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Clinical Trial
. 2017 Jul 21;19(1):171.
doi: 10.1186/s13075-017-1381-2.

Ultrasonography and dual-energy computed tomography provide different quantification of urate burden in gout: results from a cross-sectional study

Tristan Pascart  1   2   3 , Agathe Grandjean  4 , Laurène Norberciak  5 , Vincent Ducoulombier  4 , Marguerite Motte  4 , Hélène Luraschi  4 , Marie Vandecandelaere  4 , Catherine Godart  4 , Eric Houvenagel  4 , Nasser Namane  6 , Jean-François Budzik  6   7
Affiliations
Clinical Trial

Ultrasonography and dual-energy computed tomography provide different quantification of urate burden in gout: results from a cross-sectional study

Tristan Pascart et al. Arthritis Res Ther. .

Abstract

Background: Ultrasonography (US) and dual-energy computed tomography (DECT) can assess urate burden in gout. The objective of this study was to compare the quantification of urate deposition provided by US to the one provided by DECT.

Methods: Patients with a diagnosis of gout were prospectively recruited to undergo quantification of urate deposition using US and DECT. US examination for tophi and the double contour (DC) sign was performed on the knees and feet and corresponding DECT scans provided volumes of tophi and of overall urate deposition. The primary endpoint was the intra-class correlation coefficient (ICC) of the volume of the index tophus measured by US and DECT and its 95% confidence interval (CI 95%).

Results: Of the 64 patients included, 34 presented with at least one tophus on US. DECT inter-reader agreement for urate deposition was perfect with an ICC of 1 (1-1) and good for the measurement of the index tophus with an ICC of 0.69 (0.47-0.83). The ICC for the measurement of the index tophus between the two techniques was poor with a value of 0.45 (0.1-0.71). The average ratio between the index tophi volume as assessed by DECT and US was 0.65. The number of DC-positive joints did not correlate with DECT volume of overall deposits (Spearman correlation coefficient of 0.23).

Conclusions: DECT measurements of tophi give smaller volumes to the same tophi measured with US, and US signs of urate deposition in joints do not correlate with overall DECT volumes of extra-articular deposition.

Keywords: Double contour; Dual-energy computed tomography; Gout; Tophus; Ultrasonography.

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Conflict of interest statement

Ethics approval and consent to participate

Ethical approval for the study was received from the Institutional Medical Ethics Review Board of the Lille Catholic Hospitals (reference number 2016-04-06). All patients provided informed consent.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
a Tophus of the first metatarsophalangeal joint assessed by ultrasonography (US) (top) and dual-energy computed tomography (DECT) (bottom). b US double contour sign. c DECT scans of the knees. d DECT scans of the feet
Fig. 2
Fig. 2
Dual energy computed tomography (DECT) and ultrasonography (US) provide different quantification of urate deposition. a Comparison of each individual tophus volume as measured by DECT (triangles) and US (squares). b Ratio of the volume measured with DECT and US for each individual tophus. c Volume of overall urate deposition measured by DECT according to the number of joints presenting with the US double contour (DC) sign
See this image and copyright information in PMC

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