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Over a few decades, temporal artery biopsy (TAB) was regarded as the gold standard for diagnosis of giant-cell arteritis (GCA). However, is it really necessary to use this invasive test in all patients with GCA, particularly in those with typical clinical features of the disease? Can we replace TAB with imaging modalities, including ultrasound and [18F]-fluorodeoxyglucose positron emission tomography (PET), that are more sensitive and/or more readily available in many institutions? Dejaco et al said yes in the recently published European League Against Rheumatism recommendations for the use of imaging in large-vessel vasculitis in clinical practice.1 The authors suggested that in patients in whom there is a high clinical suspicion of GCA and a positive ultrasound, the diagnosis of GCA may be made without biopsy or further imaging. Other imaging modalities, that is, PET and/or MRI, are more valuable in patients with Takayasu-like GCA without cranial signs and symptoms. Noteworthy, the task force clearly emphasised that TAB should be performed in all cases, where GCA cannot be confirmed or excluded based on clinical, laboratory and imaging results. Moreover, TAB should still be a …
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