Gout tophus detection—A comparison of dual-energy CT (DECT) and histology |
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Authors: | Ralph Melzer Chantal Pauli Thomas Treumann Bernhard Krauss |
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Institution: | 1. Clinic of Rheumatology, Luzerner Kantonsspital, 6000 Lucerne 16, Switzerland;2. Institute of Pathology, Luzerner Kantonsspital, Lucerne, Switzerland;3. Institute of Radiology, Luzerner Kantonsspital, Lucerne, Switzerland;4. Imaging & Therapy Division, Healthcare Sector, Siemens AG, Forchheim, Germany |
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Abstract: | ObjectivesTo compare dual-energy CT images (DECT) directly with gold standard histology.MethodsA 85-year-old woman with chronic recurrent gouty arthritis and macroscopically visible tophi was assessed with DECT-scans of her feet. When she died 7 days later, three tophi in different regions and in different tissues of her left foot were processed for histological examination.ResultsOf the selected tophi, two were almost completely missed by the color-coding DECT sequences. The tophi remained in most of their volume below the detection threshold value of 150 HU (default value).ConclusionsIt could be demonstrated that DECT only highlights the dense tophi (corresponding of approximately 15–20 vol% urate in the tophus). Less dense tophi, despite considerable size, will be missed in the color-coded images. |
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Keywords: | Dual-energy computed tomography DECT Gout Tophi Histology |
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