Vessel wall MRI in giant cell arteritis: standardized protocol and scoring approach developed by an international working group

Rennie L Rhee; Girish Bathla; Ryan Rebello; Robert M Kurtz; Mats Junek; Kenneth J Warrington; Nader Khalidi; Peter A Merkel; Konstanze V Guggenberger; Madhura A Tamhankar; Thorsten A Bley; Vasculitis Clinical Research Consortium

doi:10.1093/rheumatology/keae498

Vessel wall MRI in giant cell arteritis: standardized protocol and scoring approach developed by an international working group

Rheumatology (Oxford). 2024 Sep 27:keae498. doi: 10.1093/rheumatology/keae498. Online ahead of print.

Affiliations

¹ Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
² Division of Neuroradiology, Mayo Clinic, Rochester, Minnesota, USA.
³ Department of Diagnostic Imaging, St Joseph's Hospital, McMaster University, Hamilton, Ontario, Canada.
⁴ Division of Neuroradiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
⁵ Division of Rheumatology, St Joseph's Healthcare, McMaster University, Hamilton, Ontario, Canada.
⁶ Division of Rheumatology, Mayo Clinic, Rochester, Minnesota, USA.
⁷ Department of Diagnostic and Interventional Radiology, University Hospital Wuerzburg, Wuerzburg, Germany.
⁸ Division of Neuro-ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

PMID: 39331619
DOI: 10.1093/rheumatology/keae498

Abstract

Objectives: There are an increasing number of centers performing research on high-resolution vessel wall magnetic resonance imaging (VW-MRI) in giant cell arteritis (GCA). However, harmonized approaches to VW-MRI in GCA are lacking and are essential to performing multicentre studies. Using a data-driven, consensus-based approach, an international expert group developed a standardized MRI protocol and scoring system to advance multi-centered research in cranial GCA.

Methods: A targeted literature review of VW-MRI in cranial GCA was conducted. A working group comprised of radiologists, rheumatologists, and ophthalmologists with expertise in VW-MRI and GCA reviewed the results of the literature search, presented relevant data and images from their respective centers, and then reached consensus on recommendations related to key MRI structures, MRI sequences, scoring system, and other important considerations.

Results: A total of 21 relevant articles were identified and reviewed. Based on published literature, structures to be evaluated on MRI were categorized based on anatomic location (extradural cranial, intradural cranial, and orbits) and prioritization (core vs elective). Essential and elective sequences to comprehensively image cranial and orbital structures while minimizing scan time were determined along with scoring systems to grade contrast enhancement.

Conclusion: This report describes a standardized approach to facilitate research of VW-MRI in cranial GCA that is the result of a multi-disciplinary, international collaboration of experts in VW-MRI and/or GCA.

Keywords: giant cell arteritis; magnetic resonance imaging; recommendation.