Abstract
Background: Giant cell arteritis (GCA) is an inflammatory disease of the larger vessels, typically affecting the temporal arteries,
but involvement of the carotid and thoracic arteries is not uncommon. Serious complications such as blindness can occur if the
disease is left untreated. Currently, the gold standard test for GCA is a temporal biopsy, but this invasive technique is not without
risks and frequently inaccurate. We investigate the use of 18-fluoro-desoxyglucose (18F-FDG) positron emission tomography
(PET) as a new diagnostic means in GCA.
Methods: We performed a literature search in the MEDLINE database for original research articles written in the English
language that discussed the use of PET in diagnosing GCA. After applying selection criteria, 9 articles were included for literature
review and 4 of these were incorporated in a meta-analysis.
Results: 18-FDG uptake in the extracranial arteries is correlated to the presence GCA within patients suspected for vasculitis. In
our meta-analysis we found the following results: sensitivity 85% (95% CI; 74-92%, I2=0.0%), specificity 91% (95% CI; 82-96%,
I2=31.2%), positive likelihood ratio 7.18 (95% CI; 3.43-15.06, I2 =10.1%) and negative likelihood ratio 0.19 (95% CI; 0.11-0.33,
I2= 0.0%).
Discussion: 18F-FDG-PET cannot replace temporal artery biopsy at the present time, because of its limited ability to visualise the
cranial arteries. However, PET may be provide valuable information when extracranial involvement is suspected, specifically in
biopsy-negative patients who are strongly suspected of having GCA