Ralph Melzer1, Chantal Pauli2, Thomas Treumann3, Bernhard Krauss4. 1. Clinic of Rheumatology, Luzerner Kantonsspital, 6000 Lucerne 16, Switzerland. Electronic address: ralph.melzer@luks.ch. 2. Institute of Pathology, Luzerner Kantonsspital, Lucerne, Switzerland. 3. Institute of Radiology, Luzerner Kantonsspital, Lucerne, Switzerland. 4. Imaging & Therapy Division, Healthcare Sector, Siemens AG, Forchheim, Germany.
Abstract
OBJECTIVES: To compare dual-energy CT images (DECT) directly with gold standard histology. METHODS: A 85-year-old woman with chronic recurrent gouty arthritis and macroscopically visible tophi was assessed with DECT-scans of her feet. When she died 7 days later, three tophi in different regions and in different tissues of her left foot were processed for histological examination. RESULTS: Of the selected tophi, two were almost completely missed by the color-coding DECT sequences. The tophi remained in most of their volume below the detection threshold value of 150HU (default value). CONCLUSIONS: It could be demonstrated that DECT only highlights the dense tophi (corresponding of approximately 15-20vol% urate in the tophus). Less dense tophi, despite considerable size, will be missed in the color-coded images.
OBJECTIVES: To compare dual-energy CT images (DECT) directly with gold standard histology. METHODS: A 85-year-old woman with chronic recurrent gouty arthritis and macroscopically visible tophi was assessed with DECT-scans of her feet. When she died 7 days later, three tophi in different regions and in different tissues of her left foot were processed for histological examination. RESULTS: Of the selected tophi, two were almost completely missed by the color-coding DECT sequences. The tophi remained in most of their volume below the detection threshold value of 150HU (default value). CONCLUSIONS: It could be demonstrated that DECT only highlights the dense tophi (corresponding of approximately 15-20vol% urate in the tophus). Less dense tophi, despite considerable size, will be missed in the color-coded images.
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