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Giant Cell Arteritis

This project focus on evaluating and optimizing photoacoustic (PA) imaging as a method to non invasively diagnose giant cell arthritis.

Temporal artery imaging setup. Photo.

Giant cell arteritis (GCA) also known as temporal arteritis is a sight- and life-threatening, granulomatous large-vessel condition. Typical symptoms are headache, fever, fatigue, night sweats and weight loss. GCA may not only cause permanent loss of vision, but also lead to cerebrovascular stroke or myocardial infarction. Current recommendations for the management of GCA are immediate treatment with high-dose corticosteroids, that may continue for several years. Temporal artery biopsy is considered the gold standard in the diagnosis of GCA, in which a segment of the temporal artery is surgically excised and analyzed histopathologically to identify inflammatory lesions in the vessel wall. This technique has high specificity but low sensitivity. Furthermore, temporal artery biopsy is associated with several complications and risks, such as injury to the facial nerve and the trigeminal nerve, peri- and postoperative hemorrhage, wound infection, scarring, and skin necrosis.

This project aims to evaluate the use of photoacoustic (PA) imaging for the non-invasive diagnosis of GCA.

Encouraging results have been obtained in animal studies (by others), showing detailed images of small blood vessels with high resolution. However, PA imaging has not yet been approved for clinical use due to a lack of clinical data. So far we have adapted the PA technique for use in humans and managed problems associated with motion artefacts and disturbances from other endogenous chromophores. We are now proceeding with measurements on healthy volunteers and patients with suspected GCA to evaluate the feasibility of using PA imaging to examine the temporal artery, diagnose GCA and to confirm the safety regarding visual function.

Photoacoustic image of GCA. Photo.
Longitudinal section of a temporal artery biopsy that is negative (GCA-) and positive (GCA+) för arteritis. A pixel-by-pixel classification is performed based on spectral features. The three highlighted regions in the GCA+ sample where there is a strong PA spectral signature of deoxygenated Hb (HbR) are likely remnants of blood that was not rinsed out prior to investigation.


Selected publications

Naumovska M, Merdasa A, Hammar B, Albinsson J, Dahlstrand U, Cinthio M, Sheikh R, Malmsjö M. Mapping the architecture of the temporal artery with photoacoustic imaging for diagnosing giant cell arteritis. Photoacoustics. 2022 Jul 4;27:100384. 

Sheikh R, Hammar B, Naumovska M, Dahlstrand U, Gesslein B, Erlöv T, Cinthio M, Malmsjö M. Photoacoustic imaging for non-invasive examination of the healthy temporal artery - systematic evaluation of visual function in healthy subjects. Acta Ophthalmol. 2021 Mar;99(2):227-231.

Sheikh R, Hammar B, Naumovska M, Dahlstrand U, Gesslein B, Erlöv T, Cinthio M, Malmsjö M: Photoacoustic imaging for non-invasive examination of the healthy temporal artery – systematic evaluation of visual function in healthy subjects. Acta Ophthalmologica 2020.

Naumovska M, Sheikh R, Engelsberg K, Blohmé J, Hammar B, Malmsjo M: Temporal artery biopsies contract upon surgical excision, but do not shrink further during formalin fixation. Scandinavian Journal of Rheumatology. 2020;49:84-86

Sheikh R, Cinthio M, Dahlstrand U, Erlov T, Naumovska M, Hammar B, Zackrisson S, Jansson T, Reistad N, Malmsjo M. Clinical Translation of a Novel Photoacoustic Imaging System for Examining the Temporal Artery. IEEE Trans Ultrason Ferroelectr Freq Control. 2019 Mar;66(3):472-480.




Project participants


Associate professor Rafi Shiekh, MD, PhD. Photo.
Associate professor Rafi Sheikh, MD, PhD
Magdalena Naumovska, MD, PhD student. Photo.
Magdalena Naumovska, MD, PhD student
Björn Hammar, MD, PhD. Photo.
Björn Hammar, MD, PhD
Professor Malin Malmsjö, MD, PhD. Photo.
Professor Malin Malmsjö, MD, PhD
Magnus Cinthio, MSc, PhD
Associate professor Magnus Cinthio, MSc, PhD
Tobias Erlöv, MSc, PhD. Photo.
Tobias Erlöv, MSc, PhD
John Albinsson, MSc, PhD
John Albinsson, MSc, PhD