Clinical utility of Dual Energy Computed Tomography in gout: current concepts and applications

Main Article Content

Marina Carotti
Fausto Salaffi
Emilio Filippucci
Giacomo Aringhieri
Federico Bruno
Sabrina Giovine
Francesco Gentili
Chiara Floridi
Alessandra Borgheresi
Massimo De Filippo
Carlo Masciocchi
Antonio Barile https://orcid.org/0000-0003-0253-3583
Andrea Giovagnoni

Keywords

gout, dual-energy computed tomography, ultrasonography, imaging, diagnosis, tophaceous gout, non-tophaceous gout

Abstract

Gout is the most common inflammatory arthritis and is increasing in prevalence and incidence in many countries worldwide. Dual Energy Computed Tomography (DECT) has a high diagnostic accuracy in established gout, but its diagnostic sensitivity is low in subjects with recent-onset gout. A meta-analysis of 17 studies showed a pooled sensitivity and specificity of 0.85 and 0.88, respectively. DECT is a useful diagnostic tool for patients with contraindications for joint aspiration or for those who refuse joint aspiration. This article aims to give an up to date review and summary of existing literature on the role and accuracy of DECT in the imaging of gout.

Abstract 796 | PDF Downloads 287

References

1. Dalbeth N, Merriman TR, Stamp LK. Gout. Lancet (London, England) 2016; 388: 2039-2052.
2. Trifiro G, Morabito P, Cavagna L, et al. Epidemiology of gout and hyperuricaemia in Italy during the years 2005-2009: a nationwide population-based study. Annals of the rheumatic diseases 2013; 72: 694-700.
3. Scire CA, Manara M, Cimmino MA, et al. Gout impacts on function and health-related quality of life beyond associated risk factors and medical conditions: results from the KING observational study of the Italian Society for Rheumatology (SIR). Arthritis research & therapy 2013; 15: R101.
4. Clarson LE, Hider SL, Belcher J, Heneghan C, Roddy E, Mallen CD. Increased risk of vascular disease associated with gout: a retrospective, matched cohort study in the UK clinical practice research datalink. Annals of the rheumatic diseases 2015; 74: 642-7.
5. McQueen FM, Chhana A, Dalbeth N. Mechanisms of joint damage in gout: evidence from cellular and imaging studies. Nature reviews. Rheumatology 2012; 8: 173-81.
6. Agliata G, Schicchi N, Agostini A, et al. Radiation exposure related to cardiovascular CT examination: comparison between conventional 64-MDCT and third-generation dualsource MDCT. La Radiologia medica 2019; 124: 753-761.
7. Agostini A, Mari A, Lanza C, et al. Trends in radiation dose and image quality for pediatric patients with a multidetector CT and a third-generation dual-source dual-energy CT. La Radiologia medica 2019; 124: 745-752.
8. Mariani S, La Marra A, Arrigoni F, et al. Dynamic measurement of patello-femoral joint alignment using weight-bearing magnetic resonance imaging (WB-MRI). European journal of radiology 2015; 84: 2571-8
9. Di Pietto F, Chianca V, de Ritis R, et al. Postoperative imaging in arthroscopic hip surgery. Musculoskeletal surgery 2017; 101: 43-49.
10. Perrotta FM, Astorri D, Zappia M, Reginelli A, Brunese L, Lubrano E. An ultrasonographic study of enthesis in early psoriatic arthritis patients naive to traditional and biologic DMARDs treatment. Rheumatology international 2016; 36: 1579-1583.
11. Bruno F, Barile A, Arrigoni F, et al. Weight-bearing MRI of the knee: a review of advantages and limits. Acta bio-medica : Atenei Parmensis 2018; 89: 78-88.
12. Cazzato RL, Arrigoni F, Boatta E, et al. Percutaneous management of bone metastases: state of the art, interventional strategies and joint position statement of the Italian College of MSK Radiology (ICoMSKR) and the Italian College of Interventional Radiology (ICIR). La Radiologia medica 2019; 124: 34-49.
13. Michelini G, Corridore A, Torlone S, et al. Dynamic MRI in the evaluation of the spine: state of the art. Acta Biomed 2018; 89: 89-101
14. Zoccali C, Arrigoni F, Mariani S, Bruno F, Barile A, Masciocchi C. An unusual localization of chondroblastoma: The triradiate cartilage; from a case report a reconstructive technique proposal with imaging evolution. Journal of clinical orthopaedics and trauma 2017; 8: S48-s52.
15. Di Geso L, Zardi EM, Afeltra A, et al. Comparison between conventional and automated software-guided ultrasound assessment of bilateral common carotids intima-media thickness in patients with rheumatic diseases. Clinical rheumatology 2012; 31: 881-4.
16. Salvati F, Rossi F, Limbucci N, et al. Mucoid metaplastic-degeneration of anterior cruciate ligament. The Journal of sports medicine and physical fitness 2008; 48: 483-487
17. Salaffi F, Carotti M, Bosello S, et al. Computer-aided quantification of interstitial lung disease from high resolution computed tomography images in systemic sclerosis: correlation with visual reader-based score and physiologic tests. BioMed research international 2015; 2015: 834262.
18. Salaffi F, Carotti M, Di Carlo M, Farah S, Gutierrez M. Adherence to Anti-Tumor Necrosis Factor Therapy Administered Subcutaneously and Associated Factors in Patients With Rheumatoid Arthritis. Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases 2015; 21: 419-25.
19. Zappia M, Castagna A, Barile A, et al. Imaging of the coracoglenoid ligament: a third ligament in the rotator interval of the shoulder. Skeletal Radiology 2017; 46: 1101-1111
20. Masciocchi C, Arrigoni F, Ferrari F, et al. Uterine fibroid therapy using interventional radiology mini-invasive treatments: current perspective. Med Oncol 2017; 34: 52
21. Zoccali C, Rossi B, Zoccali G, et al. A new technique for biopsy of soft tissue neoplasms: a preliminary experience using MRI to evaluate bleeding. Minerva Med 2015; 106: 117-120
22. Bruno F, Arrigoni F, Palumbo P, et al. The Acutely Injured Wrist. Radiol Clin North Am 2019; 57: 943-55
23. Arrigoni F, Bruno F, Zugaro L, et al. Developments in the management of bone metastases with interventional radiology. Acta Biomed 2018; 89: 166-74
24. De Filippo M, Pesce A, Barile A, et al. Imaging of postoperative shoulder instability. Musculoskeletal surgery 2017; 101: 15-22.
25. Pogliacomi F, De Filippo M, Paraskevopoulos A, Alesci M, Marenghi P, Ceccarelli F. Mini-incision direct lateral approach versus anterior mini-invasive approach in total hip replacement: results 1 year after surgery. Acta bio-medica : Atenei Parmensis 2012; 83: 114-21.
26. Giordano AV, Arrigoni F, Bruno F, et al. Interventional Radiology Management of a Ruptured Lumbar Artery Pseudoaneurysm after Cryoablation and Vertebroplasty of a Lumbar Metastasis. Cardiovasc Intervent Radiol 2017; 40: 776-79
27. Carrafiello G, Ierardi AM, Duka E, et al. Usefulness of Cone- Beam Computed Tomography and Automatic Vessel Detection Software in Emergency Transarterial Embolization. Cardiovascular and interventional radiology 2016; 39: 530-7.
28. Perri M, Grattacaso G, di Tunno V, et al. T2 shine-through phenomena in diffusion-weighted MR imaging of lumbar discs after oxygen-ozone discolysis: a randomized, double blind trial with steroid and O2-O3 discolysis versus steroid only. Radiol Med 2015; 120: 941-50
29. Bongartz T, Glazebrook KN, Kavros SJ, et al. Dual-energy CT for the diagnosis of gout: an accuracy and diagnostic yield study. Annals of the rheumatic diseases 2015; 74: 1072-7.
30. Lee YH, Song GG. Diagnostic accuracy of dual-energy computed tomography in patients with gout: A meta-analysis. Seminars in arthritis and rheumatism 2017; 47: 95-101.
31. Neogi T, Jansen TL, Dalbeth N, et al. 2015 Gout classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Annals of the rheumatic diseases 2015; 74: 1789-98.
32. Chhana A, Callon KE, Dray M, et al. Interactions between tenocytes and monosodium urate monohydrate crystals: implications for tendon involvement in gout. Annals of the rheumatic diseases 2014; 73: 1737-41.
33. Naredo E, Uson J, Jimenez-Palop M, et al. Ultrasound-detected musculoskeletal urate crystal deposition: which joints and what findings should be assessed for diagnosing gout? Annals of the rheumatic diseases 2014; 73: 1522-8.
34. Carotti M, Salaffi F, Ciapetti A. Computed Tomography in Tophaceous Gout. The Journal of Rheumatology 2010; 37: 1267-1268.
35. Dalbeth N, Kalluru R, Aati O, Horne A, Doyle AJ, Mc- Queen FM. Tendon involvement in the feet of patients with gout: a dual-energy CT study. Annals of the rheumatic diseases 2013; 72: 1545-8.
36. Therimadasamy A, Peng YP, Putti TC, Wilder-Smith EP. Carpal tunnel syndrome caused by gouty tophus of the flexor tendons of the fingers: sonographic features. Journal of clinical ultrasound : JCU 2011; 39: 463-5.
37. Grainger R, Dalbeth N, Keen H, et al. Imaging as an Outcome Measure in Gout Studies: Report from the OMERACT Gout Working Group. J Rheumatol 2015; 42: 2460-4.
38. Ogdie A, Taylor WJ, Weatherall M, et al. Imaging modalities for the classification of gout: systematic literature review and meta-analysis. Annals of the rheumatic diseases 2015; 74: 1868-74.
39. Choi HK, Burns LC, Shojania K, et al. Dual energy CT in gout: a prospective validation study. Annals of the rheumatic diseases 2012; 71: 1466-71.
40. Jia E, Zhu J, Huang W, Chen X, Li J. Dual-energy computed tomography has limited diagnostic sensitivity for short-term gout. Clinical rheumatology 2018; 37: 773-777.
41. Baer AN, Kurano T, Thakur UJ, et al. Dual-energy computed tomography has limited sensitivity for non-tophaceous gout: a comparison study with tophaceous gout. BMC musculoskeletal disorders 2016; 17: 91.
42. Dalbeth N, House ME, Aati O, et al. Urate crystal deposition in asymptomatic hyperuricaemia and symptomatic gout: a dual energy CT study. Annals of the rheumatic diseases 2015; 74: 908-11.
43. Wang P, Smith SE, Garg R, et al. Identification of monosodium urate crystal deposits in patients with asymptomatic hyperuricemia using dual-energy CT. RMD open 2018; 4: e000593.
44. Chen J, Liao M, Zhang H, Zhu D. Diagnostic accuracy of dual-energy CT and ultrasound in gouty arthritis : A systematic review. Zeitschrift fur Rheumatologie 2017; 76: 723-729.
45. Wang Y, Deng X, Xu Y, Ji L, Zhang Z. Detection of uric acid crystal deposition by ultrasonography and dual-energy computed tomography: A cross-sectional study in patients with clinically diagnosed gout. Medicine 2018; 97: e12834.
46. Klauser AS, Halpern EJ, Strobl S, et al. Gout of hand and wrist: the value of US as compared with DECT. European radiology 2018; 28: 4174-4181.
47. Terslev L, Gutierrez M, Christensen R, et al. Assessing Elementary Lesions in Gout by Ultrasound: Results of an OMERACT Patient-based Agreement and Reliability Exercise. J Rheumatol 2015; 42: 2149-54.
48. Di Matteo A, Filippucci E, Cipolletta E, et al. Hip Involvement in Patients With Calcium Pyrophosphate Deposition Disease: Potential and Limits of Musculoskeletal Ultrasound. Arthritis care & research 2019; 71: 1671-1677.
49. Bayat S, Baraf HSB, Rech J. Update on imaging in gout: contrasting and comparing the role of dual-energy computed tomography to traditional diagnostic and monitoring techniques. Clinical and experimental rheumatology 2018; 36 Suppl 114: 53-60.
50. Cortellini A, Bozzetti F, Palumbo P, et al. Weighing the role of skeletal muscle mass and muscle density in cancer patients receiving PD-1/PD-L1 checkpoint inhibitors: a multicenter real-life study. Scientific reports 2020; 10: 1456.
51. Dalbeth N, Billington K, Doyle A, et al. Effects of Allopurinol Dose Escalation on Bone Erosion and Urate Volume in Gout: A Dual-Energy Computed Tomography Imaging Study Within a Randomized, Controlled Trial. Arthritis & rheumatology (Hoboken, N.J.) 2019; 71: 1739-1746.
52. Cipriani P, Ruscitti P, Carubbi F, Liakouli V, Giacomelli R. Methotrexate in rheumatoid arthritis: optimizing therapy among different formulations. Current and emerging paradigms. Clinical therapeutics 2014; 36: 427-35.
53. Giacomelli R, Gorla R, Trotta F, et al. Quality of life and unmet needs in patients with inflammatory arthropathies: results from the multicentre, observational RAPSODIA study. Rheumatology (Oxford, England) 2015; 54: 792-7.
54. Giacomelli R, Afeltra A, Alunno A, et al. Guidelines for biomarkers in autoimmune rheumatic diseases - evidence based analysis. Autoimmunity reviews 2019; 18: 93-106.
55. Giacomelli R, Ruscitti P, Shoenfeld Y. A comprehensive review on adult onset Still’s disease. Journal of autoimmunity 2018; 93: 24-36.
56. Ruscitti P, Iacono D, Ciccia F, et al. Macrophage Activation Syndrome in Patients Affected by Adult-onset Still Disease: Analysis of Survival Rates and Predictive Factors in the Gruppo Italiano di Ricerca in Reumatologia Clinica e Sperimentale Cohort. J Rheumatol 2018; 45: 864-872.
57. Ruscitti P, Cipriani P, Ciccia F, et al. Prognostic factors of macrophage activation syndrome, at the time of diagnosis, in adult patients affected by autoimmune disease: Analysis of 41 cases collected in 2 rheumatologic centers. Autoimmunity reviews 2017; 16: 16-21.
58. Cipriani P, Di Benedetto P, Ruscitti P, et al. Perivascular Cells in Diffuse Cutaneous Systemic Sclerosis Overexpress Activated ADAM12 and Are Involved in Myofibroblast Transdifferentiation and Development of Fibrosis. J Rheumatol 2016; 43: 1340-9.
59. Carotti M, Salaffi F, Di Carlo M, Giovagnoni A. Relationship between magnetic resonance imaging findings, radiological grading, psychological distress and pain in patients with symptomatic knee osteoarthritis. La Radiologia medica 2017; 122: 934-943.
60. Russo S, Lo Re G, Galia M, et al. Videofluorography swallow study of patients with systemic sclerosis. La Radiologia medica 2009; 114: 948-59.
61. Bruno F, Arrigoni F, Palumbo P, et al. New advances in MRI diagnosis of degenerative osteoarthropathy of the peripheral joints. La Radiologia medica 2019; 124: 1121-1127.
62. Arrigoni F, Napoli A, Bazzocchi A, et al. Magnetic-resonance- guided focused ultrasound treatment of non-spinal osteoid osteoma in children: multicentre experience. Pediatric radiology 2019; 49: 1209-1216.
63. Carrafiello G, Lagana D, Pellegrino C, et al. Ablation of painful metastatic bone tumors: a systematic review. International journal of surgery (London, England) 2008; 6 Suppl 1: S47- 52.
64. Barile A, Arrigoni F, Bruno F, et al. Present role and future perspectives of interventional radiology in the treatment of painful bone lesions. Future oncology (London, England) 2018; 14: 2945-2955.
65. Reginelli A, Silvestro G, Fontanella G, et al. Validation of DWI in assessment of radiotreated bone metastases in elderly patients. International journal of surgery (London, England) 2016; 33 Suppl 1: S148-53.
66. Finkenstaedt T, Manoliou A, Toniolo M, et al Gouty arthritis: the diagnostic and therapeutic impact of dual-energy CT. 2016 Eur Radiol:1–11
67. Araujo EG, Bayat S, Petsch C, et al. Tophus resolution with pegloticase: a prospective dual-energy CT study. RMD open 2015; 1: e000075