Is colour duplex sonography-guided temporal artery biopsy useful in the diagnosis of giant cell arteritis? A randomized study

Giuseppe Germanò, Francesco Muratore, Luca Cimino, Alberto Lo Gullo, Niccolò Possemato, Pierluigi Macchioni, Alberto Cavazza, Nicolò Pipitone, Luigi Boiardi, Carlo Salvarani

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Objective. The aim of this study was to assess the usefulness of colour duplex sonography (CDS)-guided temporal artery biopsy (TAB) for the diagnosis of GCA in patients with suspected GCA. Methods. From September 2009 through December 2012, 112 consecutive patients with suspected GCA were randomized to undergo CDS-guided TAB or standard TAB. All patients underwent temporal artery physical examination and temporal artery CDS prior to TAB. CDS of the temporal artery was performed by the same ultrasonographer, who was unaware of the patient's clinical data, and all TABs were evaluated by the same pathologist. Seven patients in whom biopsy failed to sample temporal artery tissue were excluded from the analysis. Results. Fifty patients were randomized to undergo CDS-guided TAB and 55 patients to standard TAB. Except for a younger age in patients who underwent standard TAB (P = 0.026), no significant differences were observed between the two groups. There were no significant differences in the frequencies of positive TAB for classic transmural inflammation (28% vs 18.2%) or for periadventitial small vessel vasculitis and/or vasa vasorum vasculitis (6% vs 14.5%) between the two groups. No significant differences in the frequency of positive TAB in the two groups were observed when we excluded the patients treated with glucocorticoids and when we stratified the patients of the two groups for the presence or absence of the halo sign. Conclusion. Our study showed that CDS-guided TAB did not improve the sensitivity of TAB for diagnosing GCA.

Original languageEnglish
Pages (from-to)400-404
Number of pages5
JournalRheumatology
Volume54
Issue number3
DOIs
Publication statusPublished - 2015

Fingerprint

Temporal Arteries
Giant Cell Arteritis
Ultrasonography
Color
Biopsy
Vasculitis
Vasa Vasorum

Keywords

  • colour duplex sonography
  • Giant cell arteritis
  • Glucocorticoid therapy
  • Guided temporal artery biopsy
  • Halo sign
  • Periadventitial small vessel vasculitis
  • Randomization
  • Temporal artery physical examination
  • Transmural vasculitis
  • Vasa vasorum vasculitis

ASJC Scopus subject areas

  • Rheumatology
  • Pharmacology (medical)

Cite this

Is colour duplex sonography-guided temporal artery biopsy useful in the diagnosis of giant cell arteritis? A randomized study. / Germanò, Giuseppe; Muratore, Francesco; Cimino, Luca; Lo Gullo, Alberto; Possemato, Niccolò; Macchioni, Pierluigi; Cavazza, Alberto; Pipitone, Nicolò; Boiardi, Luigi; Salvarani, Carlo.

In: Rheumatology, Vol. 54, No. 3, 2015, p. 400-404.

Research output: Contribution to journalArticle

Germanò, G, Muratore, F, Cimino, L, Lo Gullo, A, Possemato, N, Macchioni, P, Cavazza, A, Pipitone, N, Boiardi, L & Salvarani, C 2015, 'Is colour duplex sonography-guided temporal artery biopsy useful in the diagnosis of giant cell arteritis? A randomized study', Rheumatology, vol. 54, no. 3, pp. 400-404. https://doi.org/10.1093/rheumatology/keu241
Germanò, Giuseppe ; Muratore, Francesco ; Cimino, Luca ; Lo Gullo, Alberto ; Possemato, Niccolò ; Macchioni, Pierluigi ; Cavazza, Alberto ; Pipitone, Nicolò ; Boiardi, Luigi ; Salvarani, Carlo. / Is colour duplex sonography-guided temporal artery biopsy useful in the diagnosis of giant cell arteritis? A randomized study. In: Rheumatology. 2015 ; Vol. 54, No. 3. pp. 400-404.
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abstract = "Objective. The aim of this study was to assess the usefulness of colour duplex sonography (CDS)-guided temporal artery biopsy (TAB) for the diagnosis of GCA in patients with suspected GCA. Methods. From September 2009 through December 2012, 112 consecutive patients with suspected GCA were randomized to undergo CDS-guided TAB or standard TAB. All patients underwent temporal artery physical examination and temporal artery CDS prior to TAB. CDS of the temporal artery was performed by the same ultrasonographer, who was unaware of the patient's clinical data, and all TABs were evaluated by the same pathologist. Seven patients in whom biopsy failed to sample temporal artery tissue were excluded from the analysis. Results. Fifty patients were randomized to undergo CDS-guided TAB and 55 patients to standard TAB. Except for a younger age in patients who underwent standard TAB (P = 0.026), no significant differences were observed between the two groups. There were no significant differences in the frequencies of positive TAB for classic transmural inflammation (28{\%} vs 18.2{\%}) or for periadventitial small vessel vasculitis and/or vasa vasorum vasculitis (6{\%} vs 14.5{\%}) between the two groups. No significant differences in the frequency of positive TAB in the two groups were observed when we excluded the patients treated with glucocorticoids and when we stratified the patients of the two groups for the presence or absence of the halo sign. Conclusion. Our study showed that CDS-guided TAB did not improve the sensitivity of TAB for diagnosing GCA.",
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AU - Germanò, Giuseppe

AU - Muratore, Francesco

AU - Cimino, Luca

AU - Lo Gullo, Alberto

AU - Possemato, Niccolò

AU - Macchioni, Pierluigi

AU - Cavazza, Alberto

AU - Pipitone, Nicolò

AU - Boiardi, Luigi

AU - Salvarani, Carlo

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N2 - Objective. The aim of this study was to assess the usefulness of colour duplex sonography (CDS)-guided temporal artery biopsy (TAB) for the diagnosis of GCA in patients with suspected GCA. Methods. From September 2009 through December 2012, 112 consecutive patients with suspected GCA were randomized to undergo CDS-guided TAB or standard TAB. All patients underwent temporal artery physical examination and temporal artery CDS prior to TAB. CDS of the temporal artery was performed by the same ultrasonographer, who was unaware of the patient's clinical data, and all TABs were evaluated by the same pathologist. Seven patients in whom biopsy failed to sample temporal artery tissue were excluded from the analysis. Results. Fifty patients were randomized to undergo CDS-guided TAB and 55 patients to standard TAB. Except for a younger age in patients who underwent standard TAB (P = 0.026), no significant differences were observed between the two groups. There were no significant differences in the frequencies of positive TAB for classic transmural inflammation (28% vs 18.2%) or for periadventitial small vessel vasculitis and/or vasa vasorum vasculitis (6% vs 14.5%) between the two groups. No significant differences in the frequency of positive TAB in the two groups were observed when we excluded the patients treated with glucocorticoids and when we stratified the patients of the two groups for the presence or absence of the halo sign. Conclusion. Our study showed that CDS-guided TAB did not improve the sensitivity of TAB for diagnosing GCA.

AB - Objective. The aim of this study was to assess the usefulness of colour duplex sonography (CDS)-guided temporal artery biopsy (TAB) for the diagnosis of GCA in patients with suspected GCA. Methods. From September 2009 through December 2012, 112 consecutive patients with suspected GCA were randomized to undergo CDS-guided TAB or standard TAB. All patients underwent temporal artery physical examination and temporal artery CDS prior to TAB. CDS of the temporal artery was performed by the same ultrasonographer, who was unaware of the patient's clinical data, and all TABs were evaluated by the same pathologist. Seven patients in whom biopsy failed to sample temporal artery tissue were excluded from the analysis. Results. Fifty patients were randomized to undergo CDS-guided TAB and 55 patients to standard TAB. Except for a younger age in patients who underwent standard TAB (P = 0.026), no significant differences were observed between the two groups. There were no significant differences in the frequencies of positive TAB for classic transmural inflammation (28% vs 18.2%) or for periadventitial small vessel vasculitis and/or vasa vasorum vasculitis (6% vs 14.5%) between the two groups. No significant differences in the frequency of positive TAB in the two groups were observed when we excluded the patients treated with glucocorticoids and when we stratified the patients of the two groups for the presence or absence of the halo sign. Conclusion. Our study showed that CDS-guided TAB did not improve the sensitivity of TAB for diagnosing GCA.

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KW - Temporal artery physical examination

KW - Transmural vasculitis

KW - Vasa vasorum vasculitis

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