Utilization of the Dual Source CT for Musculoskeletal Applications: Confirming the Pattern of Distribution of Gout
The following abstract summarizes a talk held during the 10th Annual International Symposium Multidetector Row CT, Stanford Department of Radiology, Las Vegas, Tuesday, May 13th 2008 (Session V: Trauma/ Musculoskeletal)
BACKGROUND
The dual energy application designed to identify uric acid deposition within kidneys (kidney stones) has been proven both in vitro and in vivo. The authors in this pilot study worked to expand this application to allow for visualization of uric acid crystal-induced arthropathy.
METHODS
Gout patients were recruited from the Mary Pack Arthritis Centre in Vancouver and had aspiration-proven disease. Control subjects were recruited on a volunteer basis from within the hospital and were individuals with no history of gout or arthritis. We had a total of 10 gout patients and 10 control patients. All patients received a dual source CT (Definition 64, Siemens Medical Solutions) scan of their hands, elbows, ankles, feet, and knees.
RESULTS
We found that that all 10 patients (100%) with gout had positive findings seen as uric acid proteinacous deposits on their DECT scans. Conversely, all control patients (100%) who were know to be gout-free had negative findings absence of any uric acid deposits. Furthermore, all patients with gout also had aspiration-proven uric acid crystals of their affected region.
CONCLUSION
Our pilot study suggests that DECT may be useful in the specific diagnosis of gout arthropathy and may help to monitor disease progression and response. Although we describe a novel technique in this pilot project, a follow-up large-scale prospective randomized study needs to be performed to determine the sensitivity, positive and negative predictive value of dual energy computed tomography in the assessment of gout arthropathy. Evaluating the clinical impact of this imaging tool would be equally important to clinicians in monitoring whether the treatment is efficacious in halting the progression of gouty arthropathy.
Authors: Nicolaou S, Chandler T, Hou D, Eftekhari A
