Identification and characterization of peripheral vascular color-coded DECT lesions in gout and non-gout patients: The VASCURATE study |
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| Institution: | 1. Department of Rheumatology, Lille Catholic Hospitals and Lille Catholic University, Lille, France;2. Department of Diagnostic and Interventional Radiology, Lille Catholic Hospitals and Lille Catholic University, Lille, France;3. Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, USA;4. Department of Research, Biostatistics, Lille Catholic Hospitals and Lille Catholic University, Lille, France;5. Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland;1. Rheumatology Department, Reina Sofia University Hospital, Cordoba, Spain;2. Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain;3. University of Cordoba, Cordoba, Spain;4. Rheumatology Department, Cochin Hospital, Paris, France;1. Rheumatology service, Hospital Universitario la Paz-IdiPaz, Madrid, Spain;2. Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin Berlin, Berlin, Germany;3. Department of Nephrology and Rheumatology, Kyorin University School of medicine, Tokyo, Japan;4. Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine, Tokyo, Japan;5. Department of Rheumatology, NTT Medical Center Tokyo, Tokyo, Japan;6. Rheumatology Department, Hôpital Cochin, Université de Paris. Assistance Publique- Hôpitaux de Paris, Paris, France;7. Rheumatology Department, Reina Sofia University Hospital, IMIBIC, University of Córdoba, Córdoba, Spain;8. INSERM U1153, Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, Paris, France;1. John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu HI, USA;2. Pali Momi Medical Center, Hawai''i Pacific Health, 98-1079 Moanalua Road, Suite 300, Aiea, Honolulu 96701, HI, USA;1. Department of Medicine, University of Alberta, 13-103 Clinical Sciences Building, 11350-83 Avenue, Edmonton T6G 2G3, Alberta, Canada;2. CARE Arthritis, CARE Arthritis Ltd. 316 Windermere Road NW Unit 210, Edmonton T6W 2Z8, Alberta, Canada;3. Department of Radiology and Diagnostic Imaging, University of Alberta Hospital, 2A2.41 WC Mackenzie Health Sciences Centre, 8440 112 Street NW, T6G 2B7, Medical Imaging Consultants, 202-11010 - 101 Street NW, T5H 4B9, Edmonton, Alberta, Canada;4. Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Valdemar Hansen Vej 17, 2600 Glostrup, Copenhagen, Denmark;5. Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark;6. Practice Buchsbaum, Schaffhausen, Switzerland;1. Division of Rheumatology and Research, Diakonhjemmet Hospital, Box 23 Vinderen, Oslo N-0319, Norway;2. Faculty of Medicine, University of Oslo, Oslo, Norway;3. Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen, Denmark;4. Department of Rheumatology, Cliniques Universitaires Saint Luc, Brussels, Belgium;5. Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Belgium;6. Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands;7. Department of Rheumatology, Zuyderland Medical Center, Heerlen, the Netherlands;8. Department of Clinical Medicine, Faculty of Health and Medical Sciences University of Copenhagen, Copenhagen, Denmark;9. Department of Rheumatology, Sorbonne University, APHP, Pitié-Salpêtrière Hospital, Paris, France;10. Department of radiology and biomedical imaging, University of California, San Francisco, United States;11. Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre, Leeds, UK;12. Spire Sciences, Inc., Boca Raton, FL 33487, United States |
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| Abstract: | ObjectiveTo characterize peripheral vascular plaques color-coded as monosodium urate (MSU) deposition by dual-energy computed tomography (DECT) and assess their association with the overall soft-tissue MSU crystal burden.MethodsPatients with suspected crystal arthropathies were prospectively included in the CRYSTALILLE inception cohort to undergo baseline knees and ankles/feet DECT scans; treatment-naive gout patients initiating treat-to-target urate-lowering therapy (ULT) underwent repeated DECT scans with concomitant serum urate level measurements at 6 and 12 months. We determined the prevalence of DECT-based vascular MSU-coded plaques in knee arteries, and assessed their association with the overall DECT volumes of soft-tissue MSU crystal deposition and coexistence of arterial calcifications. DECT attenuation parameters of vascular MSU-coded plaques were compared with dense calcified plaques, control vessels, control soft tissues, and tophi.ResultsWe investigated 126 gout patients and 26 controls; 17 ULT-naive gout patients were included in the follow-up study. The prevalence of DECT-based vascular MSU-coded plaques was comparable in gout patients (24.6%) and controls (23.1%; p=0.87). Vascular MSU-coded plaques were strongly associated with coexisting arterial calcifications (p<0.001), but not with soft-tissue MSU deposition. Characterization of vascular MSU-coded plaques revealed specific differences in DECT parameters compared with control vessels, control soft tissues, and tophi. During follow-up, vascular MSU-coded plaques remained stable despite effective ULT (p=0.64), which decreased both serum urate levels and soft-tissue MSU volumes (p<0.001).ConclusionOur findings suggest that DECT-based MSU-coded plaques in peripheral arteries are strongly associated with calcifications and may not reflect genuine MSU crystal deposition. Such findings should therefore not be a primary target when managing gout patients |
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