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DECT urate deposits: now you see them, now you don't
  1. Fiona Marion Florence McQueen1,2,
  2. Anthony J Doyle3,
  3. Quentin Reeves3,
  4. Greg D Gamble4,
  5. Nicola Dalbeth2,4
  1. 1Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
  2. 2Department of Rheumatology, Greenlane Clinical Centre, Auckland District Health Board, Auckland, New Zealand
  3. 3Department of Radiology, Auckland City Hospital, Auckland District Health Board, Auckland, New Zealand
  4. 4Bone and Joint Research Group, Department of Medicine, University of Auckland, Auckland, New Zealand
  1. Correspondence to Professor Fiona Marion Florence McQueen, Department of Molecular Medicine and Pathology, University of Auckland, 85 Park Road, Grafton, Auckland 92019, New Zealand; f.mcqueen{at}auckland.ac.nz

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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 …

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