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Dual energy CT (DECT) scanning has recently been applied to the detection of urate deposits in patients with gout.1 It is highly specific, with potential for use as a diagnostic tool.2 However, few studies have compared DECT with other advanced imaging modalities. We have recently studied a group of gout patients using 3T MRI scanning as well as DECT imaging and have discovered that a significant anomaly exists for the identification of urate which is contingent upon DECT software settings. This could have a major impact on the diagnosis of gout in individual patients.
We performed DECT scans of the dominant wrist in 10 patients with tophaceous gout,3 with an average disease duration of 19 years. All participants provided written informed consent and this study was approved by the Northern X Regional Ethics Committee of New Zealand. A dual x-ray tube 128-detector-row scanner (Siemens Medical, Erlangen, Germany) was used. Patients were scanned prone with arm outstretched from finger-tips to distal radius with acquisitions at 40×0.6 mm and pitch of 0.7. Tube A was operated at 80 kV/260 mAs and tube B at 140 kV/130 mAs. Images were reconstructed using bone and soft tissue algorithms, 512 matrix, 0.75-mm slices with 0.5-mm increment. Data were treated in two …
Footnotes
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Contributors FM designed the study, arranged patient recruitment and wrote the manuscript. AD scored MRI scans and assisted with the design and analysis of the study, QR scored the MRI scans and assisted with the design of the study, GG performed the statistical analysis and ND scored the DECT scans and assisted with the writing of the manuscript.
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Disclaimer The views expressed in this article are those of the authors.
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Funding Auckland Medical Research Foundation, Grant no. 1109016.
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Competing interests None.
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Ethics approval Ethics approval was provided by the Northern X Regional Ethics Committee.
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Provenance and peer review Not commissioned; externally peer reviewed.
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Data sharing statement Additional unpublished data can be obtained from the corresponding author on request.