Comparison of temporal artery ultrasound versus biopsy in the diagnosis of giant cell arteritis

Michael Stormly Hansen*, Lene Terslev, Mads Radmer Jensen, Jane Maestri Brittain, Uffe Møller Døhn, Carsten Faber, Steffen Heegaard, Oliver Niels Klefter, Elisabeth Bay Kønig, Yousif Subhi, Anne Katrine Wiencke, Steffen Hamann

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review


Background/objectives: Giant cell arteritis (GCA) is a medical and ophthalmological emergency due to risk of stroke and sudden irreversible loss of vision. Fast and accurate diagnosis is important to prevent complications and long-term high dose glucocorticoids toxicity. Temporal artery biopsy is gold standard for diagnosing GCA. However, temporal artery ultrasound is a fast and non-invasive procedure which may provide a supplement or an alternative to biopsy. This study assesses the diagnostic performance of ultrasound and biopsy in the diagnosis of GCA. Subjects/methods: Examination results of patients suspected of having GCA in the period from August 2018 to June 2019 were reviewed. Patients underwent clinical examination and blood tests. Within a few days of starting glucocorticoid treatment, temporal ultrasound and unilateral biopsy were performed. Experienced physicians established the final clinical diagnosis at 6-months follow-up. Results: Seventy-eight patients underwent both ultrasound and biopsy. Thirty-five (45%) received the final clinical diagnosis of GCA. Compared with the final clinical diagnosis, biopsy had a sensitivity of 69% (51–83%) and a specificity of 100% (92–100%), and ultrasound a sensitivity of 63% (45–79%) and a specificity of 79% (64–94%). Area under the receiver operating characteristics curves were 0.84 and 0.71 for biopsy and ultrasound respectively (p = 0.048). False negative rate of ultrasound was 4 out of 78 (5%). Conclusion: Sensitivity of ultrasound is almost on par with that of biopsy although the overall diagnostic accuracy of ultrasound was slightly lower. We find that ultrasound is a reliable tool for first line diagnosis of GCA.

Original languageEnglish
JournalEye (Basingstoke)
Issue number2
Pages (from-to)344-349
Publication statusPublished - Feb 2023
Externally publishedYes

Bibliographical note

Funding Information:
The study was funded by Synoptik Foundation and The Danish Rheumatism Association.


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