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Metanalysis shows that temporal artery biopsy (TAB) for the diagnosis of giant cell arteritis (GCA) has a sensitivity of 77%, similar to results seen with temporal artery imaging. These data suggest clinicians may be willing to accept a GCA diagnosis without proof by TAB.
A systematic literature review of GCA and TAB results identified 32 studies (3092 patients) published during 1993–2017 were analysed. The pooled proportion of TAB-positive GCA cases was 77.3% (95% CI: 71.8, 81.9%), with high between-study heterogeneity (I2 = 90%), possibly from differences in TAB sampling, processing or interpretation.
The proportion of positive temporal artery biopsy giant cell arteritis patients has slightly decreased over time, with more TAB-positive GCA cases before 2012 (P = 0.001).
Review of Temporal artery ultrasound studies (TA-US) finds that in 20 individual studies, the estimated the sensitivity of the "halo sign" for clinically diagnosed GCA was 55–77%.