{"title":"巨细胞动脉炎的PET/CT与颞动脉活检的比较。","authors":"Søren Lambæk, Marianne Pedersen, Therese Ovesen","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>This study aims to evaluate the use of PET/CT compared with temporal artery biopsy (TAB) as a diagnostic tool in patients suspected of giant cell arteritis (GCA) and to determine the influence of glucocorticoid treatment on diagnostic performance.</p><p><strong>Methods: </strong>This was a retrospective cohort study; 191 patients booked for TAB during a five-year period were screened for inclusion. The study population was divided into two groups. A TAB group containing patients who completed only TAB to assess potential selection bias and a PET/CT + TAB group containing patients with TAB and PET/CT to evaluate the diagnostic performance. The clinical diagnosis of GCA was established after a follow-up period of minimum six months.</p><p><strong>Results: </strong>A total of 157 patients were included in the study: 77 patients in the TAB group and 80 patients in the PET/CT + TAB group. The result of TAB and PET/CT did not match in 15 cases. Overall, the negative agreement rate of TAB and PET/CT was 19% (95% confidence interval (CI): 11-29%). The sensitivity of PET/CT was 76% (95% CI: 63-90%) compared with the clinical diagnosis. The sensitivity of TAB was lower: 63% (95% CI: 48-78%), but not significantly different (z = 1.26/p = 0.2). The sensitivity of both PET/CT and TAB increased to 85% (95% CI: 72-99%) and 74% (95% CI: 58-91%) if performed within three days of glucocorticoid therapy.</p><p><strong>Conclusion: </strong>This study strengthens the evidence that conventional PET/CT is a useful imaging modality in the diagnosis of the entire spectrum of GCA, including the assessment of both cranial and extra-cranial arteries.</p><p><strong>Funding: </strong>None.</p><p><strong>Trial registration: </strong>Not relevant.</p>","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"70 7","pages":""},"PeriodicalIF":1.0000,"publicationDate":"2023-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"PET/CT compared with temporal artery biopsy for giant cell arteritis.\",\"authors\":\"Søren Lambæk, Marianne Pedersen, Therese Ovesen\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>This study aims to evaluate the use of PET/CT compared with temporal artery biopsy (TAB) as a diagnostic tool in patients suspected of giant cell arteritis (GCA) and to determine the influence of glucocorticoid treatment on diagnostic performance.</p><p><strong>Methods: </strong>This was a retrospective cohort study; 191 patients booked for TAB during a five-year period were screened for inclusion. The study population was divided into two groups. A TAB group containing patients who completed only TAB to assess potential selection bias and a PET/CT + TAB group containing patients with TAB and PET/CT to evaluate the diagnostic performance. The clinical diagnosis of GCA was established after a follow-up period of minimum six months.</p><p><strong>Results: </strong>A total of 157 patients were included in the study: 77 patients in the TAB group and 80 patients in the PET/CT + TAB group. The result of TAB and PET/CT did not match in 15 cases. Overall, the negative agreement rate of TAB and PET/CT was 19% (95% confidence interval (CI): 11-29%). The sensitivity of PET/CT was 76% (95% CI: 63-90%) compared with the clinical diagnosis. The sensitivity of TAB was lower: 63% (95% CI: 48-78%), but not significantly different (z = 1.26/p = 0.2). The sensitivity of both PET/CT and TAB increased to 85% (95% CI: 72-99%) and 74% (95% CI: 58-91%) if performed within three days of glucocorticoid therapy.</p><p><strong>Conclusion: </strong>This study strengthens the evidence that conventional PET/CT is a useful imaging modality in the diagnosis of the entire spectrum of GCA, including the assessment of both cranial and extra-cranial arteries.</p><p><strong>Funding: </strong>None.</p><p><strong>Trial registration: </strong>Not relevant.</p>\",\"PeriodicalId\":11119,\"journal\":{\"name\":\"Danish medical journal\",\"volume\":\"70 7\",\"pages\":\"\"},\"PeriodicalIF\":1.0000,\"publicationDate\":\"2023-06-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Danish medical journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Danish medical journal","FirstCategoryId":"3","ListUrlMain":"","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
PET/CT compared with temporal artery biopsy for giant cell arteritis.
Introduction: This study aims to evaluate the use of PET/CT compared with temporal artery biopsy (TAB) as a diagnostic tool in patients suspected of giant cell arteritis (GCA) and to determine the influence of glucocorticoid treatment on diagnostic performance.
Methods: This was a retrospective cohort study; 191 patients booked for TAB during a five-year period were screened for inclusion. The study population was divided into two groups. A TAB group containing patients who completed only TAB to assess potential selection bias and a PET/CT + TAB group containing patients with TAB and PET/CT to evaluate the diagnostic performance. The clinical diagnosis of GCA was established after a follow-up period of minimum six months.
Results: A total of 157 patients were included in the study: 77 patients in the TAB group and 80 patients in the PET/CT + TAB group. The result of TAB and PET/CT did not match in 15 cases. Overall, the negative agreement rate of TAB and PET/CT was 19% (95% confidence interval (CI): 11-29%). The sensitivity of PET/CT was 76% (95% CI: 63-90%) compared with the clinical diagnosis. The sensitivity of TAB was lower: 63% (95% CI: 48-78%), but not significantly different (z = 1.26/p = 0.2). The sensitivity of both PET/CT and TAB increased to 85% (95% CI: 72-99%) and 74% (95% CI: 58-91%) if performed within three days of glucocorticoid therapy.
Conclusion: This study strengthens the evidence that conventional PET/CT is a useful imaging modality in the diagnosis of the entire spectrum of GCA, including the assessment of both cranial and extra-cranial arteries.
期刊介绍：
The Danish Medical Journal (DMJ) is a general medical journal. The journal publish original research in English – conducted in or in relation to the Danish health-care system. When writing for the Danish Medical Journal please remember target audience which is the general reader. This means that the research area should be relevant to many readers and the paper should be presented in a way that most readers will understand the content.
DMJ will publish the following articles:
• Original articles
• Protocol articles from large randomized clinical trials
• Systematic reviews and meta-analyses
• PhD theses from Danish faculties of health sciences
• DMSc theses from Danish faculties of health sciences.
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