The role of temporal artery biopsy in patients with giant-cell arteritis is debated

Response to: ‘The role of temporal artery biopsy in patients with giant cell arteritis is debated’ by Moiseev et al

“…We also agree with Moiseev et al that ultrasound is a possible alternative to MRI in the diagnosis of Takayasu arteritis (TAK) even though it provides only a limited access to the thoracic aorta 1. Consequently, ultrasound is presumed to have a lower sensitivity in the diagnosis of TAK compared with MRI 9.…”

“…Moiseev et al state that they prefer a [18F]-fluorodeoxyglucose positron emission tomography (PET) scan over other modalities in patients with suspected GCA and negative ultrasound,1 given that many patients with GCA have extracranial manifestations 7 8. This approach is in line with the new EULAR recommendations suggesting that patients with a high clinical probability of GCA and a negative ultrasound scan should undergo further diagnostic testing which might include other imaging or TAB 2.…”

“…Moiseev et al 1 underlined the main message of the new European League Against Rheumatism (EULAR) recommendations for the use of imaging in large vessel vasculitis (LVV), namely the importance of imaging as a first-line test for the diagnosis of LVV 2. The EULAR task force also emphasised that the recommendations should not be understood as a recommendation against performing temporal artery biopsy (TAB) in giant cell arteritis (GCA), rather a biopsy still has its place when there is diagnostic doubt after having performed imaging or when imaging is not available or not performed with sufficient expertise.…”

Large vessel vasculitis and the rising role of FDG PET-CT: A case report and review of literature

“…It is superior to the previously used Gallium-citrate scintigraphy in the detection of active inflammation or infection [9] . Therefore, PET-CT can be used to identify the extent of the involved vasculature as with our patient, rule out other causes such as infection or tumors that may be attributed to the patients symptoms and to monitor the disease activity [15] .…”

“…The vascular inflammatory uptake in patients with LVV may persist even after the patients are in remission and this may be attributed to a degree of persistent low-grade inflammation, vessel remodeling or neovascular formation [13 , 3 , 15] .…”