Development and validation of a quantitative method for estimation of the urate burden in patients with gouty arthritis using dual-energy computed tomography.

Objectives: To develop a method that allows approximating the mass of monosodium uric acid (MSU) in a gouty tophus using phantom measurements and including tophus density into the calculation of the dual-energy computed tomography (DECT) tophus volumetry.Methods: We prepared specimens of different c...

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Publicado en:European Radiology Vol. 30; no. 1; pp. 404 - 413
Autores principales: Kotlyarov, Maximilian, Hermann, Kay Geert A., Mews, Jürgen, Hamm, Bernd, Diekhoff, Torsten
Formato: diagnostic images equations & formulas pictorial research tables/charts Journal Article
Publicado: Springer Nature Jan2020
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Springer Nature
      place: New York, New York
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        atl: Development and validation of a quantitative method for estimation of the urate burden in patients with gouty arthritis using dual-energy computed tomography.
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          Kotlyarov, Maximilian
          Hermann, Kay Geert A.
          Mews, Jürgen
          Hamm, Bernd
          Diekhoff, Torsten
        affil: Department of Radiology (CCM), Charité - Universitätsmedizin Berlin, Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, Charitéplatz 1, 10117, Berlin, Germany
      sug:
        subj:
          Uric Acid Analysis
          Radiographic Image Enhancement Methods
          Tomography, X-Ray Computed Methods
          Gout
          Swine
          Phantoms, Imaging
          Male
          Animals
          Gout Metabolism
          Retrospective Design
          Algorithms
          Human
          Male
      ab: Objectives: To develop a method that allows approximating the mass of monosodium uric acid (MSU) in a gouty tophus using phantom measurements and including tophus density into the calculation of the dual-energy computed tomography (DECT) tophus volumetry.Methods: We prepared specimens of different concentrations of MSU placed in an epoxy-based phantom and an excised porcine foreleg. Density and volumetric measurements were performed in sequential single-source DECT scans acquired with increasingly higher tube currents. We developed a method for estimating the tophus mass by multiplying the detected tophus volume with its mean density and adding a specific gravimetric coefficient k. k was derived from the DECT scans by comparing the approximated MSU masses in the epoxy phantom with the known true MSU masses of the specimens.Results: Comparison of the approximated MSU masses in the porcine foreleg scans with the true MSU masses of the syringe contents showed similar performance to sole volume measurement while providing additional information on the true uric acid burden: Over 70% of the true urate masses have been detected in MSU concentrations ≥ 45%, while the detection rate was much lower for MSU concentrations ≤ 40%. Retrospective analysis of patients with proven gouty arthritis confirmed the diagnostic potential of the mass approximation technique.Conclusions: We successfully established a method to include tophus density measurement for estimation of the uric acid burden in milligrams (instead of ml) in a phantom setting for MSU concentrations above 40%. Future studies should validate its use for follow-up in clinical practice.Key Points: • Including tophus density measurement in dual-energy computed tomography scans in a phantom setting can be used for estimating the urate burden in milligrams, which might be useful for imaging follow-up. • The mass [mg] of the uric acid burden in a patient with gouty arthritis can be calculated by multiplying volume [ml] with mean density [HU] using a specific gravimetric coefficient. • Retrospective analysis of two patients with gouty tophi showed the relevance of measuring urate mass in addition to urate volume alone.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        equations & formulas
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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