Katharina Ziegeler1, Sandra Hermann2, Kay Geert A Hermann3, Bernd Hamm3, Torsten Diekhoff3. 1. Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany. katharina.ziegeler@charite.de. 2. Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany. 3. Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Abstract
OBJECTIVES: To evaluate the ability of dual-energy computed tomography (DECT) to improve diagnostic discrimination between gout and other crystal arthropathies such as calcium pyrophosphate deposition disease (CPPD) of the wrist in a clinical patient population. MATERIALS AND METHODS: This retrospective case-control study included 29 patients with either gout (case group; n = 9) or CPPD (control group; n = 20) who underwent DECT of the wrist for clinically suspected crystal arthropathy. Color-coded urate and enhanced calcium as well as virtual 120 kVe blended images were reconstructed from the DECT datasets. Two independent and blinded readers evaluated each reconstructed dataset for the presence of depositions in 17 predefined regions. Additionally, a global diagnosis was made first for 120 kVe images only, based solely on morphologic criteria, and subsequently for all reconstructed images. RESULTS: Sensitivity for the global diagnosis of gout was 1.0 (95% CI 0.63-1) for both DECT and 120 kVe images with specificities of 0.70 (95% CI 0.46-0.87) for DECT and 0.80 (95% CI 0.56-0.93) for 120 kVe images. Color-coded DECT images did not detect more depositions than monochrome standard CT images. CONCLUSION: Discrimination of crystal arthropathies of the wrist is limited using DECT and primarily relying on color-coded images. Evaluation of morphologic criteria on standard CT images is essential for accurate diagnosis.
OBJECTIVES: To evaluate the ability of dual-energy computed tomography (DECT) to improve diagnostic discrimination between gout and other crystal arthropathies such as calcium pyrophosphate deposition disease (CPPD) of the wrist in a clinical patient population. MATERIALS AND METHODS: This retrospective case-control study included 29 patients with either gout (case group; n = 9) or CPPD (control group; n = 20) who underwent DECT of the wrist for clinically suspected crystal arthropathy. Color-coded urate and enhanced calcium as well as virtual 120 kVe blended images were reconstructed from the DECT datasets. Two independent and blinded readers evaluated each reconstructed dataset for the presence of depositions in 17 predefined regions. Additionally, a global diagnosis was made first for 120 kVe images only, based solely on morphologic criteria, and subsequently for all reconstructed images. RESULTS: Sensitivity for the global diagnosis of gout was 1.0 (95% CI 0.63-1) for both DECT and 120 kVe images with specificities of 0.70 (95% CI 0.46-0.87) for DECT and 0.80 (95% CI 0.56-0.93) for 120 kVe images. Color-coded DECT images did not detect more depositions than monochrome standard CT images. CONCLUSION: Discrimination of crystal arthropathies of the wrist is limited using DECT and primarily relying on color-coded images. Evaluation of morphologic criteria on standard CT images is essential for accurate diagnosis.
Authors: Katrina N Glazebrook; Luis S Guimarães; Naveen S Murthy; David F Black; Tim Bongartz; Nisha J Manek; Shuai Leng; Joel G Fletcher; Cynthia H McCollough Journal: Radiology Date: 2011-09-16 Impact factor: 11.105
Authors: P Richette; P Clerson; S Bouée; G Chalès; M Doherty; R M Flipo; C Lambert; F Lioté; T Poiraud; T Schaeverbeke; T Bardin Journal: Ann Rheum Dis Date: 2014-05-05 Impact factor: 19.103