DWI scrolling artery sign for the diagnosis of giant cell arteritis: a pattern recognition approach
Objectives To investigate the diagnostic accuracy of a pattern recognition approach for the evaluation of MRI scans of the head with diffusion-weighted imaging (DWI) in suspected giant cell arteritis (GCA).Methods Retrospectively, 156 patients with suspected GCA were included. The ‘DWI-Scrolling-Art...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2024-03-01
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| Series: | RMD Open |
| Online Access: | https://rmdopen.bmj.com/content/10/1/e003652.full |
| _version_ | 1797230216842575872 |
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| author | Britta Maurer Lukas Bütikofer Luca Seitz Fabian Lötscher Susana Bucher Harald M Bonel Pascal Seitz |
| author_facet | Britta Maurer Lukas Bütikofer Luca Seitz Fabian Lötscher Susana Bucher Harald M Bonel Pascal Seitz |
| author_sort | Britta Maurer |
| collection | DOAJ |
| description | Objectives To investigate the diagnostic accuracy of a pattern recognition approach for the evaluation of MRI scans of the head with diffusion-weighted imaging (DWI) in suspected giant cell arteritis (GCA).Methods Retrospectively, 156 patients with suspected GCA were included. The ‘DWI-Scrolling-Artery-Sign’ (DSAS) was defined as hyperintense DWI signals in the cranial subcutaneous tissue that gives the impression of a blood vessel when scrolling through a stack of images. The DSAS was rated by experts and a novice in four regions (frontotemporal and occipital, bilaterally). The temporal, occipital and posterior auricular arteries were assessed in the T1-weighted black-blood sequence (T1-BB). The diagnostic reference was the clinical diagnosis after ≥6 months of follow-up.Results The population consisted of 87 patients with and 69 without GCA; median age was 71 years and 59% were women. The DSAS showed a sensitivity of 73.6% and specificity of 94.2% (experts) and 59.8% and 95.7% (novice), respectively. Agreement between DSAS and T1-BB was 80% for the region level (499/624; kappa(κ)=0.59) and 86.5% for the patient level (135/156; κ=0.73). Inter-reader agreement was 95% (19/20; κ=0.90) for DSAS on the patient level and 91.3% (73/80; κ=0.81) on the region level for experts. For expert versus novice, inter-reader agreement for DSAS was 87.8% on the patient level (137/156; κ=0.75) and 91.2% on the region level (569/624; κ=0.77).Conclusions The DSAS can be assessed in less than 1 min and has a good diagnostic accuracy and reliability for the diagnosis of GCA. The DSAS can be used immediately in clinical practice. |
| first_indexed | 2024-04-24T15:24:58Z |
| format | Article |
| id | doaj.art-d5cbcc60bef947ca8576317e0bfc9d55 |
| institution | Directory Open Access Journal |
| issn | 2056-5933 |
| language | English |
| last_indexed | 2024-04-24T15:24:58Z |
| publishDate | 2024-03-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | RMD Open |
| spelling | doaj.art-d5cbcc60bef947ca8576317e0bfc9d552024-04-02T06:50:09ZengBMJ Publishing GroupRMD Open2056-59332024-03-0110110.1136/rmdopen-2023-003652DWI scrolling artery sign for the diagnosis of giant cell arteritis: a pattern recognition approachBritta Maurer0Lukas Bütikofer1Luca Seitz2Fabian Lötscher3Susana Bucher4Harald M Bonel5Pascal Seitz6Department of Rheumatology and Immunology, Inselspital University Hospital Bern, Bern, Switzerland7 CTU, Universität Bern, Bern, Switzerland55 Rheumatology and Immunology, Inselspital University Hospital Bern, Bern, SwitzerlandDepartment of Rheumatology and Immunology, Inselspital University Hospital Bern, University of Bern, Bern, SwitzerlandDepartment of Rheumatology and Immunology, Inselspital, University Hospital Bern, University of Bern, Bern, SwitzerlandDepartment of Diagnostic, Interventional and Pediatric Radiology, Inselspital, University Hospital Bern, University of Bern, Bern, SwitzerlandDepartment of Rheumatology and Immunology, Inselspital, University Hospital Bern, University of Bern, Bern, SwitzerlandObjectives To investigate the diagnostic accuracy of a pattern recognition approach for the evaluation of MRI scans of the head with diffusion-weighted imaging (DWI) in suspected giant cell arteritis (GCA).Methods Retrospectively, 156 patients with suspected GCA were included. The ‘DWI-Scrolling-Artery-Sign’ (DSAS) was defined as hyperintense DWI signals in the cranial subcutaneous tissue that gives the impression of a blood vessel when scrolling through a stack of images. The DSAS was rated by experts and a novice in four regions (frontotemporal and occipital, bilaterally). The temporal, occipital and posterior auricular arteries were assessed in the T1-weighted black-blood sequence (T1-BB). The diagnostic reference was the clinical diagnosis after ≥6 months of follow-up.Results The population consisted of 87 patients with and 69 without GCA; median age was 71 years and 59% were women. The DSAS showed a sensitivity of 73.6% and specificity of 94.2% (experts) and 59.8% and 95.7% (novice), respectively. Agreement between DSAS and T1-BB was 80% for the region level (499/624; kappa(κ)=0.59) and 86.5% for the patient level (135/156; κ=0.73). Inter-reader agreement was 95% (19/20; κ=0.90) for DSAS on the patient level and 91.3% (73/80; κ=0.81) on the region level for experts. For expert versus novice, inter-reader agreement for DSAS was 87.8% on the patient level (137/156; κ=0.75) and 91.2% on the region level (569/624; κ=0.77).Conclusions The DSAS can be assessed in less than 1 min and has a good diagnostic accuracy and reliability for the diagnosis of GCA. The DSAS can be used immediately in clinical practice.https://rmdopen.bmj.com/content/10/1/e003652.full |
| spellingShingle | Britta Maurer Lukas Bütikofer Luca Seitz Fabian Lötscher Susana Bucher Harald M Bonel Pascal Seitz DWI scrolling artery sign for the diagnosis of giant cell arteritis: a pattern recognition approach RMD Open |
| title | DWI scrolling artery sign for the diagnosis of giant cell arteritis: a pattern recognition approach |
| title_full | DWI scrolling artery sign for the diagnosis of giant cell arteritis: a pattern recognition approach |
| title_fullStr | DWI scrolling artery sign for the diagnosis of giant cell arteritis: a pattern recognition approach |
| title_full_unstemmed | DWI scrolling artery sign for the diagnosis of giant cell arteritis: a pattern recognition approach |
| title_short | DWI scrolling artery sign for the diagnosis of giant cell arteritis: a pattern recognition approach |
| title_sort | dwi scrolling artery sign for the diagnosis of giant cell arteritis a pattern recognition approach |
| url | https://rmdopen.bmj.com/content/10/1/e003652.full |
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