ArticleArthritis research & therapy2020
Dual-energy CT in gout patients: Do all colour-coded lesions actually represent monosodium urate crystals?
Article in Arthritis research & therapy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed.
- Precision imaging biomarkers for gout: artifact-specific spectral CT parameters for personalized differentiation of tophi in a prospective study.Therapeutic advances in musculoskeletal disease · 2026Article
- Article
- Endoscopic management of lumbar spinal tophaceous gout: six cases treated with percutaneous transforaminal (PTED) and interlaminar (PIED) discectomy and a literature review.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Review
- Imaging of gout: an atlas.Rheumatology advances in practice · 2025Review
- Advanced imaging techniques in crystal arthritis.Therapeutic advances in musculoskeletal disease · 2025Review
- Virtual noncontrast images reveal gouty tophi in contrast-enhanced dual-energy CT: a phantom study.European radiology experimental · 2024Article
- Single photon emission computed tomography/computed tomography imaging of gouty arthritis: A new voice.Journal of translational internal medicine · 2024Article
- Diffuse-Type Tenosynovial Giant Cell Tumor: What Are the Important Findings on the Initial and Follow-Up MRI?Cancers · 2024Review
- Review
- Dual-Energy Computed Tomography (DECT) Resolves the Diagnostic Dilemma in an Atypically Presenting Case of Gout.Cureus · 2023Article
- Imaging Features of Soft Tissue Tumor Mimickers: A Pictorial Essay.The Indian journal of radiology & imaging · 2022Article
- Two-year reduction of dual-energy CT urate depositions during a treat-to-target strategy in gout in the NOR-Gout longitudinal study.Rheumatology (Oxford, England) · 2022Article
- Optimization of dual energy computed tomography post-processing to reduce lower limb artifacts in gout.Quantitative imaging in medicine and surgery · 2022Article
- Differential diagnosis of T2 hypointense masses in musculoskeletal MRI.Skeletal radiology · 2021Review
- Limitations of dual-energy CT in the detection of monosodium urate deposition in dense liquid tophi and calcified tophi.Skeletal radiology · 2021Article
- What Has Dual Energy CT Taught Us About Gout?Current rheumatology reports · 2021Review
- Properties of colour-coded DECT lesions vary.Nature reviews. Rheumatology · 2020Article
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8 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundDual-energy CT (DECT) can acknowledge differences in tissue compositions and can colour-code tissues with specific features including monosodium urate (MSU) crystals. However, when evaluating gout patients, DECT frequently colour-codes material not truly representing MSU crystals and this might lead to misinterpretations. The characteristics of and variations in properties of colour-coded DECT lesions in gout patients have not yet been systematically investigated. The objective of this study was to evaluate the properties and locations of colour-coded DECT lesions in gout patients.
methodsDECT of the hands, knees and feet were performed in patients with suspected gout using factory default gout settings, and colour-coded DECT lesions were registered. For each lesion, properties [mean density (mean of Hounsfield Units (HU) at 80 kV and Sn150kV), mean DECT ratio and size] and location were determined. Subgroup analysis was performed post hoc evaluating differences in locations of lesions when divided into definite MSU depositions and possibly other lesions.
resultsIn total, 4033 lesions were registered in 27 patients (23 gout patients, 3918 lesions; 4 non-gout patients, 115 lesions). In gout patients, lesions had a median density of 160.6 HU and median size of 6 voxels, and DECT ratios showed an approximated normal distribution (mean 1.06, SD 0.10), but with a right heavy tail consistent with the presence of smaller amounts of high effective atomic number lesions (e.g. calcium-containing lesions). The most common locations of lesions were 1st metatarsophalangeal (MTP1), knee and midtarsal joints along with quadriceps and patella tendons. Subgroup analyses showed that definite MSU depositions (large volume, low DECT ratio, high density) had a similar distribution pattern, whereas possible calcium-containing material (high DECT ratio) and non-gout MSU-imitating lesions (properties as definite MSU depositions in non-gout patients) were primarily found in some larger joints (knee, midtarsal and talocrural) and tendons (Achilles and quadriceps). MTP1 joints and patella tendons showed only definite MSU depositions.
conclusionColour-coded DECT lesions in gout patients showed heterogeneity in properties and distribution. MTP1 joints and patella tendons exclusively showed definite MSU depositions. Hence, a sole focus on these regions in the evaluation of gout patients may improve the specificity of DECT scans.
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