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Dual-Energy Computed Tomography for Gout Diagnosis and Management

  • CRYSTAL ARTHRITIS (MH PILLINGER, SECTION EDITOR)
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Abstract

The central feature of gout is deposition of monosodium urate crystals. Dual-energy computed tomography (DECT) is a recently developed advanced imaging method that enables visualisation of urate deposits by analysis of the chemical composition of the scanned materials. This review summarises recent research describing the use of DECT in gout management. This technology may assist in both diagnosis and monitoring of the disease. Studies of patients with established disease indicate diagnostic accuracy for gout is high. Excellent inter-reader agreement has been reported for detection of urate deposits by use of DECT. Automated volume assessment software also enables rapid and reproducible measurement of urate deposits within tophi, suggesting that this modality may be useful for monitoring the disease. Although several case reports indicate DECT can be used to reveal reduction in the size of urate deposits, the sensitivity to change in response to urate-lowering therapy has not yet been systematically reported. DECT images reveal variable urate deposition within tophi of the same physical size. The ability to visualise urate deposits in tissue may provide new insights into the pathology and mechanisms of gout.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Disclosure

Dr Dalbeth has served as a consultant for Takeda Pharmaceuticals, Novartis, Ardea Biosciences, and Metabolex; has received grant support from Fonterra; and holds patents on milk products for gout with support from Fonterra. Dr Choi has served as a consultant for Takeda Pharmaceuticals and Novartis.

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Authors and Affiliations

  1. Department of Medicine, University of Auckland, Auckland, New Zealand

    Nicola Dalbeth

  2. Section of Rheumatology and the Clinical Epidemiology Unit, Boston University School of Medicine, Boston, MA, USA

    Hyon K. Choi

  3. Bone and Joint Research Group, Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, 85 Park Rd, Grafton, Auckland, 1023, New Zealand

    Nicola Dalbeth

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  1. Nicola Dalbeth
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  2. Hyon K. Choi
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Correspondence to Nicola Dalbeth.

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This article is part of the Topical Collection on Crystal Arthritis

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Dalbeth, N., Choi, H.K. Dual-Energy Computed Tomography for Gout Diagnosis and Management. Curr Rheumatol Rep 15, 301 (2013). https://doi.org/10.1007/s11926-012-0301-3

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  • DOI: https://doi.org/10.1007/s11926-012-0301-3

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