First experience with single-source dual-energy computed tomography in six patients with acute arthralgia: a feasibility experiment using joint aspiration as a reference

Skeletal Radiol. 2015 Nov;44(11):1573-7. doi: 10.1007/s00256-015-2204-7. Epub 2015 Jul 5.

Abstract

Objectives: Dual-energy computed tomography (DECT) is an emerging imaging technique for examining patients with suspected gout. Single-source dual-energy CT (S-DECT) is a new way of obtaining DECT information on conventional CT scanners rather than using special dual-source CT systems.

Methods: We tested the feasibility of S-DECT (320-row CT; Aquilion ONE, Toshiba Medical Systems, Otawara, Japan) in 6 patients (5 men, 1 woman; mean age 61.3, range 48 to 69 years) with acute arthralgia and suspected gout, and compared the S-DECT findings with the results of joint aspiration.

Results: Three patients had a diagnosis of gouty arthritis with negatively birefringent crystals in synovial fluid, in addition to gouty tophi in S-DECT. Three patients had no detectable crystals by polarization microscopy and no tophi on DECT. Their final diagnoses were rheumatoid arthritis, activated osteoarthritis, and septic arthritis in one case each.

Conclusion: This initial experience suggests that S-DECT might be a valuable alternative to dual-source CT. Hence, more patients may benefit from its additional diagnostic abilities in the future.

Keywords: Dual energy; Gout; Single source.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Aged
  • Arthralgia / complications
  • Arthralgia / diagnostic imaging*
  • Arthralgia / pathology
  • Biopsy, Needle
  • Feasibility Studies
  • Female
  • Gout / complications
  • Gout / diagnostic imaging
  • Gout / pathology
  • Humans
  • Imaging, Three-Dimensional
  • Male
  • Middle Aged
  • Radiography, Dual-Energy Scanned Projection
  • Reference Values
  • Tomography, X-Ray Computed / methods*