Colour Doppler ultrasound and the giant cell arteritis probability score for the diagnosis of giant cell arteritis: a Canadian single-centre experience

Abstract Objectives The aim was to compare the accuracy of colour Doppler ultrasonography (CDUS) and temporal artery biopsy (TAB) to establish the final diagnosis of GCA and to determine how the GCA probability score (GCAPS) performs as a risk stratification tool. Methods Descriptive statistics were...

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Bibliographic Details
Published in:Rheumatology advances in practice 2021-01, Vol.5 (3), p.rkab083-rkab083
Main Authors: Zarka, Farah, Rhéaume, Maxime, Belhocine, Meriem, Goulet, Michelle, Febrer, Guillaume, Mansour, Anne-Marie, Troyanov, Yves, Starnino, Tara, Meunier, Rosalie-Sélène, Chagnon, Isabelle, Routhier, Nathalie, Bénard, Valérie, Ducharme-Bénard, Stéphanie, Ross, Carolyn, Makhzoum, Jean-Paul
Format: Article
Language:English
Subjects:
Diagnostic imaging
Hospitals
Original
Quebec
Ultrasound imaging
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Summary:Abstract Objectives The aim was to compare the accuracy of colour Doppler ultrasonography (CDUS) and temporal artery biopsy (TAB) to establish the final diagnosis of GCA and to determine how the GCA probability score (GCAPS) performs as a risk stratification tool. Methods Descriptive statistics were performed on a retrospective cohort of patients referred to our vasculitis referral centre between 1 July 2017 and 1 October 2020 for suspected GCA. CDUS, TAB, centre-specific TAB (vasculitis centre vs referring hospitals) and GCAPS were compared against the final diagnosis of GCA as determined by a GCA expert; CDUS was also compared with TAB results. Results Data from 198 patients were included: 60 patients with GCA and 138 patients without GCA. Sixty-two patients had a TAB. Using the final diagnosis by a GCA expert as a reference, the sensitivity, specificity, positive predictive value and negative predictive value were 93.3%, 98.5%, 96.6% and 97.1% for CDUS and 69.2%, 100%, 100% and 81.8% for TAB, respectively. The false-negative rate was 6.7% for CDUS and 30.8% for TAB. False-negative TAB mostly occurred when performed in referring hospitals (57.1%) as opposed to our vasculitis centre (21.1%). With a cut-off at 9.5 points, sensitivity for GCAPS was 98.3% and specificity 74.3%. Conclusion CDUS of the temporal and axillary arteries showed a high sensitivity and specificity and helped to diagnose GCA in patients with negative TAB. We validated that GCAPS is a useful clinical tool, with a score of
ISSN:2514-1775
2514-1775
DOI:10.1093/rap/rkab083