Detection and Characterization of Crystal Suspensions Using Single-Source Dual-Energy Computed Tomography

Diekhoff, Torsten; Kiefer, Tobias; Stroux, Andrea; Pilhofer, I; Juran, R.; Mews, Jürgen; Blobel, Jörg; Tsuyuki, Masaharu; Ackermann, Beate; Hamm, Bernd; Hermann, Kay-Geert A.

doi:10.1097/rli.0000000000000099

Cited by 54 publications

(29 citation statements)

References 35 publications

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“…The authors suggest that DECT scanning could be useful when conventional radiographs are difficult to interpret or when crystals cannot be examined. Diekhoff et al used single source DECT to differentiate between urate and CPP crystals in synthetic tissue [22]. Using a model composed of a phantom hand, the investigators placed synthetic MSU and CPP crystals in ultrasound gel and measured imaging parameters using DECT.…”

Section: Ct Scanningmentioning

confidence: 99%

Imaging of Calcium Pyrophosphate Deposition Disease

Miksanek

Rosenthal

2015

Curr Rheumatol Rep

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Calcium pyrophosphate deposition disease (CPPD) is a common and clinically heterogeneous form of arthritis caused by the deposition of calcium pyrophosphate (CPP) crystals in articular tissues. The diagnosis of CPPD is supported by the presence of radiographic chondrocalcinosis; yet, conventional radiography detects only about 40 % of clinically important CPPD. Here, we critically review the recent literature on imaging in CPPD. New studies inform our use of conventional radiographic screening methodologies for CPPD and provide additional evidence for the utility of diagnostic ultrasound. Recent work also highlights the polyarticular nature of CPPD, its association with tissue damage, and the high prevalence of tendon involvement. While dual energy CT and diffraction-enhanced synchrotron imaging remain research tools, they present potential avenues for improved visualization of CPP deposits. Advances in imaging in CPPD will increase diagnostic accuracy and eventually result in better management of this common form of arthritis.

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Section: Ct Scanningmentioning

confidence: 99%

Imaging of Calcium Pyrophosphate Deposition Disease

Miksanek

Rosenthal

2015

Curr Rheumatol Rep

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“…DECT scans were obtained on a 320-row scanner (Toshiba Aquilion ONE TM and from September 2013 Toshiba Aquilion ONE Vision TM ; Toshiba, Otawara, Japan) with 16-cm z-axis coverage without table movement using 135-kVp (high) and 80-kVp (low) tube voltage [3]. The applied tube current and the resulting radiation exposure depended on the availability of iterative reconstructions (since 2013), patients’ physique, and the examined region (see Table 1 for details).…”

Section: Methodsmentioning

confidence: 99%

“…Dual-energy computed tomography (DECT) is known for its ability to detect uric acid tophi in patients with chronic gouty arthritis [1–3]. Therefore, it has become a problem-solving tool in patients with unclassified arthritis and suspicion of crystal arthropathy when deemed necessary based on the clinical presentation [4].…”

Section: Introductionmentioning

confidence: 99%

Osteitis: a retrospective feasibility study comparing single-source dual-energy CT to MRI in selected patients with suspected acute gout

et al. 2016

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ObjectiveDual-energy computed tomography detects tophi in patients with chronic gout. However, other information that can be obtained from the same scan is not the focus of the current research, e.g., the detection of bone marrow edema (BME) using virtual bone marrow imaging (VBMI). The aim of this study was to evaluate if BME in patients with acute arthritis can be detected with VBMI using magnetic resonance imaging (MRI) as the standard of reference.Materials and methodsThis retrospective study included 11 patients who underwent both MRI and dual-energy computed tomography (mean interval of 40 days). BME in MRI (standard of reference) and VBMI was judged independently by two different blinded readers. φ-correlation coefficient and Cohen’s κ were performed for statistical analysis. Approval was waived by the IRB.ResultsTwo patients with a final diagnosis of RA and one with septic arthritis showed osteitis on MRI and VBMI. However, in each case, there were individual bones identified with osteitis on MRI but not VBMI. Three additional patients with the final diagnosis of RA were identified correctly as negative for BME. There was a good correlation between both modalities (φ = 0.8; κ = 0.8). Inter-rater reliability was excellent for both modalities (κ = 0.9).ConclusionsWe have shown that detecting osteitis using VBMI is feasible in patients with inflammatory arthritis. Further studies are needed on larger, more-targeted populations to better define the indications, accuracy, and added value of this technique.

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“…The attenuation gradient is then color coded to provide easy identification of different substances on the CT images. 14,15 This color coding typically uses blue to represent calcium and green to represent uric acid but is dependent on the software used. While DECT cannot differentiate between CPP crystals and calcium hydroxyapatite crystals, CPP crystals are deposited in the hyaline cartilage, fibrocartilage, and ligaments, whereas hydroxyapatite crystals are more often deposited in tendons.…”

Section: Discussionmentioning

confidence: 99%

Dual-Energy Computed Tomography Demonstrating Destructive Calcium Pyrophosphate Deposition Disease of the Distal Radioulnar Joint Mimicking Tophaceous Gout

Ward¹,

Scott²,

Mansfield³

et al. 2015

JCR: Journal of Clinical Rheumatology

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Calcium pyrophosphate dihydrate deposition (CPPD) disease is a common etiology of crystalline arthropathy; however, it can manifest in multiple patterns such as acute calcium pyrophosphate (CPP) crystal arthritis, osteoarthritis with CPPD, and chronic CPP crystal inflammatory arthritis. Tumoral or tophaceous-like CPPD is a rare manifestation that is occasionally mistaken for gouty tophus or a soft tissue malignancy. Dual-energy computed tomography (DECT) is a new imaging modality currently utilized in assessing monosodium urate crystal deposition; however, its value in CPPD is uncertain. We describe a case using DECT to diagnose tumoral CPPD mimicking tophaceous gout versus recurrence of a previous synovial sarcoma. The imaging findings on DECT prevented unnecessary surgery to assess for possible malignancy, allowing for the prompt diagnosis of tumoral CPPD. Further studies should be performed to determine the role of DECT in assessing for crystalline deposition disease other than gout.

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Detection and Characterization of Crystal Suspensions Using Single-Source Dual-Energy Computed Tomography

Cited by 54 publications

References 35 publications

Imaging of Calcium Pyrophosphate Deposition Disease

Imaging of Calcium Pyrophosphate Deposition Disease

Osteitis: a retrospective feasibility study comparing single-source dual-energy CT to MRI in selected patients with suspected acute gout

Dual-Energy Computed Tomography Demonstrating Destructive Calcium Pyrophosphate Deposition Disease of the Distal Radioulnar Joint Mimicking Tophaceous Gout

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