Area of Science:

• Rheumatology
• Radiology
• Medical Imaging

Background:

• Vasculitis diagnosis and management rely heavily on clinical assessment, but imaging advancements offer objective biomarkers.
• Current imaging modalities require standardization and novel approaches for improved accuracy in disease assessment.

Purpose of the Study:

• To review recent advancements in imaging for vasculitis assessment presented at a breakout session.
• To highlight novel imaging biomarkers and methodologies for improved disease monitoring and prediction of outcomes.

Main Methods:

• Evaluation of cranial MRI for giant cell arteritis (GCA) and introduction of the Propensity for Enhancement for GCA (PEG) score.
• Analysis of CT chest scans using a radiomic model for ANCA-associated vasculitis relapse prediction.
• Assessment of FDG-PET for monitoring GCA in patients on tocilizumab.
• Comparative analysis of Takayasu arteritis using the Takayasu Arteritis Disease Activity Index (TAIDAI).
• Development of a protocolized ultrasonography pathway for large vessel vasculitis diagnosis.

Main Results:

• The PEG score shows potential for assessing inflammation in GCA.
• A novel radiomic CT model accurately predicted relapses in ANCA-associated vasculitis.
• FDG-PET demonstrated limited predictive value for GCA monitoring.
• Standardized evaluations are needed for Takayasu arteritis.
• A combined ultrasound and CRP-guided second test approach shows promise for large vessel vasculitis diagnosis.

Conclusions:

• Integrating advanced imaging biomarkers with clinical assessments is crucial for optimizing vasculitis disease management.
• Novel imaging strategies, including radiomics and standardized ultrasound protocols, can enhance diagnostic accuracy and predictive capabilities for various vasculitis types.