Performance of Deauville Criteria in <sup>[18F]</sup>FDG-PET/CT Diagnostics of Giant Cell Arteritis
Jeffrey Siefert,
Jonas Kaufmann,
Felix Thiele,
Thula Walter-Rittel,
Julian Rogasch,
Robert Biesen,
Gerd R. Burmester,
Holger Amthauer,
Udo Schneider,
Christian Furth
Affiliations
Jeffrey Siefert
Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Nucelar Medicine, Augustenburger Platz 1, 13353 Berlin, Germany
Jonas Kaufmann
Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Nucelar Medicine, Augustenburger Platz 1, 13353 Berlin, Germany
Felix Thiele
Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Nucelar Medicine, Augustenburger Platz 1, 13353 Berlin, Germany
Thula Walter-Rittel
Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Radiology, Augustenburger Platz 1, 13353 Berlin, Germany
Julian Rogasch
Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Nucelar Medicine, Augustenburger Platz 1, 13353 Berlin, Germany
Robert Biesen
Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Rheumatology and Clinical Immunology, Charitéplatz 1, 10117 Berlin, Germany
Gerd R. Burmester
Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Rheumatology and Clinical Immunology, Charitéplatz 1, 10117 Berlin, Germany
Holger Amthauer
Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Nucelar Medicine, Augustenburger Platz 1, 13353 Berlin, Germany
Udo Schneider
Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Rheumatology and Clinical Immunology, Charitéplatz 1, 10117 Berlin, Germany
Christian Furth
Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Nucelar Medicine, Augustenburger Platz 1, 13353 Berlin, Germany
In this retrospective study, PET/CT data from 59 patients with suspected giant cell arteritis (GCA) were reviewed using the Deauville criteria to determine an optimal cut-off between PET positivity and negativity. Seventeen standardised vascular regions were analysed per patient by three investigators blinded to clinical information. Statistical analysis included ROC curves with areas under the curve (AUC), Cohen’s and Fleiss’ kappa (κ) to calculate sensitivity, specificity, accuracy, and agreement. According to final clinician’s diagnosis and the revised 2017 ACR criteria GCA was confirmed in 29 of 59 (49.2 %) patients. With a diagnostic cut-off ≥ 4 (highest tracer uptake of a vessel wall exceeds liver uptake) for PET positivity, all investigators achieved high accuracy (range, 89.8–93.2%) and AUC (range, 0.94–0.97). Sensitivity and specificity ranged from 89.7–96.6% and 83.3–96.7%, respectively. Agreement between the three investigators suggested ‘almost perfect agreement’ (Fleiss’ κ = 0.84) A Deauville score of ≥4 as threshold for PET positivity yielded excellent results with high accuracy and almost perfect inter-rater agreement, suggesting a standardized, reproducible, and reliable score in diagnosing GCA. However, the small sample size and reference standard could lead to biases. Therefore, verification in a multicentre study with a larger patient cohort and prospective setting is needed.
