RT Journal Article
SR Electronic
T1 EULAR recommendations for the use of imaging in large vessel vasculitis in clinical practice
JF Annals of the Rheumatic Diseases
JO Ann Rheum Dis
FD BMJ Publishing Group Ltd and European League Against Rheumatism
SP annrheumdis-2017-212649
DO 10.1136/annrheumdis-2017-212649
A1 Christian Dejaco
A1 Sofia Ramiro
A1 Christina Duftner
A1 Florent L Besson
A1 Thorsten A Bley
A1 Daniel Blockmans
A1 Elisabeth Brouwer
A1 Marco A Cimmino
A1 Eric Clark
A1 Bhaskar Dasgupta
A1 Andreas P Diamantopoulos
A1 Haner Direskeneli
A1 Annamaria Iagnocco
A1 Thorsten Klink
A1 Lorna Neill
A1 Cristina Ponte
A1 Carlo Salvarani
A1 Riemer H J A Slart
A1 Madeline Whitlock
A1 Wolfgang A Schmidt
YR 2018
UL http://ard.bmj.com/content/early/2018/02/13/annrheumdis-2017-212649.abstract
AB To develop evidence-based recommendations for the use of imaging modalities in primary large vessel vasculitis (LVV) including giant cell arteritis (GCA) and Takayasu arteritis (TAK).European League Against Rheumatism (EULAR) standardised operating procedures were followed. A systematic literature review was conducted to retrieve data on the role of imaging modalities including ultrasound, MRI, CT and [18F]-fluorodeoxyglucose positron emission tomography (PET) in LVV. Based on evidence and expert opinion, the task force consisting of 20 physicians, healthcare professionals and patients from 10 EULAR countries developed recommendations, with consensus obtained through voting. The final level of agreement was voted anonymously. A total of 12 recommendations have been formulated. The task force recommends an early imaging test in patients with suspected LVV, with ultrasound and MRI being the first choices in GCA and TAK, respectively. CT or PET may be used alternatively. In case the diagnosis is still in question after clinical examination and imaging, additional investigations including temporal artery biopsy and/or additional imaging are required. In patients with a suspected flare, imaging might help to better assess disease activity. The frequency and choice of imaging modalities for long-term monitoring of structural damage remains an individual decision; close monitoring for aortic aneurysms should be conducted in patients at risk for this complication. All imaging should be performed by a trained specialist using appropriate operational procedures and settings. These are the first EULAR recommendations providing up-to-date guidance for the role of imaging in the diagnosis and monitoring of patients with (suspected) LVV.