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Advanced imaging assessment of gout: comparison of dual-energy CT and MRI with anatomical pathology
  1. Ashika Chhana1,
  2. Anthony Doyle2,
  3. Amy Sevao2,
  4. Satya Amirapu2,
  5. Peter Riordan2,
  6. Michael Dray3,
  7. Sue McGlashan2,
  8. Jillian Cornish1,
  9. Nicola Dalbeth1
  1. 1 Bone & Joint Research Group, Department of Medicine, University of Auckland, Auckland, New Zealand
  2. 2 Department of Anatomy and Medical Imaging, University of Auckland, Auckland, New Zealand
  3. 3 Histology Department, Waikato Hospital, Hamilton, New Zealand
  1. Correspondence to Dr Ashika Chhana, Bone & Joint Research Group, Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, 85 Park Rd, Grafton, Auckland 1142, New Zealand; a.chhana{at}auckland.ac.nz

http://dx.doi.org/10.1136/annrheumdis-2017-211343

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    Dual-energy CT (DECT) and MRI are advanced imaging methods used to visualise gout pathology. DECT can identify monosodium urate (MSU) crystals in people with gout,1 ,2 and also has conventional CT properties, allowing assessment of tophus and bone pathology.3 ,4 MRI is used to assess inflammation, bone erosion and cartilage damage in gout.5–7 This study aimed to compare DECT and MRI with corresponding anatomical pathology in the assessment of gout.

    Cadaveric joint specimens were obtained from two donors; a donor aged 82 years with crystal-proven tophaceous gout and a control donor aged 89 years without gout (12 joints from each).

    All joints were scanned by DECT (SOMATOM Definition Flash, Siemens Medical, Erlangen, Germany) and MRI (3T MAGNETOM Skyra, Siemens Medical), and then processed for histology, including digital photography of sectioned digits (sagittal plane) for macroscopic analysis, and preparation of histology slides from each individual joint for microscopic analysis. Slides were stained with H&E or 1% toluidine blue. Collection and use of cadaveric tissue was in accordance with the New Zealand Human Tissue Act 2008.

    All images and histology data were systematically assessed for gout pathology by experienced readers who were blinded to diagnosis and each other's scores. …

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    Footnotes

    • Contributors AC (the guarantor) accepts full responsibility for the work and the conduct of the study, had access to the data and controlled the decision to publish. Design of study protocol: AC, AD, MD, SM, JC and ND. Collection of cadaveric tissue samples: AC, PR and ND. Acquisition of study data: AC, AD, AS, SA and ND. Data analysis: AC, AD and ND. Interpretation of data: AC, AD, MD, SM, JC and ND. Drafting of manuscript: AC and ND. Final approval of manuscript: all authors.

    • Funding This study was funded by a University of Auckland PBRF grant (9801/3704255).

    • Competing interests ND has received consulting fees, speaker fees or grants from Takeda, Teijin, Menarini, Pfizer, Ardea, AstraZeneca, Cymabay, Fonterra and Crealta, outside the submitted work.

    • Provenance and peer review Not commissioned; internally peer reviewed.