ArticleEuropean radiology experimental2023
Influence of contrast medium on tophus detection using dual-energy CT: phantom study and clinical illustration.
Article in European radiology experimental, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed, 6 citations in OpenAlex.
- Current and future role of CT and advanced CT applications in inflammatory arthritis in the clinic and trials.Skeletal radiology · 2025Review
- Material decomposition approaches for monosodium urate (MSU) quantification in gouty arthritis: a (bio)phantom study.European radiology experimental · 2024Article
- Virtual noncontrast images reveal gouty tophi in contrast-enhanced dual-energy CT: a phantom study.European radiology experimental · 2024Article
- Updates on the Applications of Spectral Computed Tomography for Musculoskeletal Imaging.Diagnostics (Basel, Switzerland) · 2024Review
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Authors and funding
6 authors at 2 institutions in 2 countries.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundTo investigate the influence of iodinated contrast medium (ICM) on detection of monosodium urate (MSU) with dual-energy computed tomography (DECT) in two types of phantoms and demonstrate an example patient for clinical illustration.
methodsApproval is by the institutional review board, and written informed consent was obtained. A grid-like and a biophantom with 25 suspensions containing different concentrations of ICM (0 to 2%) and MSU (0 to 50%) were prepared and scanned with sequential single-source DECT using established methodology. Ascending orders of tube currents were applied at 80 kVp (16.5 to 220.0 mAs) and 135 kVp (2.75 to 19.25 mAs). Volume and mass measurements were performed using clinical gout software (dual-energy decomposition analysis). Numbers of true-positive and false-positive MSU detections were recorded and compared for different ICM concentrations. We demonstrate a patient with gouty arthritis for clinical illustration.
resultsEffects of ICM on MSU detection varied with the amount of iodine. Lower ICM concentrations (0.25 and 0.50%) improved detection of small uric acid concentrations of 35 to 45% in comparison to scans without ICM. However, high ICM concentrations (1 and 2%) almost completely precluded MSU detection for all MSU concentrations investigated. In a patient with gouty arthritis, tophi in the wrist were only detected after intravenous ICM administration.
conclusionsExploring multimodal DECT for arthritis imaging, enhancement of ICM influences tophus detection. It can help in visualizing previously undetected MSU depositions but, with too strong enhancement, also obscure tophi. RELEVANCE STATEMENT: Use of iodinated contrast media in dual-energy CT might help in visualizing previously undetected uric acid depositions but, with too strong enhancement, obscure gouty tophi. KEY POINTS: • Iodine significantly influences the uric acid crystal detection in systematic phantom studies. • Lower iodine concentrations improved detection of low and medium uric acid concentrations. • High concentrations of iodine hampered detection of all uric acid concentrations.
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