All members of the OMERACT LVV-US Working Group were asked to submit 16 representative still images and 20 representative videos (figures 1-3 ): eight still images and eight videos represented normal anatomical segments (common temporal artery, frontal branch, parietal branch and axillar arteries) in longitudinal and transverse planes; and the eight other still images and eight videos represented the same segments exhibiting the ‘halo’ sign. Four additional videos showed a positive and a negative ‘compression’ sign of the temporal artery branches in longitudinal and transverse views, respectively. All pathological images and videos originated from patients with active disease who met the expanded ACR classification criteria of GCA, and in whom diagnosis was confirmed either by temporal artery biopsy or on a clinical basis, including US and follow-up.19 (link) The images and videos were collected by a facilitator of the group (SC) who constructed an electronic database using REDCap (Research Electronic Data Capture; Vanderbilt University, Nashville, Tennessee, USA) hosted by a server from the Italian Society for Rheumatology.20 (link)
From 550 submitted images and videos, 150 images and videos were selected by the facilitator for the web-based reliability exercise: 20 videos of axillary arteries, 20 still images of axillary arteries, 45 videos of temporal arteries, 45 still images of temporal arteries and 20 videos of the ‘compression’ sign applied to temporal arteries. The distribution between longitudinal/transverse views and normal/pathological vessels was as follows: temporal artery still images and videos: transverse 56, longitudinal 54, pathological 57 and normal 53. Axillary artery still images and videos: transverse 18, longitudinal 22, pathological 19 and normal 21. A link with the web-based exercise was sent to the same physicians who participated in the Delphi process, asking them to apply the definitions agreed in the Delphi exercise to decide whether each still image or video was suggestive of vasculitis according to the definitions. Two weeks after the first evaluation, the participants received the same images and videos in a different order for evaluating the intra-rater agreement.
All images and videos were anonymised for patients’ data, the centre where the image was obtained, US machine settings/producer and intima-media thickness (IMT) measurements. Images and videos from patients were only submitted from countries without restrictions for patient image transfer.
From 550 submitted images and videos, 150 images and videos were selected by the facilitator for the web-based reliability exercise: 20 videos of axillary arteries, 20 still images of axillary arteries, 45 videos of temporal arteries, 45 still images of temporal arteries and 20 videos of the ‘compression’ sign applied to temporal arteries. The distribution between longitudinal/transverse views and normal/pathological vessels was as follows: temporal artery still images and videos: transverse 56, longitudinal 54, pathological 57 and normal 53. Axillary artery still images and videos: transverse 18, longitudinal 22, pathological 19 and normal 21. A link with the web-based exercise was sent to the same physicians who participated in the Delphi process, asking them to apply the definitions agreed in the Delphi exercise to decide whether each still image or video was suggestive of vasculitis according to the definitions. Two weeks after the first evaluation, the participants received the same images and videos in a different order for evaluating the intra-rater agreement.
All images and videos were anonymised for patients’ data, the centre where the image was obtained, US machine settings/producer and intima-media thickness (IMT) measurements. Images and videos from patients were only submitted from countries without restrictions for patient image transfer.