SpringerLink
Log in

Reproducibility and accuracy of vessel wall MRI in diagnosing giant cell arteritis: a study with readers of varying expertise

  • Head and Neck
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objective

To evaluate the reproducibility of vessel wall magnetic resonance imaging (VW-MRI) in diagnosing giant cell arteritis (GCA) among groups of radiologists with varying levels of expertise.

Methods

This institutional review board–approved retrospective single-center study recruited patients with suspected GCA between December 2014 and September 2021. Patients underwent 3 -T VW-MRI before temporal artery biopsy. Ten radiologists with varying levels of expertise, blinded to all data, evaluated several intracranial and extracranial arteries to assess GCA diagnosis. Interobserver reproducibility and diagnostic performance were evaluated.

Results

Fifty patients (27 women and 23 men) with a mean age of 75.9 ± 9 years were included. Thirty-one of 50 (62%) had a final diagnosis of GCA.VW-MRI had an almost perfect reproducibility among expert readers (kappa = 0.93; 95% CI 0.77–1) and substantial reproducibility among all readers, junior and non-expert senior readers (kappa = 0.7; 95% CI 0.66–0.73; kappa = 0.67 95% CI 0.59–0.74; kappa = 0.65; 95% CI 0.43–0.88 respectively) when diagnosing GCA. Substantial interobserver agreement was observed for the frontal branch of superficial temporal artery. Moderate interobserver agreement was observed for the superficial temporal artery and its parietal branch, as well as ophthalmic arteries in all groups of readers. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy varied depending on the group of readers.

Conclusion

VW-MRI is a reproducible and accurate imaging modality for detecting GCA, even among less-experienced readers. This study advocates for the use of VW-MRI when diagnosing GCA even in less-experienced centers.

Clinical relevance statement

VW-MRI is a reproducible and accurate imaging modality for detecting GCA, even among less-experienced readers, and it could be used as a first-line diagnostic tool for GCA in centers with limited expertise in GCA diagnosis.

Key Points

• Vessel wall magnetic resonance imaging (VW-MRI) is a reproducible and accurate imaging modality for detecting giant cell arteritis (GCA) in both extracranial and intracranial arteries.

• The reproducibility of vessel wall magnetic resonance imaging for giant cell arteritis diagnosis was high among expert readers and moderate among less-experienced readers.

• The use of vessel wall magnetic resonance imaging for giant cell arteritis diagnosis can be recommended even in centers with less-experienced readers.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Abbreviations

ACR:

American College of Rheumatology

EULAR:

European Alliance of Associations for Rheumatology

GCA:

Giant cell arteritis

MRI:

Magnetic resonance imaging

TAB:

Temporal artery biopsy

VW:

Vessel wall

WI:

Weighted Imaging

References

  1. Salvarani C, Cantini F, Boiardi L, Hunder GG (2002) Polymyalgia rheumatica and giant-cell arteritis. N Engl J Med 347:261–271. https://doi.org/10.1056/NEJMra011913

    Article  PubMed  Google Scholar 

  2. Younger DS (2019) Giant cell arteritis. Neurol Clin 37:335–344. https://doi.org/10.1016/j.ncl.2019.01.008

    Article  PubMed  Google Scholar 

  3. Dejaco C, Ramiro S, Duftner C et al (2018) EULAR recommendations for the use of imaging in large vessel vasculitis in clinical practice. Ann Rheum Dis 77:636–643. https://doi.org/10.1136/annrheumdis-2017-212649

    Article  PubMed  Google Scholar 

  4. Maz M, Chung SA, Abril A et al (2021) American College of Rheumatology/Vasculitis Foundation Guideline for the Management of Giant Cell Arteritis and Takayasu Arteritis. Arthritis Rheumatol 73(2021):1349–1365. https://doi.org/10.1002/art.41774

    Article  PubMed  Google Scholar 

  5. Ponte C, Grayson PC, Robson JC et al (2022) American College of Rheumatology/EULAR Classification Criteria for Giant Cell Arteritis. Arthritis Rheumatol 74(2022):1881–1889. https://doi.org/10.1002/art.42325

    Article  CAS  PubMed  Google Scholar 

  6. Moiseev SV, Smitienko I, Bulanov N, Novikov PI (2019) The role of temporal artery biopsy in patients with giant-cell arteritis is debated. Ann Rheum Dis 78:e31–e31. https://doi.org/10.1136/annrheumdis-2018-213282

    Article  CAS  PubMed  Google Scholar 

  7. Hellmich B, Agueda A, Monti S et al (2018) Update of the EULAR recommendations for the management of large vessel vasculitis. Ann Rheum Dis 79(2020):19–30. https://doi.org/10.1136/annrheumdis-2019-215672

    Article  Google Scholar 

  8. Lecler A, Hage R, Charbonneau F et al (2022) Validation of a multimodal algorithm for diagnosing giant cell arteritis with imaging. Diagn Interv Imaging 103:103–110. https://doi.org/10.1016/j.diii.2021.09.008

    Article  PubMed  Google Scholar 

  9. Mohammed-Brahim N, Clavel G et al (2019) Three tesla 3D high-resolution vessel wall MRI of the orbit may differentiate arteritic from nonarteritic anterior ischemic optic neuropathy. Invest Radiol 54:712–718. https://doi.org/10.1097/RLI.0000000000000595

    Article  PubMed  Google Scholar 

  10. Mournet S, Sené T, Charbonneau F et al (2021) High-resolution MRI demonstrates signal abnormalities of the 3rd cranial nerve in giant cell arteritis patients with 3rd cranial nerve impairment. Eur Radiol 31:4472–4480. https://doi.org/10.1007/s00330-020-07595-x

    Article  PubMed  Google Scholar 

  11. Klink T, Geiger J, Both M et al (2014) Giant cell arteritis: diagnostic accuracy of MR imaging of superficial cranial arteries in initial diagnosis—results from a multicenter trial. Radiology 273:844–852. https://doi.org/10.1148/radiol.14140056

    Article  PubMed  Google Scholar 

  12. Siemonsen S, Brekenfeld C, Holst B, Kaufmann-Buehler A-K, Fiehler J, Bley TA (2015) 3T MRI reveals extra- and intracranial involvement in giant cell arteritis. AJNR Am J Neuroradiol 36:91–97. https://doi.org/10.3174/ajnr.A4086

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Poillon G, Collin A, Benhamou Y et al (2020) Increased diagnostic accuracy of giant cell arteritis using three-dimensional fat-saturated contrast-enhanced vessel-wall magnetic resonance imaging at 3 T. Eur Radiol 30:1866–1875. https://doi.org/10.1007/s00330-019-06536-7

    Article  PubMed  Google Scholar 

  14. Zhang K-J, Li M-X, Zhang P, Qin H-Q, Guo Z-N, Yang Y (2022) Validity of high resolution magnetic resonance imaging in detecting giant cell arteritis: a meta-analysis. Eur Radiol 32:3541–3552. https://doi.org/10.1007/s00330-021-08413-8

    Article  PubMed  Google Scholar 

  15. Hayreh SS, Podhajsky PA, Zimmerman B (1998) Ocular manifestations of giant cell arteritis. Am J Ophthalmol 125:509–520. https://doi.org/10.1016/S0002-9394(99)80192-5

    Article  CAS  PubMed  Google Scholar 

  16. Barat M, Jannot A-S, Dohan A, Soyer P (2022) How to report and compare quantitative variables in a radiology article. Diagn Interv Imaging 103:571–573. https://doi.org/10.1016/j.diii.2022.09.007

    Article  PubMed  Google Scholar 

  17. Puppo C, Massollo M, Paparo F et al (2014) Giant cell arteritis: a systematic review of the qualitative and semiquantitative methods to assess vasculitis with 18F-fluorodeoxyglucose positron emission tomography. Biomed Res Int 2014:574248. https://doi.org/10.1155/2014/574248

  18. Blockmans D, Stroobants S, Maes A, Mortelmans L (2000) Positron emission tomography in giant cell arteritis and polymyalgia rheumatica: evidence for inflammation of the aortic arch. Am J Med 108:246–249. https://doi.org/10.1016/S0002-9343(99)00424-6

    Article  CAS  PubMed  Google Scholar 

  19. Lariviere D, Benali K, Coustet B et al (2016) Positron emission tomography and computed tomography angiography for the diagnosis of giant cell arteritis. Medicine (Baltimore) 95:e4146. https://doi.org/10.1097/MD.0000000000004146

    Article  PubMed  Google Scholar 

  20. Bahrami M, Mohammadi H, Mirgaloyebayat H et al (2023) The role of 18F-fluorodeoxyglucose PET/computed tomography in the diagnosis and monitoring of large vessel vasculitides - a review article. Am J Nucl Med Mol Imaging 13:127–135

    PubMed  PubMed Central  Google Scholar 

  21. Geiger J, Bley T, Uhl M, Frydrychowicz A, Langer M, Markl M (2010) Diagnostic value of T2-weighted imaging for the detection of superficial cranial artery inflammation in giant cell arteritis. J Magn Reson Imaging JMRI 31:470–474. https://doi.org/10.1002/jmri.22047

    Article  PubMed  Google Scholar 

  22. Bley TA, Uhl M, Carew J et al (2007) Diagnostic value of high-resolution MR imaging in giant cell arteritis. AJNR Am J Neuroradiol 28:1722–1727. https://doi.org/10.3174/ajnr.A0638

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Bley TA, Reinhard M, Hauenstein C et al (2008) Comparison of duplex sonography and high-resolution magnetic resonance imaging in the diagnosis of giant cell (temporal) arteritis. Arthritis Rheumatol 58:2574–2578. https://doi.org/10.1002/art.23699

    Article  CAS  Google Scholar 

  24. Rodriguez-Régent C, Ben Hassen W, Seners P, Oppenheim C, Régent A (2020) 3D T1-weighted black-blood magnetic resonance imaging for the diagnosis of giant cell arteritis. Clin Exp Rheumatol. 38 Suppl 124 95–98

  25. Rhéaume M, Rebello R, Pagnoux C et al (2017) High-resolution magnetic resonance imaging of scalp arteries for the diagnosis of giant cell arteritis: results of a prospective cohort study. Arthritis Rheumatol 69:161–168. https://doi.org/10.1002/art.39824

    Article  PubMed  Google Scholar 

  26. Franke P, Markl M, Heinzelmann S et al (2014) Evaluation of a 32-channel versus a 12-channel head coil for high-resolution post-contrast MRI in giant cell arteritis (GCA) at 3T. Eur J Radiol 83:1875–1880. https://doi.org/10.1016/j.ejrad.2014.06.022

    Article  PubMed  Google Scholar 

  27. Bley TA, Weiben O, Uhl M et al (2005) Assessment of the cranial involvement pattern of giant cell arteritis with 3T magnetic resonance imaging. Arthritis Rheumatol 52:2470–2477. https://doi.org/10.1002/art.21226

    Article  CAS  Google Scholar 

  28. Gospe SM, Amrhein TJ, Malinzak MD, Bhatti MT, Mettu P, El-Dairi MA (2021) Magnetic resonance imaging abnormalities of the optic nerve sheath and intracranial internal carotid artery in giant cell arteritis. J Neuroophthalmol 41:54–59. https://doi.org/10.1097/WNO.0000000000000860

    Article  PubMed  Google Scholar 

  29. Chen JJ, Leavitt JA, Fang C, Crowson CS, Matteson EL, Warrington KJ (2016) Evaluating the incidence of arteritic ischemic optic neuropathy and other causes of vision loss from giant cell arteritis. Ophthalmology 123:1999–2003. https://doi.org/10.1016/j.ophtha.2016.05.008

    Article  PubMed  Google Scholar 

Download references

Funding

The authors state that this work has not received any funding.

Author information

Authors and Affiliations

  1. Department of Neuroradiology, A. Rothschild Foundation Hospital, Paris, France

    Jérôme El Haddad, Frédérique Charbonneau, Guillaume Poillon, Alexia Tran, Alexandre Niro, Rémi Sore, Luca Litman-Roventa, Kévin Mahe, Samantha Chhour, Julien Savatovsky & Augustin Lecler

  2. Department of Clinical Research, A. Rothschild Foundation Hospital, Paris, France

    Jessica Guillaume

  3. Department of Internal Medicine, A. Rothschild Foundation Hospital, Paris, France

    Gaëlle Clavel & Thibaud Chazal

Authors
  1. Jérôme El Haddad
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Frédérique Charbonneau
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jessica Guillaume
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gaëlle Clavel
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Thibaud Chazal
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Guillaume Poillon
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Alexia Tran
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Alexandre Niro
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Rémi Sore
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Luca Litman-Roventa
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Kévin Mahe
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Samantha Chhour
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Julien Savatovsky
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Augustin Lecler
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Jérôme El Haddad or Augustin Lecler.

Ethics declarations

Guarantor

The scientific guarantor of this publication is Augustin Lecler, M.D. Ph. D.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors, Jessica Guillaume, has significant statistical expertise.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained (Rothschild Foundation Hospital review board–IRB 00012801, under the study number CE_20220322_1_ALR).

Study subjects or cohorts overlap

Study subjects or cohorts have not been previously reported.

Methodology

• retrospective

• observational study

• performed at one institution

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (PDF 65 KB)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

El Haddad, J., Charbonneau, F., Guillaume, J. et al. Reproducibility and accuracy of vessel wall MRI in diagnosing giant cell arteritis: a study with readers of varying expertise. Eur Radiol (2024). https://doi.org/10.1007/s00330-023-10567-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s00330-023-10567-6

Keywords

Search

Navigation