Giant cell arteritis (GCA) is a medium to large vessel vasculitis with a predilection for the superficial cranial and intrathoracic arteries. Diagnosing the condition and predicting which patients will develop large vessel complications remains a challenge. There are limitations with temporal artery biopsy, magnetic resonance angiography and ultrasound of temporal arteries and American College of Rheumatology classification criteria. Positron emission tomography (PET) has been shown to be a useful modality in detecting inflammation in large intra-thoracic vessels but previously has not been able to accurately detect FDG uptake in the superficial cranial arteries due to poor spatial resolution. Newer scanners can perform finer cuts of the head and can detect uptake in these arteries. This study has three main components: 1. Cross sectional study assessing the accuracy of PET uptake in the superficial cranial and intrathoracic arteries of suspected GCA patients for the diagnosis of GCA 2. Cohort study assessing the prognostic implication of FDG aortic uptake on aortic diameter at 24 months 3. Cohort study assessing the Th1 and Th17 cytokine profile in patients with and without FDG PET uptake at 0, 6 and 24 months
Study Type
OBSERVATIONAL
Enrollment
64
Royal North Shore Hospital
St Leonards, New South Wales, Australia
Diagnostic accuracy of FDG uptake in the superficial cranial or intrathoracic arteries for the diagnosis of temporal artery biopsy proven GCA amongst patients with suspected GCA
Time frame: Baseline
Difference in aortic diameter at 24 months between patients with and without PET scan aortic uptake at time 0.
Time frame: 24 months
Difference in Th1 and Th17 axis cytokines in patients with and without thoracic large vessel PET uptake at 0, 6 and 24 months
Time frame: 24 months
Prevalence of varicella zoster virus antigen and DNA in temporal artery biopsy GCA specimens
Time frame: 24 months
Prevalence of acute varicella zoster IgM serology positivity in biopsy confirmed GCA patients
Time frame: 24 months
Difference in combined vascular events between GCA patients with and without thoracic large vessel PET uptake at 0, 6 and 24 months
Time frame: 24 months
Difference in temporal artery histology between GCA patients with and without thoracic large vessel PET uptake at 0 months
Time frame: Baseline
Difference in temporal artery histology between GCA patients with and without temporal artery PET uptake at 0 months
Time frame: Baseline
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