Frequently Encountered Artifacts in the Application of Dual-Energy Computed Tomography to Cardiovascular Imaging for Urate Crystals in Gout: A Matched-Control Study.

Autor: Yokose C; Massachusetts General Hospital, Boston., Eide SE; National University Hospital of Singapore, Singapore., Huber FA; Massachusetts General Hospital and Harvard Medical School, Boston, and University Hospital Zurich and University of Zurich, Zurich, Switzerland., Simeone FJ; Massachusetts General Hospital and Harvard Medical School, Boston., Ghoshhajra BB; Massachusetts General Hospital, Boston., Shojania K; Vancouver General Hospital and Arthritis Research Canada, Vancouver, British Columbia, Canada., Nicolaou S; Vancouver General Hospital, Vancouver, British Columbia, Canada., Becce F; Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland., Choi HK; Massachusetts General Hospital, Boston.
Jazyk: angličtina
Zdroj: Arthritis care & research [Arthritis Care Res (Hoboken)] 2024 Jul; Vol. 76 (7), pp. 953-963. Date of Electronic Publication: 2024 Mar 18.
DOI: 10.1002/acr.25312
Abstrakt: Objective: There is surging interest in using dual-energy computed tomography (DECT) to identify cardiovascular monosodium urate (MSU) deposits in patients with gout. We sought to examine the prevalence and characterization of cardiovascular DECT artifacts using non-electrocardiogram (EKG)-gated DECT pulmonary angiograms.
Methods: We retrospectively reviewed non-EKG-gated DECT pulmonary angiograms performed on patients with and without gout at a single academic center. We noted the presence and locations of vascular green colorization using the default postprocessing two-material decomposition algorithm for MSU. The high- and low-energy grayscale images and advanced DECT measurements were used to determine whether they were true findings or artifacts. We classified artifacts into five categories: streak, contrast medium mixing, misregistration due to motion, foreign body, and noise.
Results: Our study included CT scans from 48 patients with gout and 48 age- and sex-matched controls. The majority of patients were male with a mean age of 67 years. Two independent observers attributed all areas of vascular green colorization to artifacts. The most common types of artifacts were streak (56% vs 57% between patients and controls, respectively) and contrast medium mixing (51% vs 65%, respectively). Whereas some of the default DECT measurements of cardiovascular green colorization were consistent with values reported for subcutaneous tophi, advanced DECT measurements were not consistent with that of tophi.
Conclusion: Artifacts that could be misconstrued as cardiovascular MSU deposits were commonly identified in patients with and without gout on non-EKG-gated DECT pulmonary angiograms. These artifacts can inform future vascular DECT studies on patients with gout to minimize false-positive findings.
(© 2024 American College of Rheumatology.)
Databáze: MEDLINE
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