Definitions of elementary ultrasound lesions in Takayasu arteritis: a study from the OMERACT Ultrasound Working Group

Objective To systematically assess the evidence on the use of ultrasonography (US) for the detection of vascular inflammation in Takayasu arteritis (TAK), with a focus on evaluating existing scoring systems and identifying elementary sonographic lesions for diagnosis, disease monitoring and outcome...

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Main Authors: Louise Falzon, Christian Dejaco, Peter Mandl, Wolfgang A Schmidt, Christina Duftner, L Terslev, Carlos Pineda, Alessandro Tomelleri, Helen Keen, Gerhard Krönke, Maria Antonietta D’Agostino, Milena Bond, Vincent Casteleyn
Format: Article
Language:English
Published: BMJ Publishing Group 2025-05-01
Series:RMD Open
Online Access:https://rmdopen.bmj.com/content/11/2/e005738.full
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author Louise Falzon
Christian Dejaco
Peter Mandl
Wolfgang A Schmidt
Christina Duftner
L Terslev
Carlos Pineda
Alessandro Tomelleri
Helen Keen
Gerhard Krönke
Maria Antonietta D’Agostino
Milena Bond
Vincent Casteleyn
author_facet Louise Falzon
Christian Dejaco
Peter Mandl
Wolfgang A Schmidt
Christina Duftner
L Terslev
Carlos Pineda
Alessandro Tomelleri
Helen Keen
Gerhard Krönke
Maria Antonietta D’Agostino
Milena Bond
Vincent Casteleyn
author_sort Louise Falzon
collection DOAJ
description Objective To systematically assess the evidence on the use of ultrasonography (US) for the detection of vascular inflammation in Takayasu arteritis (TAK), with a focus on evaluating existing scoring systems and identifying elementary sonographic lesions for diagnosis, disease monitoring and outcome prediction.Methods A systematic literature review (SLR) was conducted using PubMed, EMBASE, the Cochrane Library and Epistemonikos from their inception until 15 March 2024. Only original research articles evaluating the diagnostic accuracy, outcome prediction or monitoring ability of US in TAK, with a minimum sample size of 15 patients, were included. Data extraction was performed independently by two reviewers. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool for diagnostic studies and the Quality In Prognosis Studies tool for prognostic studies.Results 21 studies met the inclusion criteria. Three of them proposed a US scoring system for TAK, while the remainder focused on reporting elementary lesions. The common findings included increased intima-media thickness (IMT), stenosis, occlusion, aneurysm and increased contrast enhancement. All studies evaluated the common carotid arteries, with less frequent assessment of other vascular territories such as the subclavian and common femoral arteries and the abdominal aorta. Although increased IMT and contrast enhancement of the arterial wall correlated with clinical measures of disease activity, heterogeneity of lesion definitions and measurement thresholds, along with small sample sizes and moderate-to-high risk of bias, limits the generalisability of the findings.Conclusions This SLR highlights the current lack of a fully validated US scoring system for TAK and underscores the need for standardised definitions of elementary sonographic lesions.
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spelling doaj-art-d52b39b1018341409dc3f5f4055cb92c2025-08-20T03:21:34ZengBMJ Publishing GroupRMD Open2056-59332025-05-0111210.1136/rmdopen-2025-005738Definitions of elementary ultrasound lesions in Takayasu arteritis: a study from the OMERACT Ultrasound Working GroupLouise Falzon0Christian Dejaco1Peter Mandl2Wolfgang A Schmidt3Christina Duftner4L Terslev5Carlos Pineda6Alessandro Tomelleri7Helen Keen8Gerhard Krönke9Maria Antonietta D’Agostino10Milena Bond11Vincent Casteleyn12Health Economics and Decision Science, The University of Sheffield, Sheffield, UKRheumatology, Medical University Graz, Graz, AustriaInternal Medicine 3; Division of Rheumatology, Medical University Vienna, Vienna, AustriaRheumatology, Hospital Waldfriede, Berlin, GermanyDepartment of Internal Medicine, Clinical Division of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Tyrol, AustriaCenter for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, Glostrup, DenmarkInstituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, MexicoUnit of Immunology, Rheumatology, Allergy and Rare diseases, San Raffaele Scientific Institute, Milan, ItalyThe University of Western Australia School of Medicine and Pharmacology, Perth, Western Australia, AustraliaRheumatology and Clinical Immunology, Friedrich-Alexander University Erlangen-Nuremberg, Berlin, GermanyFoundation Policlinico Universitario Agostino gemelli IRCSS, Rome, ItalyDepartment of Rheumatology, Hospital of Bruneck, Brunico, Bozen, ItalyRheumatology, Charité Universitätsmedizin Berlin, Berlin, GermanyObjective To systematically assess the evidence on the use of ultrasonography (US) for the detection of vascular inflammation in Takayasu arteritis (TAK), with a focus on evaluating existing scoring systems and identifying elementary sonographic lesions for diagnosis, disease monitoring and outcome prediction.Methods A systematic literature review (SLR) was conducted using PubMed, EMBASE, the Cochrane Library and Epistemonikos from their inception until 15 March 2024. Only original research articles evaluating the diagnostic accuracy, outcome prediction or monitoring ability of US in TAK, with a minimum sample size of 15 patients, were included. Data extraction was performed independently by two reviewers. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool for diagnostic studies and the Quality In Prognosis Studies tool for prognostic studies.Results 21 studies met the inclusion criteria. Three of them proposed a US scoring system for TAK, while the remainder focused on reporting elementary lesions. The common findings included increased intima-media thickness (IMT), stenosis, occlusion, aneurysm and increased contrast enhancement. All studies evaluated the common carotid arteries, with less frequent assessment of other vascular territories such as the subclavian and common femoral arteries and the abdominal aorta. Although increased IMT and contrast enhancement of the arterial wall correlated with clinical measures of disease activity, heterogeneity of lesion definitions and measurement thresholds, along with small sample sizes and moderate-to-high risk of bias, limits the generalisability of the findings.Conclusions This SLR highlights the current lack of a fully validated US scoring system for TAK and underscores the need for standardised definitions of elementary sonographic lesions.https://rmdopen.bmj.com/content/11/2/e005738.full
spellingShingle Louise Falzon
Christian Dejaco
Peter Mandl
Wolfgang A Schmidt
Christina Duftner
L Terslev
Carlos Pineda
Alessandro Tomelleri
Helen Keen
Gerhard Krönke
Maria Antonietta D’Agostino
Milena Bond
Vincent Casteleyn
Definitions of elementary ultrasound lesions in Takayasu arteritis: a study from the OMERACT Ultrasound Working Group
RMD Open
title Definitions of elementary ultrasound lesions in Takayasu arteritis: a study from the OMERACT Ultrasound Working Group
title_full Definitions of elementary ultrasound lesions in Takayasu arteritis: a study from the OMERACT Ultrasound Working Group
title_fullStr Definitions of elementary ultrasound lesions in Takayasu arteritis: a study from the OMERACT Ultrasound Working Group
title_full_unstemmed Definitions of elementary ultrasound lesions in Takayasu arteritis: a study from the OMERACT Ultrasound Working Group
title_short Definitions of elementary ultrasound lesions in Takayasu arteritis: a study from the OMERACT Ultrasound Working Group
title_sort definitions of elementary ultrasound lesions in takayasu arteritis a study from the omeract ultrasound working group
url https://rmdopen.bmj.com/content/11/2/e005738.full
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