Non-surgical diagnostic tools for giant cell arteritis

Giant cell arteritis (GCA) is a form of sight-threatening, granulomatous large-vessel vasculitis. Typical symptoms are headache, fever, and weight loss, and the condition may cause retinal ischemia and loss of vision. GCA is usually treated with high dosage, long-term oral glucocorticoids. Temporal artery biopsy is considered the golden standard in the diagnosis of GCA, in which a 2 cm long piece of the temporal artery is surgically excised (biopsy) and analyzed histologically to identify inflammatory lesions in the vessel wall. This technique has high specificity but low sensitivity. 30-70% of the biopsies are negative due to discontinuous inflammation (also known as skipped lesions), too short a part of the artery being excised, and/or pre-operative steroid treatment. Furthermore, risks are associated with surgical biopsy, including facial nerve palsy. Attempts have been made to develop non-invasive imaging techniques for the diagnosis of GCA, in particular, ultrasonography, but the sensitivity has been disappointing.

The aim of this project is to develop and implement non-invasive imaging techniques for the diagnosis of GCA with high sensitivity and specificity, in order to avoid surgical excision and, at the same time, enable multiple examinations and treatment follow-up.

The project is both experimental and clinical and will be performed in collaboration with researchers from the Faculty of Engineering, Lund University.

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