Five-Year Data from the Interdisciplinary Giant-Cell Arteritis Registry at the University Hospital of Würzburg: Value of Temporal Artery Biopsy.

Abstract

Background: Giant-cell arteritis (GCA) requires immediate diagnosis and therapy. The University Hospital of Würzburg established the Centre for Giant-cell Arteritis (ZeRi) to improve interdisciplinary collaboration.

Aim of the study: Retrospective evaluation of five-year data to assess the clinical relevance of several diagnostic methods, including temporal artery biopsy.

Patients and methods: Retrospective evaluation of 101 patients with suspected GCA who had undergone interdisciplinary examination and biopsy between 2017 and 2022. We analysed specificity and sensitivity in clinical symptoms, ESR, CRP, scalp MRI, temporal artery sonography, and temporal artery biopsy.

Results: GCA was diagnosed after completing diagnostic testing in 75 of 101 patients with suspected GCA. By definition, biopsy showed a positive predictive value of 100% and a specificity of 84.6%; however, negative predictive value was 51.2%. Sonography of the temporal artery and MRI showed a positive predictive value of more than 93% and sensitivity of 62.5% and 76.1%, respectively. Clinical symptoms showed the highest sensitivity at 92% with a specificity of 57.7%. ESR and CRP were significantly higher in patients with GCA than in patients without GCA, whereby CRP values showed higher predictive power than did ESR.

Conclusions: Most GCA cases can be detected with a precise medical history as well as ESR and CRP assessment. Sonography and MRI on the scalp can usually confirm suspected GCA, only requiring temporal artery biopsy in exceptional cases.