Torsten Diekhoff1, Katharina Ziegeler2, Eugen Feist2, Tobias Kiefer3, Jürgen Mews4, Bernd Hamm3, Kay-Geert A Hermann3. 1. Department of Radiology, Charité-Universitätsmedizin Berlin Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, Charitéplatz 1, 10117, Berlin, Germany. torsten.diekhoff@charite.de. 2. Department of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, Charitéplatz 1, 10117, Berlin, Germany. 3. Department of Radiology, Charité-Universitätsmedizin Berlin Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, Charitéplatz 1, 10117, Berlin, Germany. 4. Toshiba Medical Systems Europe, BV, Zilverstraat 1, 2701 RP, Zoetermeer, Netherlands.
Abstract
OBJECTIVES: Dual-energy computed tomography (DECT) is an emerging imaging technique for examining patients with suspected gout. Single-source dual-energy CT (S-DECT) is a new way of obtaining DECT information on conventional CT scanners rather than using special dual-source CT systems. METHODS: We tested the feasibility of S-DECT (320-row CT; Aquilion ONE, Toshiba Medical Systems, Otawara, Japan) in 6 patients (5 men, 1 woman; mean age 61.3, range 48 to 69 years) with acute arthralgia and suspected gout, and compared the S-DECT findings with the results of joint aspiration. RESULTS: Three patients had a diagnosis of gouty arthritis with negatively birefringent crystals in synovial fluid, in addition to gouty tophi in S-DECT. Three patients had no detectable crystals by polarization microscopy and no tophi on DECT. Their final diagnoses were rheumatoid arthritis, activated osteoarthritis, and septic arthritis in one case each. CONCLUSION: This initial experience suggests that S-DECT might be a valuable alternative to dual-source CT. Hence, more patients may benefit from its additional diagnostic abilities in the future.
OBJECTIVES: Dual-energy computed tomography (DECT) is an emerging imaging technique for examining patients with suspected gout. Single-source dual-energy CT (S-DECT) is a new way of obtaining DECT information on conventional CT scanners rather than using special dual-source CT systems. METHODS: We tested the feasibility of S-DECT (320-row CT; Aquilion ONE, Toshiba Medical Systems, Otawara, Japan) in 6 patients (5 men, 1 woman; mean age 61.3, range 48 to 69 years) with acute arthralgia and suspected gout, and compared the S-DECT findings with the results of joint aspiration. RESULTS: Three patients had a diagnosis of gouty arthritis with negatively birefringent crystals in synovial fluid, in addition to gouty tophi in S-DECT. Three patients had no detectable crystals by polarization microscopy and no tophi on DECT. Their final diagnoses were rheumatoid arthritis, activated osteoarthritis, and septic arthritis in one case each. CONCLUSION: This initial experience suggests that S-DECT might be a valuable alternative to dual-source CT. Hence, more patients may benefit from its additional diagnostic abilities in the future.
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