Update in imaging for large vessel vasculitis

ElsevierVolume 39, Issue 3, September 2025, 102060Best Practice & Research Clinical RheumatologyAuthor links open overlay panel, , Abstract

Diagnostic imaging is recommended to confirm suspected giant cell arteritis (GCA) or Takayasu arteritis (TAK), and may, in the follow-up of these patients, be used to assess vascular damage. Ultrasound, magnetic resonance imaging (MRI) and 18F-Fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) can all visualise inflammation in vascular regions affected. Ultrasound and MRI are recommended first line diagnostic test in GCA and TAK, respectively, but local expertise, availability and potential differential diagnoses are important prerequisites for the choice of imaging modality. Ultrasound, MR- and CT-angiography may also be used to assess morphologic changes. Further research is necessary on the role of imaging for monitoring disease activity and guide treatment decisions. Advantages and limitations apply to all modalities separately. This review will discuss the pros and cons, the application and pitfalls of each of these imaging modalities in the diagnosis and management of GCA and TAK.

Keywords

Large vessel vasculitis

Giant cell arteritis

Takayasu arteritis

Diagnostic imaging

Vascular ultrasound

Positron emissions tomography

Magnetic ressonance imaging

Monitoring

© 2025 The Authors. Published by Elsevier Ltd.

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