French recommendations for the use of imaging in giant cell arteritis.

In 30 seconds

This French practice guideline, informed by a systematic literature review, addresses imaging for diagnosis, monitoring and prognosis in giant cell arteritis (GCA). A task force of 23 physicians developed recommendations using evidence and expert opinion, with anonymous voting to establish consensus. It recommends early imaging when GCA is suspected, with Doppler ultrasound as the first-line test. FDG-PET, cranial or aortic MRI, and CT angiography are alternatives for assessing cranial or extracranial arteries. Imaging of large vessels may also inform prognosis and follow-up.

Key findings

• The task force recommends early imaging for suspected GCA and Doppler ultrasound as the first-line imaging test.
• FDG-PET, cranial MRI, aortic MRI and CT can provide alternative assessment of cranial and/or extracranial arteries.
• For suspected visual GCA, fundus examination, optical coherence tomography and retinal angiography are recommended as emergency assessments.
• Imaging is not routinely recommended for follow-up, but may help assess suspected relapse or long-term structural damage.

Why it matters

The recommendations provide a structured approach to selecting imaging across diagnosis, prognosis and follow-up in GCA. They distinguish first-line ultrasound from alternative modalities and identify circumstances in which imaging may be useful despite not being routine, including suspected relapse when inflammatory biomarkers are unreliable. This may support more consistent evaluation while recognising the role of clinical context.

What to keep in mind

Recommendations were developed from a systematic review combined with expert opinion and consensus; the abstract does not report comparative diagnostic performance or patient outcomes.