Optimal Length of Temporal Artery Biopsy for Giant Cell Arteritis Diagnosis Is Determined

The optimal length of temporal artery biopsy for the diagnosis of giant cell arteritis is between 1.5 cm and 2 cm, new study findings suggest.

“In giant cell arteritis, temporal artery biopsies often show vasculitis with giant cell formation, but optimal biopsy length for diagnosis is debated,” the researchers wrote. “We reviewed temporal artery biopsies from a 10-year period in the province of Alberta, Canada, to identify an ideal biopsy length in the diagnostic process for giant cell arteritis.”

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The researchers evaluated electronic medical record data for 1190 temporal artery biopsies that took place in Alberta between January 1, 2008, and January 1, 2018. The data spanned 1163 patients with a mean age of 72 years.

Analysis revealed several predictors of positive giant cell arteritis diagnosis. Increases in age, erythrocyte sedimentation rate, C-reactive protein, and biopsy length were significantly associated with positive diagnosis, the study found.  

The change point for diagnostic sensitivity using the Akaike information criterion was 1.5 cm, the researchers reported.

“Accounting for postfixation shrinkage, our findings suggest a 1.5-2.0 cm prefixation length as the optimal biopsy length to diagnose patients with giant cell arteritis, with greater lengths unlikely to provide significant additional diagnostic yield to justify risks associated with surgery,” the authors concluded.

—Jolynn Tumolo

Reference:

Chu R, Foster C, Ali M, et al. Optimal length and usefulness of temporal artery biopsies in the diagnosis of giant cell arteritis: a 10-year retrospective review of medical records. Lancet Rheumatol. 2020;2(12):e774-e778. doi:10.1016/S2665-9913(20)30222-8