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The Clinical Utility of Dual-Energy Computed Tomography in the Diagnosis of Gout—A Cross-Sectional Study

Dual-energy computed tomography (DECT) is an imaging technique that detects monosodium urate (MSU) deposits. This study aimed to assess the clinical utility of DECT in the diagnosis of gout. A total of 120 patients with clinical suspicion of gout who underwent DECT were retrospectively enrolled. The...

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Autores principales: Sotniczuk, Maria, Nowakowska-Płaza, Anna, Wroński, Jakub, Wisłowska, Małgorzata, Sudoł-Szopińska, Iwona
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9457243/
https://www.ncbi.nlm.nih.gov/pubmed/36079179
http://dx.doi.org/10.3390/jcm11175249
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author Sotniczuk, Maria
Nowakowska-Płaza, Anna
Wroński, Jakub
Wisłowska, Małgorzata
Sudoł-Szopińska, Iwona
author_facet Sotniczuk, Maria
Nowakowska-Płaza, Anna
Wroński, Jakub
Wisłowska, Małgorzata
Sudoł-Szopińska, Iwona
author_sort Sotniczuk, Maria
collection PubMed
description Dual-energy computed tomography (DECT) is an imaging technique that detects monosodium urate (MSU) deposits. This study aimed to assess the clinical utility of DECT in the diagnosis of gout. A total of 120 patients with clinical suspicion of gout who underwent DECT were retrospectively enrolled. The sensitivity and specificity of DECT alone, American College of Rheumatology (ACR)/European Alliance of Associations for Rheumatology (EULAR) classification criteria without DECT, and ACR/EULAR criteria with DECT were assessed. Additionally, an analysis of gout risk factors was performed. When artifacts were excluded, any MSU volume provided the best diagnostic value of DECT (AUC = 0.872, 95% CI 0.806–0.938). DECT alone had a sensitivity of 90.4% and specificity of 74.5%. Although ACR/EULAR criteria without DECT provided better diagnostic accuracy than DECT alone (AUC = 0.926, 95% CI 0.878–0.974), the best value was obtained when combing both (AUC = 0.957, 95% CI 0.924–0.991), with 100% sensitivity and 76.6% specificity. In univariate analysis, risk factors for gout were male sex, presence of tophi, presence of MSU deposits on DECT, increased uric acid in serum (each p < 0.001), and decreased glomerular filtration rate (GFR) (p = 0.029). After logistic regression, only increased serum uric acid (p = 0.034) and decreased GFR (p = 0.018) remained independent risk factors for gout. Our results suggest that DECT significantly increases the sensitivity of the ACR/EULAR criteria in the diagnosis of gout.
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spelling pubmed-94572432022-09-09 The Clinical Utility of Dual-Energy Computed Tomography in the Diagnosis of Gout—A Cross-Sectional Study Sotniczuk, Maria Nowakowska-Płaza, Anna Wroński, Jakub Wisłowska, Małgorzata Sudoł-Szopińska, Iwona J Clin Med Article Dual-energy computed tomography (DECT) is an imaging technique that detects monosodium urate (MSU) deposits. This study aimed to assess the clinical utility of DECT in the diagnosis of gout. A total of 120 patients with clinical suspicion of gout who underwent DECT were retrospectively enrolled. The sensitivity and specificity of DECT alone, American College of Rheumatology (ACR)/European Alliance of Associations for Rheumatology (EULAR) classification criteria without DECT, and ACR/EULAR criteria with DECT were assessed. Additionally, an analysis of gout risk factors was performed. When artifacts were excluded, any MSU volume provided the best diagnostic value of DECT (AUC = 0.872, 95% CI 0.806–0.938). DECT alone had a sensitivity of 90.4% and specificity of 74.5%. Although ACR/EULAR criteria without DECT provided better diagnostic accuracy than DECT alone (AUC = 0.926, 95% CI 0.878–0.974), the best value was obtained when combing both (AUC = 0.957, 95% CI 0.924–0.991), with 100% sensitivity and 76.6% specificity. In univariate analysis, risk factors for gout were male sex, presence of tophi, presence of MSU deposits on DECT, increased uric acid in serum (each p < 0.001), and decreased glomerular filtration rate (GFR) (p = 0.029). After logistic regression, only increased serum uric acid (p = 0.034) and decreased GFR (p = 0.018) remained independent risk factors for gout. Our results suggest that DECT significantly increases the sensitivity of the ACR/EULAR criteria in the diagnosis of gout. MDPI 2022-09-05 /pmc/articles/PMC9457243/ /pubmed/36079179 http://dx.doi.org/10.3390/jcm11175249 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Sotniczuk, Maria
Nowakowska-Płaza, Anna
Wroński, Jakub
Wisłowska, Małgorzata
Sudoł-Szopińska, Iwona
The Clinical Utility of Dual-Energy Computed Tomography in the Diagnosis of Gout—A Cross-Sectional Study
title The Clinical Utility of Dual-Energy Computed Tomography in the Diagnosis of Gout—A Cross-Sectional Study
title_full The Clinical Utility of Dual-Energy Computed Tomography in the Diagnosis of Gout—A Cross-Sectional Study
title_fullStr The Clinical Utility of Dual-Energy Computed Tomography in the Diagnosis of Gout—A Cross-Sectional Study
title_full_unstemmed The Clinical Utility of Dual-Energy Computed Tomography in the Diagnosis of Gout—A Cross-Sectional Study
title_short The Clinical Utility of Dual-Energy Computed Tomography in the Diagnosis of Gout—A Cross-Sectional Study
title_sort clinical utility of dual-energy computed tomography in the diagnosis of gout—a cross-sectional study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9457243/
https://www.ncbi.nlm.nih.gov/pubmed/36079179
http://dx.doi.org/10.3390/jcm11175249
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