Vessel wall MRI in giant cell arteritis: standardized protocol and scoring approach developed by an international working group.

This article focuses on the development of standardized recommendations for vessel wall magnetic resonance imaging (VW-MRI) in cranial giant cell arteritis (GCA) to facilitate multicentre research. An international expert working group conducted a targeted literature review of 21 studies and reached consensus on core and elective cranial and orbital structures to image, optimal MRI sequences—favoring high-resolution 3-Tesla scanners with fat suppression and black-blood techniques—and a semiquantitative scoring system for vessel wall enhancement. These guidelines aim to harmonize imaging protocols across centers, improving reproducibility and enabling comprehensive assessment of GCA beyond traditional methods like biopsy and ultrasound. The report acknowledges current limitations, including variable evidence quality, scanner availability, and the need for further research on timing post-glucocorticoid treatment and clinical integration of VW-MRI.