Computed tomography in rheumatology – From DECT to high-resolution peripheral quantitative CT

Girish, Gandikota; Fakuda, Takeshi; Finzel, Stephanie

doi:10.1016/j.berh.2020.101641

Cited by 11 publications

(9 citation statements)

References 74 publications

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“…For structural joint changes such as bone erosions, the Study grouP for xtrEme‐Computed Tomography in Rheumatoid Arthritis (SPECTRA) collaboration has created a common consensus on how to define and measure these lesions using HR‐pQCT 27 . However, the collaboration has not yet agreed on a definition for BPs 27 . With no standard definition or standard measurement methodology for BPs, direct comparison of study results is not without limitations.…”

Section: Discussionmentioning

confidence: 99%

“…BPs have a clinical interest as studies have reported the number and size are associated with pain and dysfunction in PsA‐, RA‐ and OA patients 3–5,11,18,19 . For structural joint changes such as bone erosions, the Study grouP for xtrEme‐Computed Tomography in Rheumatoid Arthritis (SPECTRA) collaboration has created a common consensus on how to define and measure these lesions using HR‐pQCT 27 . However, the collaboration has not yet agreed on a definition for BPs 27 .…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5]11,18,19 For structural joint changes such as bone erosions, the Study grouP for xtrEme-Computed Tomography in Rheumatoid Arthritis (SPECTRA) collaboration has created a common consensus on how to define and measure these lesions using HR-pQCT. 27 neural networks. 28 For future developments of this technology together with future reporting on BPs, agreements on characteristics and measurement techniques are needed to enable comparable and validated outcome measures.…”

Section: Definitions and Measurement Techniques Of Bpsmentioning

confidence: 99%

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Bony proliferations in rheumatoid arthritis, psoriatic arthritis and osteoarthritis using high‐resolution peripheral quantitative computed tomography—A systematic literature review

Moen,

Hänel,

Therkildsen

et al. 2024

Int J of Rheum Dis

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PurposeOsteoarthritis (OA), rheumatoid arthritis (RA), and psoriatic arthritis (PsA) can all lead to the formation of bony proliferations (BP). This systematic review aimed to examine the characteristics of BPs in patients with RA, PsA, OA, and healthy controls (HC) using high‐resolution peripheral quantitative computed tomography (HR‐pQCT). Secondarily, we examined any treatment‐related effect on BP number and size.MethodsA systematic literature search was conducted in PubMed and Embase, and a total of 15 studies were included.ResultsSeven studies demonstrated a disease‐specific variation in BP location. One study showed no difference in the number of BPs between patients with PsA and OA. The number of BPs was greater in patients with PsA compared to RA in one study, and to HC in another study, while one study documented no difference in the number of BPs between patients with RA and HC. Five studies showed larger BPs in patients with PsA compared to HC, and one study larger BPs in patients with PsA compared to RA. One study showed no difference in BP size between patients with PsA and OA. Secukinumab may have a potential effect on arresting BP progression. Otherwise, no other treatment was reported to influence BP size and progression. No standard definitions or measurement techniques for BPs using HR‐pQCT have been identified.ConclusionBPs showed disease‐specific variations in location, size, and number. Results regarding treatment‐related effects are sparse. An agreement on the definition and measurement technique for BPs using HR‐pQCT is warranted for diagnostic accuracy, disease comparability, and monitoring potential.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Definitions and Measurement Techniques Of Bpsmentioning

confidence: 99%

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Bony proliferations in rheumatoid arthritis, psoriatic arthritis and osteoarthritis using high‐resolution peripheral quantitative computed tomography—A systematic literature review

Moen,

Hänel,

Therkildsen

et al. 2024

Int J of Rheum Dis

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“…DECT is particularly beneficial in assessing atypical presentations of CPPD or sites where aspiration is unavailable, as gout and pseudogout can be clinically indistinguishable in the hands and wrist [29]. Figure 3 demonstrates a scenario in which DECT differentiated between monosodium urate crystals and calcium pyrophosphate crystals in the hand [30]. Collagen density mapping can also provide information regarding the ligament integrity of patients with CPPD.…”

Section: Inflammatory Arthropathiesmentioning

confidence: 99%

Updates on the Applications of Spectral Computed Tomography for Musculoskeletal Imaging

Eibschutz,

Matcuk,

Chiu

et al. 2024

Diagnostics

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Spectral CT represents a novel imaging approach that can noninvasively visualize, quantify, and characterize many musculoskeletal pathologies. This modality has revolutionized the field of radiology by capturing CT attenuation data across multiple energy levels and offering superior tissue characterization while potentially minimizing radiation exposure compared to traditional enhanced CT scans. Despite MRI being the preferred imaging method for many musculoskeletal conditions, it is not viable for some patients. Moreover, this technique is time-consuming, costly, and has limited availability in many healthcare settings. Thus, spectral CT has a considerable role in improving the diagnosis, characterization, and treatment of gout, inflammatory arthropathies, degenerative disc disease, osteoporosis, occult fractures, malignancies, ligamentous injuries, and other bone-marrow pathologies. This comprehensive review will delve into the diverse capabilities of dual-energy CT, a subset of spectral CT, in addressing these musculoskeletal conditions and explore potential future avenues for its integration into clinical practice.

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“…The simplest case of 1-material decomposition, which binarizes an image into MSU or not MSU, is referred to herein as dual-thresholding (DT) method. 16,17 These implementations have reported limitations for MSU detection to crystal aggregates greater than 2 mm 12,18 and serum urate concentrations greater than 8.5 mg/dL, 7,19 both of which are typically found in gout patients more than 6 weeks at the time of diagnosis. These techniques are susceptible to voxel misclassification arising from (1) beam-hardening artifacts typically related to bone or metal, which alter the apparent HU values of tissues; (2) nontarget tissues within the HU range of either material pair; (3) threshold values based on high concentrations of MSU, potentially resulting in misclassification of lowconcentration MSU deposits; and (4) partial volume effects.…”

mentioning

confidence: 99%

Assessing the Sensitivity of Dual-Energy Computed Tomography 3-Material Decomposition for the Detection of Gout

Tse

Kondro²,

Kuczynski

et al. 2022

Invest Radiol

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ObjectivesThe aim of this study was to assess the accuracy and precision of a novel application of 3-material decomposition (3MD) with virtual monochromatic images (VMIs) in the dual-energy computed tomography (DECT) assessment of monosodium urate (MSU) and hydroxyapatite (HA) phantoms compared with a commercial 2-material decomposition (2MD) and dual-thresholding (DT) material decomposition methods.Materials and MethodsMonosodium urate (0.0, 3.4, 13.3, 28.3, and 65.2 mg/dL tubes) and HA (100, 400, and 800 mg/cm3 tubes) phantoms were DECT scanned individually and together in the presence of the foot and ankle of 15 subjects. The raw data were decomposed with 3MD-VMI, 2MD, and DT to produce MSU-only and HA-only images. Mean values of 10 × 10 × 10–voxel volumes of interest (244 μm3) placed in each MSU and HA phantom well were obtained and compared with their known concentrations and across measurements with subjects' extremities to obtain accuracy and precision measures. A statistical difference was considered significant if P < 0.05.ResultsCompared with known phantom standards, 3MD-VMI was accurate for the detection of MSU concentrations as low as 3.4 mg/dL (P = 0.75). In comparison, 2MD was limited to 13.3 mg/dL (P = 0.06) and DT was unable to detect MSU concentrations below 65.2 mg/L (P = 0.16). For the HA phantom, 3MD-VMI and 2MD were accurate for all concentrations including the lowest at 100 mg/cm3 (P = 0.63 and P = 0.55, respectively). Dual-thresholding was not useful for the decomposition of HA phantom. Precision was high for both 3MD-VMI and 2MD measurements for both MSU and HA phantoms. Qualitatively, 3MD-VMI MSU-only images demonstrated reduced beam-hardening artifact and voxel misclassification, compared with 2MD and DT.ConclusionsThree-material decomposition-VMI DECT is accurate for quantification of MSU and HA concentrations in phantoms and accurately detects a lower concentration of MSU than either 2MD or DT. For concentration measurements of both MSU and HA phantoms, 3MD-VMI and 2MD have high precision, but DT had limitations. Clinical implementation of 3MD-VMI DECT promises to improve the performance of this imaging modality for diagnosis and treatment monitoring of gout.

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Computed tomography in rheumatology – From DECT to high-resolution peripheral quantitative CT

Cited by 11 publications

References 74 publications

Bony proliferations in rheumatoid arthritis, psoriatic arthritis and osteoarthritis using high‐resolution peripheral quantitative computed tomography—A systematic literature review

Bony proliferations in rheumatoid arthritis, psoriatic arthritis and osteoarthritis using high‐resolution peripheral quantitative computed tomography—A systematic literature review

Updates on the Applications of Spectral Computed Tomography for Musculoskeletal Imaging

Assessing the Sensitivity of Dual-Energy Computed Tomography 3-Material Decomposition for the Detection of Gout

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