Definitions and reliability assessment of elementary ultrasound lesions in giant cell arteritis: A study from the OMERACT large vessel vasculitis ultrasound working group

Stavros Chrysidis, Christina Duftner, Christian Dejaco, Valentin S. Schäfer, Sofia Ramiro, Greta Carrara, Carlo Alberto Scirè, Alojzija Hocevar, Andreas P. Diamantopoulos, Annamaria Iagnocco, Chetan Mukhtyar, Cristina Ponte, Esperanza Naredo, Eugenio De Miguel, George A. Bruyn, Kenneth J Warrington, Lene Terslev, Marcin Milchert, Maria Antonietta D'Agostino, Matthew KosterNaina Rastalsky, Petra Hanova, Pierluigi Macchioni, Tanaz A. Kermani, Tove Lorenzen, Uffe Møller Døhn, Ulrich Fredberg, Wolfgang Hartung, Bhaskar Dasgupta, Wolfgang A. Schmidt

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Objectives To define the elementary ultrasound (US) lesions in giant cell arteritis (GCA) and to evaluate the reliability of the assessment of US lesions according to these definitions in a web-based reliability exercise. Methods Potential definitions of normal and abnormal US findings of temporal and extracranial large arteries were retrieved by a systematic literature review. As a subsequent step, a structured Delphi exercise was conducted involving an expert panel of the Outcome Measures in Rheumatology (OMERACT) US Large Vessel Vasculitis Group to agree definitions of normal US appearance and key elementary US lesions of vasculitis of temporal and extracranial large arteries. The reliability of these definitions on normal and abnormal blood vessels was tested on 150 still images and videos in a web-based reliability exercise. Results Twenty-four experts participated in both Delphi rounds. From originally 25 statements, nine definitions were obtained for normal appearance, vasculitis and arteriosclerosis of cranial and extracranial vessels. The 'halo' and 'compression' signs were the key US lesions in GCA. The reliability of the definitions for normal temporal and axillary arteries, the 'halo' sign and the 'compression' sign was excellent with inter-rater agreements of 91-99% and mean kappa values of 0.83-0.98 for both inter-rater and intra-rater reliabilities of all 25 experts. Conclusions The 'halo' and the 'compression' signs are regarded as the most important US abnormalities for GCA. The inter-rater and intra-rater agreement of the new OMERACT definitions for US lesions in GCA was excellent.

Original languageEnglish (US)
Article numbere000598
JournalRMD Open
Volume4
Issue number1
DOIs
StatePublished - Jan 1 2018

Fingerprint

Giant Cell Arteritis
Vasculitis
Arteries
Axillary Artery
Temporal Arteries
Arteriosclerosis
Rheumatology
Blood Vessels
Outcome Assessment (Health Care)

Keywords

  • giant cell arteritis
  • systemic vasculitis
  • ultrasonography

ASJC Scopus subject areas

  • Rheumatology
  • Immunology and Allergy
  • Immunology

Cite this

Definitions and reliability assessment of elementary ultrasound lesions in giant cell arteritis : A study from the OMERACT large vessel vasculitis ultrasound working group. / Chrysidis, Stavros; Duftner, Christina; Dejaco, Christian; Schäfer, Valentin S.; Ramiro, Sofia; Carrara, Greta; Scirè, Carlo Alberto; Hocevar, Alojzija; Diamantopoulos, Andreas P.; Iagnocco, Annamaria; Mukhtyar, Chetan; Ponte, Cristina; Naredo, Esperanza; De Miguel, Eugenio; Bruyn, George A.; Warrington, Kenneth J; Terslev, Lene; Milchert, Marcin; D'Agostino, Maria Antonietta; Koster, Matthew; Rastalsky, Naina; Hanova, Petra; Macchioni, Pierluigi; Kermani, Tanaz A.; Lorenzen, Tove; Døhn, Uffe Møller; Fredberg, Ulrich; Hartung, Wolfgang; Dasgupta, Bhaskar; Schmidt, Wolfgang A.

In: RMD Open, Vol. 4, No. 1, e000598, 01.01.2018.

Research output: Contribution to journalArticle

Chrysidis, S, Duftner, C, Dejaco, C, Schäfer, VS, Ramiro, S, Carrara, G, Scirè, CA, Hocevar, A, Diamantopoulos, AP, Iagnocco, A, Mukhtyar, C, Ponte, C, Naredo, E, De Miguel, E, Bruyn, GA, Warrington, KJ, Terslev, L, Milchert, M, D'Agostino, MA, Koster, M, Rastalsky, N, Hanova, P, Macchioni, P, Kermani, TA, Lorenzen, T, Døhn, UM, Fredberg, U, Hartung, W, Dasgupta, B & Schmidt, WA 2018, 'Definitions and reliability assessment of elementary ultrasound lesions in giant cell arteritis: A study from the OMERACT large vessel vasculitis ultrasound working group', RMD Open, vol. 4, no. 1, e000598. https://doi.org/10.1136/rmdopen-2017-000598
Chrysidis, Stavros ; Duftner, Christina ; Dejaco, Christian ; Schäfer, Valentin S. ; Ramiro, Sofia ; Carrara, Greta ; Scirè, Carlo Alberto ; Hocevar, Alojzija ; Diamantopoulos, Andreas P. ; Iagnocco, Annamaria ; Mukhtyar, Chetan ; Ponte, Cristina ; Naredo, Esperanza ; De Miguel, Eugenio ; Bruyn, George A. ; Warrington, Kenneth J ; Terslev, Lene ; Milchert, Marcin ; D'Agostino, Maria Antonietta ; Koster, Matthew ; Rastalsky, Naina ; Hanova, Petra ; Macchioni, Pierluigi ; Kermani, Tanaz A. ; Lorenzen, Tove ; Døhn, Uffe Møller ; Fredberg, Ulrich ; Hartung, Wolfgang ; Dasgupta, Bhaskar ; Schmidt, Wolfgang A. / Definitions and reliability assessment of elementary ultrasound lesions in giant cell arteritis : A study from the OMERACT large vessel vasculitis ultrasound working group. In: RMD Open. 2018 ; Vol. 4, No. 1.
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abstract = "Objectives To define the elementary ultrasound (US) lesions in giant cell arteritis (GCA) and to evaluate the reliability of the assessment of US lesions according to these definitions in a web-based reliability exercise. Methods Potential definitions of normal and abnormal US findings of temporal and extracranial large arteries were retrieved by a systematic literature review. As a subsequent step, a structured Delphi exercise was conducted involving an expert panel of the Outcome Measures in Rheumatology (OMERACT) US Large Vessel Vasculitis Group to agree definitions of normal US appearance and key elementary US lesions of vasculitis of temporal and extracranial large arteries. The reliability of these definitions on normal and abnormal blood vessels was tested on 150 still images and videos in a web-based reliability exercise. Results Twenty-four experts participated in both Delphi rounds. From originally 25 statements, nine definitions were obtained for normal appearance, vasculitis and arteriosclerosis of cranial and extracranial vessels. The 'halo' and 'compression' signs were the key US lesions in GCA. The reliability of the definitions for normal temporal and axillary arteries, the 'halo' sign and the 'compression' sign was excellent with inter-rater agreements of 91-99{\%} and mean kappa values of 0.83-0.98 for both inter-rater and intra-rater reliabilities of all 25 experts. Conclusions The 'halo' and the 'compression' signs are regarded as the most important US abnormalities for GCA. The inter-rater and intra-rater agreement of the new OMERACT definitions for US lesions in GCA was excellent.",
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T1 - Definitions and reliability assessment of elementary ultrasound lesions in giant cell arteritis

T2 - A study from the OMERACT large vessel vasculitis ultrasound working group

AU - Chrysidis, Stavros

AU - Duftner, Christina

AU - Dejaco, Christian

AU - Schäfer, Valentin S.

AU - Ramiro, Sofia

AU - Carrara, Greta

AU - Scirè, Carlo Alberto

AU - Hocevar, Alojzija

AU - Diamantopoulos, Andreas P.

AU - Iagnocco, Annamaria

AU - Mukhtyar, Chetan

AU - Ponte, Cristina

AU - Naredo, Esperanza

AU - De Miguel, Eugenio

AU - Bruyn, George A.

AU - Warrington, Kenneth J

AU - Terslev, Lene

AU - Milchert, Marcin

AU - D'Agostino, Maria Antonietta

AU - Koster, Matthew

AU - Rastalsky, Naina

AU - Hanova, Petra

AU - Macchioni, Pierluigi

AU - Kermani, Tanaz A.

AU - Lorenzen, Tove

AU - Døhn, Uffe Møller

AU - Fredberg, Ulrich

AU - Hartung, Wolfgang

AU - Dasgupta, Bhaskar

AU - Schmidt, Wolfgang A.

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N2 - Objectives To define the elementary ultrasound (US) lesions in giant cell arteritis (GCA) and to evaluate the reliability of the assessment of US lesions according to these definitions in a web-based reliability exercise. Methods Potential definitions of normal and abnormal US findings of temporal and extracranial large arteries were retrieved by a systematic literature review. As a subsequent step, a structured Delphi exercise was conducted involving an expert panel of the Outcome Measures in Rheumatology (OMERACT) US Large Vessel Vasculitis Group to agree definitions of normal US appearance and key elementary US lesions of vasculitis of temporal and extracranial large arteries. The reliability of these definitions on normal and abnormal blood vessels was tested on 150 still images and videos in a web-based reliability exercise. Results Twenty-four experts participated in both Delphi rounds. From originally 25 statements, nine definitions were obtained for normal appearance, vasculitis and arteriosclerosis of cranial and extracranial vessels. The 'halo' and 'compression' signs were the key US lesions in GCA. The reliability of the definitions for normal temporal and axillary arteries, the 'halo' sign and the 'compression' sign was excellent with inter-rater agreements of 91-99% and mean kappa values of 0.83-0.98 for both inter-rater and intra-rater reliabilities of all 25 experts. Conclusions The 'halo' and the 'compression' signs are regarded as the most important US abnormalities for GCA. The inter-rater and intra-rater agreement of the new OMERACT definitions for US lesions in GCA was excellent.

AB - Objectives To define the elementary ultrasound (US) lesions in giant cell arteritis (GCA) and to evaluate the reliability of the assessment of US lesions according to these definitions in a web-based reliability exercise. Methods Potential definitions of normal and abnormal US findings of temporal and extracranial large arteries were retrieved by a systematic literature review. As a subsequent step, a structured Delphi exercise was conducted involving an expert panel of the Outcome Measures in Rheumatology (OMERACT) US Large Vessel Vasculitis Group to agree definitions of normal US appearance and key elementary US lesions of vasculitis of temporal and extracranial large arteries. The reliability of these definitions on normal and abnormal blood vessels was tested on 150 still images and videos in a web-based reliability exercise. Results Twenty-four experts participated in both Delphi rounds. From originally 25 statements, nine definitions were obtained for normal appearance, vasculitis and arteriosclerosis of cranial and extracranial vessels. The 'halo' and 'compression' signs were the key US lesions in GCA. The reliability of the definitions for normal temporal and axillary arteries, the 'halo' sign and the 'compression' sign was excellent with inter-rater agreements of 91-99% and mean kappa values of 0.83-0.98 for both inter-rater and intra-rater reliabilities of all 25 experts. Conclusions The 'halo' and the 'compression' signs are regarded as the most important US abnormalities for GCA. The inter-rater and intra-rater agreement of the new OMERACT definitions for US lesions in GCA was excellent.

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