OMERACT GCA Phantom Project: Validation of a 3D-Printed Ultrasound Training Phantom for Diagnosis of Giant Cell Arteritis

Tobias Schremmer,Christian Dejaco， Richard J Wakefield,Valentin Sebastian Schäfer

RMD open（2025）

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Abstract

Objective Ultrasonography is crucial for diagnosing giant cell arteritis (GCA); however, training opportunities are rare. This study tested the reliability of ultrasonography findings and measurements of the intima-media thickness (IMT) among ultrasonography experts by using phantoms of the axillary (AA) and temporal arteries (TA) created with high-resolution 3D printing.Methods Twenty-eight participants from 12 European countries received eight sets of phantoms of the AA and the superficial TA (including common, frontal and parietal branches), which were examined in a blinded fashion according to a predefined protocol and evaluated based on Outcome Measures in Rheumatology (OMERACT) GCA ultrasound definitions. Due to difficulties with the delineation of the intima-media complex, the parietal branch of the phantoms was modified, and a second round was conducted. The IMT was measured, and phantoms were classified as normal or vasculitic.Results In both rounds, the phantoms were correctly classified as normal/abnormal in >81% of cases yielding a Fleiss’ kappa of 0.80 (95% CI 0.78 to 0.81) in round 1 and 0.74 (95% CI 0.72 to 0.75) in round 2. IMT measurements revealed an intraclass correlation coefficient (ICC 1.1) of 0.98 (95% CI 0.98 to 0.99) in both rounds. Intrarater reliability was good with a median Cohens Kappa of 0.83 and median ICC of 0.78.Conclusion The study demonstrated high reliability among ultrasound experts in applying the OMERACT ultrasound definitions for GCA and in measuring the IMT using a 3D-printed phantom of the AA and TA. This phantom could assist clinicians in training to assess the large arteries of patients with suspected or established GCA.

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【要点】：本研究验证了使用3D打印的超声培训模型在巨细胞动脉炎（GCA）诊断中的可靠性，为临床医生提供了一种新的训练工具。

【方法】：通过高分辨率3D打印技术制作了腋动脉（AA）和颞动脉（TA）模型，28名来自12个欧洲国家的参与者根据OMERACT GCA超声定义进行盲测。

【实验】：两轮实验均正确分类了超过81%的模型为正常/异常，第一轮Fleiss’ kappa为0.80，第二轮为0.74；IMT测量的 intraclass correlation coefficient (ICC) 在两轮中均为0.98，表现出良好的测试者间和测试者内可靠性。