Thorsten Alexander Bley MD, Presenter: Nothing to Disclose

Julia Geiger MD, Abstract Co-Author: Nothing to Disclose

Marcus Both MD, Abstract Co-Author: Nothing to Disclose

Thomas Ness, Abstract Co-Author: Nothing to Disclose

Peter Vaith, Abstract Co-Author: Nothing to Disclose

Michael Markl PhD, Abstract Co-Author: Nothing to Disclose

Gerhard B. Adam MD, Abstract Co-Author: Nothing to Disclose

Mathias F. J. Langer MD, PhD, Abstract Co-Author: Nothing to Disclose

Martin Heller MD, Abstract Co-Author: Nothing to Disclose

Bernhard Noelle, Abstract Co-Author: Nothing to Disclose

THORSTEN KLINK MD, Abstract Co-Author: Nothing to Disclose

To assess the value of high resolution magnetic resonance imaging (MRI) for diagnosing giant cell arteritis (GCA) in a large cohort of patients form 3 academic medical centers.

184 patients (71% female, 29% male, mean 70,1±10.6 years) with suspected GCA underwent high resolution MRI at 3.0T (139 patients) and 1.5T (45 patients) in three academic medical centers between February 2006 and August 2011. Mural inflammatory changes such as contrast enhancement and thickening were evaluated by two blinded observers on post contrast (0.1mmol/kg Gd-BOPTA), multislice T1-weighted spin echo images with an acquired spatial resolution of 196µm×260µm (TR 500, TE 22). Temporal artery biopsy (TAB) was available in 107 patients. Sensitivity, specificity, positive and negative predictive value (PPV, NPV) and the inter-observer agreement were calculated.

Compared with biopsy results the two observers achieved sensitivities of 95% and 89%, specificities of 73% and 80%, NPV of 83% and 86%, and PPV of 91% and 83%, respectively. Substantial inter-observer-agreement with a kappa value of 0.657 was found. TAB was positive in 58,9% of 107 biopsied patients. Compared with the final clinical diagnosis in all 187 patients, the two observers achieved sensitivities of 84% and 78%, specificities of 85% and 94%, NPV of 82% and 79%, and PPV of 86% and 94%, respectively.

This multicenter study revealed high sensitivities and specificities of MRI in detection of mural inflammatory changes in GCA as compared with temporal artery biopsy and the final clinical diagnosis in a large patient cohort. The substantial inter-observer-agreement between the two observer who read images acquired at three different centers underscores the value of this non-invasive test.

High resolution MRI is a valid non-invasive imaging test for diagnosing giant cell arteritis and has the potential to replace invasive temporal artery biopsy as diagnostic reference standard.

Bley, T, Geiger, J, Both, M, Ness, T, Vaith, P, Markl, M, Adam, G, Langer, M, Heller, M, Noelle, B, KLINK, T, Prospective Multicenter Cohort Study of High Resolution MRI in Giant Cell (Temporal) Arteritis.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12033078.html