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Abstract Details

Comparison of Temporal Artery Ultrasound and Temporal Artery Biopsy in Diagnosing Giant Cell Arteritis in a Single Institution
Neuro-ophthalmology/Neuro-otology
P4 - Poster Session 4 (8:00 AM-9:00 AM)
17-007
To compare the diagnostic yield of temporal artery ultrasound (TAUS) and temporal artery biopsy (TAB) in confirming giant cell arteritis in a single institution.
Giant cell arteritis (GCA) affects approximately 1 in 5000 U.S. adults. Diagnosis is typically based on clinical symptoms and elevation of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Definitive diagnosis relies on TAB showing granulomatous inflammation and internal elastic lamina fragmentation. Recent studies suggest TAUS as a viable alternative to TAB.
This quality improvement initiative reviewed patients who underwent both TAB and TAUS between January 2019 and September 2025 at Trinity Health Grand Rapids, MI. Included were patients presenting with clinical features suggestive of GCA, elevated ESR and/or CRP. Diagnostic criteria were calculated for both TAB and TAUS. The area under the curve (AUC) was statistically compared between the procedures.
A total of 25 patients underwent both TAB and TAUS. Of those, 14 (56%) were diagnosed with GCA. TAB had a sensitivity of 85.7% (95% CI: 57.2%, 98.2%) and specificity of 100% (95% CI: 71.5%, 100%); while TAUS had a sensitivity of 21.4% (95% CI: 4.7%, 50.8%) and specificity of 72.7% (95% CI: 39.0%, 94%). The diagnostic accuracy of TAB was 92% vs 44% for TAUS. The AUC was significantly different (p<0.001) between TAB (AUC: 0.471; 95% CI: 0.293, 0.648) and TAUS (AUC: 0.929; 95% CI: 0.833, 1.000)
The diagnostic utility of TAUS for GCA was poor compared to TAB in this single institution. While TAUS is a fast and non-invasive test to assist in the diagnosis of GCA, it is highly operator-dependent, and the sensitivity can be decreased by corticosteroid use. TAB remains the gold standard for diagnosis of GCA at our institution
Authors/Disclosures
Jason T. Schick, DO (Trinity Health Grand Rapids)
PRESENTER 		Dr. Schick has nothing to disclose.
Carlos R. Santos An immediate family member of Mr. Santos has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Cochrane. An immediate family member of Mr. Santos has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Giarmarco, Mullins & Horton PC. The institution of an immediate family member of Mr. Santos has received research support from Saint Mary's Foundation. An immediate family member of Mr. Santos has received research support from 好色先生.
Saad Umar Mr. Umar has nothing to disclose.
Tracy J. Koehler Tracy J. Koehler has nothing to disclose.
Muhammad Farooq, MD (Neuroscience Program,Saint Mary'S Health) Dr. Farooq has nothing to disclose.
Jose R. Santos, MD (Trinity Health Saint Mary's) An immediate family member of Dr. Santos has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Cochrane. Dr. Santos has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Giarmarco, Mullins & Horton PC. Dr. Santos has or had stock in Gilead Sciences.Dr. Santos has or had stock in Novocure.Dr. Santos has or had stock in Shockwave Medical.Dr. Santos has or had stock in Teva. An immediate family member of Dr. Santos has received research support from 好色先生. The institution of an immediate family member of Dr. Santos has received research support from Trinity Health Saint Mary's Foundation. An immediate family member of Dr. Santos has a non-compensated relationship as a Delegate with AAN Neurology on the Hill that is relevant to AAN interests or activities. An immediate family member of Dr. Santos has a non-compensated relationship as a Participant with AAN Palatucci Advocacy Leadership Forum that is relevant to AAN interests or activities. An immediate family member of Dr. Santos has a non-compensated relationship as a Scholar with AAN Health Equity Symposium Scholarship that is relevant to AAN interests or activities. An immediate family member of Dr. Santos has a non-compensated relationship as a Participant with AAN Emerging Leaders Program that is relevant to AAN interests or activities.
Alex Dombrowski, MD Dr. Dombrowski has nothing to disclose.
Aileen Antonio, MD, FAAN (Trinity Health Saint Mary's Hauenstein Neurosciences) Dr. Antonio has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Cochrane. An immediate family member of Dr. Antonio has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Giamarco, Mullins & Horton PC. The institution of Dr. Antonio has received research support from Saint Mary's Foundation. Dr. Antonio has received research support from 好色先生.