TY - JOUR
T1 - Assessing vasculitis in giant cell arteritis by ultrasound: Results of OMERACT patient-based reliability exercises
AU - Schäfer, Valentin S.
AU - Chrysidis, Stavros
AU - Dejaco, Christian
AU - Duftner, Christina
AU - Iagnocco, Annamaria
AU - Bruyn, George A.
AU - Carrara, Greta
AU - D'Agostino, Maria Antonietta
AU - De Miguel, Eugenio
AU - Diamantopoulos, Andreas P.
AU - Fredberg, Ulrich
AU - Hartung, Wolfgang
AU - Hocevar, Alojzija
AU - Juche, Aaron
AU - Kermani, Tanaz A.
AU - Koster, Matthew J.
AU - Lorenzen, Tove
AU - Macchioni, Pierluigi
AU - Milchert, Marcin
AU - Døhn, Uffe Møller
AU - Mukhtyar, Chetan
AU - Ponte, Cristina
AU - Ramiro, Sofia
AU - Scirè, Carlo A.
AU - Terslev, Lene
AU - Warrington, Kenneth J.
AU - Dasgupta, Bhaskar
AU - Schmidt, Wolfgang A.
PY - 2018/9/1
Y1 - 2018/9/1
N2 - OBJECTIVE: To test the reliability of Outcome Measures in Rheumatology Clinical Trials (OMERACT) consensus-based ultrasound definitions for normal and vasculitic temporal and axillary arteries in patients with giant cell arteritis (GCA) and in controls. METHODS: A preliminary 1-day meeting and a full 3-day meeting fulfilling OMERACT Ultrasound Group guidelines were held. Temporal and axillary arteries were examined at 2 timepoints by 12 sonographers on 4 patients with GCA and 2 controls. The aim was to test inter- and intrareader reliability for normal findings, halo sign, and compression sign. In both meetings, patients had established GCA. Pathology was more recent in the full meeting, which was preceded by 6 h of training. Scanning time was 15-20 min instead of 10-13 min. RESULTS: In the preliminary exercise, interreader reliabilities were fair to moderate for the overall diagnosis of GCA (Light κ 0.29-0.51), and poor to fair for identifying vasculitis in the respective anatomical segments (Light κ 0.02-0.46). Intrareader reliabilities were moderate (Cohen κ 0.32-0.64). In the main exercise, interreader reliability was good to excellent (Light κ 0.76-0.86) for the overall diagnosis of GCA, and moderate to good (Light κ 0.46-0.71) for identifying vasculitis in the respective anatomical segments. Intrareader reliability was excellent for diagnosis of GCA (Cohen κ 0.91) and good (Cohen κ 0.71-0.80) for the anatomical segments. CONCLUSION: OMERACT-derived definitions of halo and compression signs of temporal and axillary arteries are reliable in recent-onset GCA if experienced sonographers (> 300 examinations) have 15-20 min for a standardized examination with prior training and apply > 15 MHz probes.
AB - OBJECTIVE: To test the reliability of Outcome Measures in Rheumatology Clinical Trials (OMERACT) consensus-based ultrasound definitions for normal and vasculitic temporal and axillary arteries in patients with giant cell arteritis (GCA) and in controls. METHODS: A preliminary 1-day meeting and a full 3-day meeting fulfilling OMERACT Ultrasound Group guidelines were held. Temporal and axillary arteries were examined at 2 timepoints by 12 sonographers on 4 patients with GCA and 2 controls. The aim was to test inter- and intrareader reliability for normal findings, halo sign, and compression sign. In both meetings, patients had established GCA. Pathology was more recent in the full meeting, which was preceded by 6 h of training. Scanning time was 15-20 min instead of 10-13 min. RESULTS: In the preliminary exercise, interreader reliabilities were fair to moderate for the overall diagnosis of GCA (Light κ 0.29-0.51), and poor to fair for identifying vasculitis in the respective anatomical segments (Light κ 0.02-0.46). Intrareader reliabilities were moderate (Cohen κ 0.32-0.64). In the main exercise, interreader reliability was good to excellent (Light κ 0.76-0.86) for the overall diagnosis of GCA, and moderate to good (Light κ 0.46-0.71) for identifying vasculitis in the respective anatomical segments. Intrareader reliability was excellent for diagnosis of GCA (Cohen κ 0.91) and good (Cohen κ 0.71-0.80) for the anatomical segments. CONCLUSION: OMERACT-derived definitions of halo and compression signs of temporal and axillary arteries are reliable in recent-onset GCA if experienced sonographers (> 300 examinations) have 15-20 min for a standardized examination with prior training and apply > 15 MHz probes.
KW - Aged
KW - Female
KW - Giant Cell Arteritis/diagnostic imaging
KW - Humans
KW - Male
KW - Middle Aged
KW - Reproducibility of Results
KW - Sensitivity and Specificity
KW - Temporal Arteries/diagnostic imaging
KW - Ultrasonography
KW - Vasculitis/diagnostic imaging
U2 - 10.3899/jrheum.171428
DO - 10.3899/jrheum.171428
M3 - Article
C2 - 29961687
SN - 0315-162X
VL - 45
SP - 1289
EP - 1295
JO - Journal of Rheumatology
JF - Journal of Rheumatology
IS - 9
ER -