A new Canadian study has revealed that chest radiographs (CXR), a common and affordable imaging tool, could play a vital role in detecting aortic structural damage in patients suffering from Giant Cell Arteritis (GCA).
The research was conducted at the University of Alberta by student researcher, Uday Chauhan, under the supervision of Dr. Alison Clifford, with contributions from Dr. Martha Decker.
The retrospective study analysed electronic medical records of 81 patients who met the 1990 American College of Rheumatology criteria for GCA.
These patients, seen between April 2012 and December 2017, had an average age of 71 and were primarily female.
The team reviewed their imaging records to determine how often chest X-rays and advanced imaging such as CT angiography, MR angiography, and PET/CT were used and how effective they were in identifying aortic issues.
Findings showed that 70 patients underwent imaging, 43 received only a chest X-ray (CXR), 20 received only a CXR and advanced imaging, and 7 received only advanced imaging. Notably, the baseline CXR revealed potential aortic issues in 22% of patients, including aortic tortuosity and a widened mediastinum.
Over an average follow-up period of 27 months, further abnormalities were identified in five additional patients, thereby increasing the detection rate to 30%.
Interestingly, of the 20 patients with both CXR and advanced imaging, CXR showed a 100% sensitivity and 83% specificity compared to advanced imaging, the gold standard.
This suggests that CXR may be a reliable initial screening method for detecting aortic damage in GCA patients.
The study concluded that while screening methods vary, chest X-rays-despite their simplicity-could be a helpful first step in detecting severe aortic conditions in GCA patients. The researchers recommend further prospective studies to directly compare chest X-rays and advanced imaging on a larger scale.
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