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Diagnostic value of axillary artery ultrasound in patients with suspected giant cell arteritis
OBJECTIVES: To compare colour duplex ultrasonography (CDU) findings with axillary (18)F-fluorodeoxyglucose (FDG) PET/CT findings and to compare the diagnostic performance of temporal and axillary artery CDU with temporal artery CDU alone. METHODS: Patients suspected of GCA were retrospectively inclu...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7733725/ https://www.ncbi.nlm.nih.gov/pubmed/32240306 http://dx.doi.org/10.1093/rheumatology/keaa102 |
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author | Hop, Hilde Mulder, Douwe J Sandovici, Maria Glaudemans, Andor W J M van Roon, Arie M Slart, Riemer H J A Brouwer, Elisabeth |
author_facet | Hop, Hilde Mulder, Douwe J Sandovici, Maria Glaudemans, Andor W J M van Roon, Arie M Slart, Riemer H J A Brouwer, Elisabeth |
author_sort | Hop, Hilde |
collection | PubMed |
description | OBJECTIVES: To compare colour duplex ultrasonography (CDU) findings with axillary (18)F-fluorodeoxyglucose (FDG) PET/CT findings and to compare the diagnostic performance of temporal and axillary artery CDU with temporal artery CDU alone. METHODS: Patients suspected of GCA were retrospectively included. Presence of a halo or occlusion was considered a positive CDU finding. FDG-PET/CT-assessed axillary artery involvement was defined as axillary artery FDG uptake higher than liver uptake. The reference was the clinical diagnosis after 6 months, which was based on symptomatology and additional diagnostic tests, with the exception of CDU. RESULTS: Of the 113 included patients, GCA was diagnosed in 41. Twenty-eight out of 41 GCA patients underwent a FDG-PET/CT. FDG-PET-assessed extra-cranial GCA was present in 20/41 patients, of which 13 showed axillary involvement on FDG-PET/CT. An axillary halo was found in eight of these 13 patients. Six out of the 20 patients with FDG-PET-assessed GCA showed no axillary involvement on CDU or FDG-PET/CT. Five of them had single artery involvement on FDG-PET/CT (two aorta; three vertebral artery). One patient had an axillary occlusion on CDU, consistent with FDG-PET/CT results. Overall, sensitivity and specificity of temporal artery CDU was 52% (95% CI: 35, 67) and 93% (95% CI: 84, 97), respectively. Adding axillary artery results improved sensitivity to 71% (95% CI: 55, 84), while specificity did not change. CONCLUSION: Presence of an axillary halo or occlusion on CDU is consistent with axillary artery FDG-PET/CT results, but a negative CDU does not rule out axillary involvement. Adding axillary artery assessment to temporal artery assessment may substantially increase the diagnostic performance of CDU. |
format | Online Article Text |
id | pubmed-7733725 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-77337252020-12-17 Diagnostic value of axillary artery ultrasound in patients with suspected giant cell arteritis Hop, Hilde Mulder, Douwe J Sandovici, Maria Glaudemans, Andor W J M van Roon, Arie M Slart, Riemer H J A Brouwer, Elisabeth Rheumatology (Oxford) Clinical Science OBJECTIVES: To compare colour duplex ultrasonography (CDU) findings with axillary (18)F-fluorodeoxyglucose (FDG) PET/CT findings and to compare the diagnostic performance of temporal and axillary artery CDU with temporal artery CDU alone. METHODS: Patients suspected of GCA were retrospectively included. Presence of a halo or occlusion was considered a positive CDU finding. FDG-PET/CT-assessed axillary artery involvement was defined as axillary artery FDG uptake higher than liver uptake. The reference was the clinical diagnosis after 6 months, which was based on symptomatology and additional diagnostic tests, with the exception of CDU. RESULTS: Of the 113 included patients, GCA was diagnosed in 41. Twenty-eight out of 41 GCA patients underwent a FDG-PET/CT. FDG-PET-assessed extra-cranial GCA was present in 20/41 patients, of which 13 showed axillary involvement on FDG-PET/CT. An axillary halo was found in eight of these 13 patients. Six out of the 20 patients with FDG-PET-assessed GCA showed no axillary involvement on CDU or FDG-PET/CT. Five of them had single artery involvement on FDG-PET/CT (two aorta; three vertebral artery). One patient had an axillary occlusion on CDU, consistent with FDG-PET/CT results. Overall, sensitivity and specificity of temporal artery CDU was 52% (95% CI: 35, 67) and 93% (95% CI: 84, 97), respectively. Adding axillary artery results improved sensitivity to 71% (95% CI: 55, 84), while specificity did not change. CONCLUSION: Presence of an axillary halo or occlusion on CDU is consistent with axillary artery FDG-PET/CT results, but a negative CDU does not rule out axillary involvement. Adding axillary artery assessment to temporal artery assessment may substantially increase the diagnostic performance of CDU. Oxford University Press 2020-04-02 /pmc/articles/PMC7733725/ /pubmed/32240306 http://dx.doi.org/10.1093/rheumatology/keaa102 Text en © The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Rheumatology. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Clinical Science Hop, Hilde Mulder, Douwe J Sandovici, Maria Glaudemans, Andor W J M van Roon, Arie M Slart, Riemer H J A Brouwer, Elisabeth Diagnostic value of axillary artery ultrasound in patients with suspected giant cell arteritis |
title | Diagnostic value of axillary artery ultrasound in patients with suspected giant cell arteritis |
title_full | Diagnostic value of axillary artery ultrasound in patients with suspected giant cell arteritis |
title_fullStr | Diagnostic value of axillary artery ultrasound in patients with suspected giant cell arteritis |
title_full_unstemmed | Diagnostic value of axillary artery ultrasound in patients with suspected giant cell arteritis |
title_short | Diagnostic value of axillary artery ultrasound in patients with suspected giant cell arteritis |
title_sort | diagnostic value of axillary artery ultrasound in patients with suspected giant cell arteritis |
topic | Clinical Science |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7733725/ https://www.ncbi.nlm.nih.gov/pubmed/32240306 http://dx.doi.org/10.1093/rheumatology/keaa102 |
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