Assessing Vasculitis in Giant Cell Arteritis by Ultrasound: Results of OMERACT Patient-based Reliability Exercises

Valentin S Schäfer, Stavros Chrysidis, Christian Dejaco, Christina Duftner, Annamaria Iagnocco, George A Bruyn, Greta Carrara, Maria Antonietta D'Agostino, Eugenio De Miguel, Andreas P Diamantopoulos, Ulrich Fredberg, Wolfgang Hartung, Alojzija Hocevar, Aaron Juche, Tanaz A Kermani, Matthew J Koster, Tove Lorenzen, Pierluigi Macchioni, Marcin Milchert, Uffe Møller DøhnChetan Mukhtyar, Cristina Ponte, Sofia Ramiro, Carlo A Scirè, Lene Terslev, Kenneth J Warrington, Bhaskar Dasgupta, Wolfgang A Schmidt

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Abstract

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.

Original languageEnglish
Pages (from-to)1289-1295
Number of pages7
JournalJournal of Rheumatology
Volume45
Issue number9
DOIs
Publication statusPublished - 1 Sep 2018

Keywords

  • Aged
  • Female
  • Giant Cell Arteritis/diagnostic imaging
  • Humans
  • Male
  • Middle Aged
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Temporal Arteries/diagnostic imaging
  • Ultrasonography
  • Vasculitis/diagnostic imaging

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