Kenneth Warrington<\/b>, MD,<\/b> told Healio. Image: Rob Volansky | Healio<\/i>
Temporal artery ultrasound, temporal artery biopsy, MRI of the brain with vessel wall imaging, computed tomography angiography (CTA) of the chest or abdomen, magnetic resonance angiography (MRA) of the chest or abdomen, or fluorodeoxyglucose-positron emission tomography (FDG-PET)\/CT scan all may be used in various patients and at various time points in the disease course, according to Warrington. <\/p>\n
\u201cNow we have a whole menu of tests we can use to evaluate patients,\u201d he said in his presentation. \u201cThe question is, how do we choose.\u201d<\/p>\n
For example, temporal artery ultrasound can be effective but comes with a qualification. <\/p>\n
\u201cPatients with atherosclerosis may receive an erroneous GCA diagnosis,\u201d Warrington said.<\/p>\n
Meanwhile, vessel wall MRI is being used with increasing frequency. <\/p>\n
\u201cIt is a powerful tool to know whether arteries are inflamed or not,\u201d Warrington said. \u201cIt has great specificity and sensitivity.\u201d<\/p>\n
However, the issue with vessel wall MRI is availability. Many centers do not yet have this technology, Warrington said.<\/p>\n
When imaging the chest or abdomen, CTA can show thickening of the vasculature, while MRA can show edemas, according to Warrington. <\/p>\n
\u201cCT can tell us something is going wrong, but it does not give us any information about whether inflammation is active or not,\u201d he said. \u201cMRI is better at doing that.\u201d<\/p>\n
FDG-PET imaging may save time and effort in patients who \u201chave bounced around\u201d with a negative biopsy or ultrasound, if they have had a fever or inflammation of unknown origin, or a suspected malignancy, according to Warrington. <\/p>\n
\u201cIt can be helpful even in patients on treatment,\u201d he said.<\/p>\n
Regarding the choice between biopsy and ultrasound, Warrington noted that the American College of Rheumatology recommends biopsy, while European guidelines favor ultrasound. Practitioners are encouraged to follow the guidelines in their region and assess individual patients for the preferential test, he said.<\/p>\n
\u201cThe main take-home message for rheumatologists is the importance of early, accurate diagnosis, along with thoughtful use of imaging, and temporal artery biopsy in some cases, as a complement to clinical assessment,\u201d Warrington told Healio. \u201cWhen we have imaging and histopathology, we get a much better picture of what is going on with our patients.\u201d<\/p>\n
For more information:<\/h2>\n Kenneth J. Warrington<\/b>,<\/b> MD,<\/b> can be reached at Warrington.Kenneth@mayo.edu. <\/p>\n\n
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Published by:<\/span>\n
Sources\/Disclosures<\/h3>\n Source: <\/h2>\n Warrington K. Advances in the diagnosis and treatment of giant cell arteritis. Presented at The Congress of Clinical Rheumatology East; April 30-May 3, 2026; Destin, Florida (hybrid meeting).<\/p>\n
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