{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T06:52:54Z","timestamp":1791269574421,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ACR Open Rheumatology"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the diagnostic accuracy, reproducibility, and acquisition time of focused bilateral frontal\u2010branch ultrasonography based on intima\u2010media thickness (IMT) in suspected giant cell arteritis (GCA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective single\u2010center study, 171 patients underwent color Doppler ultrasonography of the temporal and large arteries and ultrasonography\u2010guided temporal artery biopsy. Bilateral mean frontal\u2010branch IMT was evaluated against the expert diagnosis established at six months. Diagnostic performance was assessed using ROC analysis and multivariable logistic regression. Reproducibility was assessed in 100 randomly selected images.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>GCA was diagnosed in 107 patients, including 96 biopsy\u2010positive cases. Mean frontal\u2010branch IMT had the highest observed area under the curve among the temporal artery segments (0.87). At the 0.28\u2010mm cutoff, sensitivity was 71%, specificity 94%, LR+ 11.4, and LR\u2212 0.31. Frontal IMT \u2265 0.28 mm was the strongest independent predictor of GCA (odds ratio 43.0). At a cutoff of \u22653, the exploratory PAMELA (Performance Analysis of a Monosegmental Ultrasonographic Evaluation of the Frontal\u2010Branch of the Superficial Temporal Artery in Giant Cell Arteritis) score had a sensitivity of 74.8% and specificity of 93.7%. Focused bilateral frontal\u2010branch assessment required 1.07\u2009\u00b1\u20090.24 minutes versus 7.62\u2009\u00b1\u20091.11 minutes for the complete temporal artery protocol. Intraobserver and interobserver intraclass correlation coefficients were 0.96 and 0.93.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Focused bilateral frontal\u2010branch ultrasonography provides a highly specific, reproducible, and time\u2010efficient initial cranial assessment in suspected GCA. However, the 0.28\u2010mm cutoff and PAMELA score require external validation, and the remaining temporal and large\u2010vessel territories should be examined when frontal findings are negative or equivocal.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr2.90144","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T06:30:11Z","timestamp":1791268211000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prospective Diagnostic Accuracy of Focused Frontal\u2010Branch Ultrasonography in Giant Cell Arteritis"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8739-058X","authenticated-orcid":false,"given":"Giuseppe","family":"German\u00f2","sequence":"first","affiliation":[{"name":"Rheumatology Unit, Department of Internal Medicine Azienda Unit\u00e0 Sanitaria Locale Istituto di Ricovero e Cura a Carattere Scientifico, Arcispedale Santa Maria Nuova  Reggio Emilia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3708-3148","authenticated-orcid":false,"given":"Carlo","family":"Salvarani","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Internal Medicine Azienda Unit\u00e0 Sanitaria Locale Istituto di Ricovero e Cura a Carattere Scientifico, Arcispedale Santa Maria Nuova  Reggio Emilia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluigi","family":"Bajocchi","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Internal Medicine Azienda Unit\u00e0 Sanitaria Locale Istituto di Ricovero e Cura a Carattere Scientifico, Arcispedale Santa Maria Nuova  Reggio Emilia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Boiardi","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Internal Medicine Azienda Unit\u00e0 Sanitaria Locale Istituto di Ricovero e Cura a Carattere Scientifico, Arcispedale Santa Maria Nuova  Reggio Emilia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Grazia","family":"Orlando","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Internal Medicine Azienda Unit\u00e0 Sanitaria Locale Istituto di Ricovero e Cura a Carattere Scientifico, Arcispedale Santa Maria Nuova  Reggio Emilia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Cavazza","sequence":"additional","affiliation":[{"name":"Pathology Unit, Azienda Unit\u00e0 Sanitaria Locale Istituto di Ricovero e Cura a Carattere Scientifico Arcispedale Santa Maria Nuova  Reggio Emilia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierluigi","family":"Macchioni","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Internal Medicine Azienda Unit\u00e0 Sanitaria Locale Istituto di Ricovero e Cura a Carattere Scientifico, Arcispedale Santa Maria Nuova  Reggio Emilia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra011913"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2665-9913(24)00024-9"},{"key":"e_1_2_6_4_1","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.1001\/jamainternmed.2020.3050","article-title":"Diagnostic accuracy of symptoms, physical signs, and laboratory tests for giant cell arteritis: a systematic review and meta\u2010analysis","volume":"180","author":"Geest KSM","year":"2020","journal-title":"JAMA Intern 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disease risk: a consensus statement from the American Society of Echocardiography Carotid Intima\u2010Media Thickness Task Force","volume":"21","author":"Stein JH","year":"2008","journal-title":"J Am Soc Echocardiogr"},{"key":"e_1_2_6_23_1","doi-asserted-by":"crossref","DOI":"10.3389\/fmed.2024.1389655","article-title":"Ultrasound intima\u2010media thickness cut\u2010off values for the diagnosis of giant cell arteritis using a dual clinical and MRI reference standard and cardiovascular risk stratification","volume":"11","author":"Seitz P","year":"2024","journal-title":"Front Med 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