A comparative study of Doppler ultrasound against temporal artery biopsy in the diagnosis of giant cell arteritis

Porto, Sara Alicia González; Díaz, María Teresa Silva; Arias, Ana Reguera; Otero, Jorge Pombo; Rodríguez, Alba González; Gasalla, Javier Valero; Santos, Francisco Javier de Toro

doi:10.1016/j.reumae.2018.08.008

Cited by 3 publications

(2 citation statements)

References 27 publications

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“…Most of the GCA studies tested the halo sign as a main lesion to define vasculitis. Other US signs addressed (mostly in combination with the halo sign) were stenosis and occlusion [ 33 , 39 , 43 , 50 ] and the compression sign [ 24 , 40 ]. Two studies reported the compression sign [ 24 , 40 ], and four studies reported stenosis and occlusion along with halo sign [ 33 , 39 , 43 , 50 ].…”

Section: Resultsmentioning

confidence: 99%

“…Other US signs addressed (mostly in combination with the halo sign) were stenosis and occlusion [ 33 , 39 , 43 , 50 ] and the compression sign [ 24 , 40 ]. Two studies reported the compression sign [ 24 , 40 ], and four studies reported stenosis and occlusion along with halo sign [ 33 , 39 , 43 , 50 ]. Fifteen studies used TAB [ 15 , 33 , 34 , 39 , 41–46 , 48–50 , 52 , 53 ], and two studies used the compression sign [ 24 , 40 ] as reference.…”

Section: Resultsmentioning

confidence: 99%

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Role of the halo sign in the assessment of giant cell arteritis: a systematic review and meta-analysis

Sebastian

Coath

Innes

et al. 2021

Rheumatology Advances in Practice

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Objectives This systematic review and meta-analysis aimed to evaluate the diagnostic value of the halo sign in the assessment of GCA. Methods A systematic literature review was performed using MEDLINE, EMBASE and Cochrane central register databases up to August 2020. Studies informing on the sensitivity and specificity of the US halo sign for GCA (index test) were selected. Studies with a minimum of five participants were included. Study articles using clinical criteria, imaging such as PET-CT and/or temporal artery biopsy (TAB) as the reference standards were selected. Meta-analysis was conducted with a bivariate model. Results The initial search yielded 4023 studies. Twenty-three studies (patients n = 2711) met the inclusion criteria. Prospective (11 studies) and retrospective (12 studies) studies in academic and non-academic centres were included. Using clinical diagnosis as the standard (18 studies) yielded a pooled sensitivity of 67% (95% CI: 51, 80) and a specificity of 95% (95% CI: 89, 98%). This gave a positive and negative likelihood ratio for the diagnosis of GCA of 14.2 (95% CI: 5.7, 35.5) and 0.375 (95% CI: 0.22, 0.54), respectively. Using TAB as the standard (15 studies) yielded a pooled sensitivity of 63% (95% CI: 50, 75) and a specificity of 90% (95% CI: 81, 95). Conclusion The US halo sign is a sensitive and specific approach for GCA assessment and plays a pivotal role in diagnosis of GCA in routine clinical practice. Registration PROSPERO 2020 CRD42020202179.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Role of the halo sign in the assessment of giant cell arteritis: a systematic review and meta-analysis

Sebastian

Coath

Innes

et al. 2021

Rheumatology Advances in Practice

View full text Add to dashboard Cite

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Halo sign on temporal artery ultrasound versus temporal artery biopsy for giant cell arteritis

Pouncey,

Yeldham,

Magan

et al. 2024

Cochrane Database of Systematic Reviews

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Diagnostic use of ultrasound in giant cell arteritis in Counties Manukau District Health Board, New Zealand

Nagarajah

Kumar

2022

Rheumatology Advances in Practice

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Objectives A retrospective observational study was undertaken to assess the diagnostic performance (sensitivity and specificity) of colour duplex ultrasound (CDUS) compared with temporal artery biopsy (TAB) for the diagnosis of GCA in Counties Manukau District Health Board (CMDHB), New Zealand using clinical diagnosis as the reference standard. Methods The study population included patients with clinically suspected GCA who were referred to Middlemore hospital and underwent either CDUS or TAB, or both, between January 2019 and December 2020. Results Sixty-nine patients were included in the study. Sixty-one percent were over the age of 75, with no cases below 50 years and a female predominance of 71%. The sensitivity of CDUS was 26% [95% confidence interval (CI) 10% to 48%] and specificity 97% (95% CI 84% to 100%). The sensitivity of TAB was 57% (95% CI 34% to 77%) and specificity 100%. CDUS had a positive predictive value of 86% (95% CI 42% to 99%) and a negative predictive value of 65% (95% CI 49% to 78%). Conclusion Positive CDUS in patients with high risk for GCA may preclude the need for TAB due to the high specificity of CDUS in GCA. In contrast, patients with high risk for GCA with negative CDUS may still need TAB to confirm or exclude GCA. The duration from commencement of steroids to the time of CDUS is crucial in confirming GCA and for this, shortening waiting time in CMDHB would be necessary to ensure adequate test performance in practice.

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A comparative study of Doppler ultrasound against temporal artery biopsy in the diagnosis of giant cell arteritis

Cited by 3 publications

References 27 publications

Role of the halo sign in the assessment of giant cell arteritis: a systematic review and meta-analysis

Role of the halo sign in the assessment of giant cell arteritis: a systematic review and meta-analysis

Halo sign on temporal artery ultrasound versus temporal artery biopsy for giant cell arteritis

Diagnostic use of ultrasound in giant cell arteritis in Counties Manukau District Health Board, New Zealand

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