Differentiation of Crystals Associated With Arthropathies by Spectral Photon-Counting Radiography: A Proof-of-Concept Study.
Journal
Investigative radiology
ISSN: 1536-0210
Titre abrégé: Invest Radiol
Pays: United States
ID NLM: 0045377
Informations de publication
Date de publication:
01 03 2021
01 03 2021
Historique:
pubmed:
28
8
2020
medline:
16
10
2021
entrez:
28
8
2020
Statut:
ppublish
Résumé
The aims of this study were to test whether spectral photon-counting radiography (SPCR) is able to identify and distinguish different crystals associated with arthropathies in vitro and to validate findings in a gouty human third toe ex vivo. Industry-standard calibration rods of calcium pyrophosphate, calcium hydroxyapatite (HA), and monosodium urate (MSU) were scanned with SPCR in an experimental setup. Each material was available at 3 different concentrations, and a dedicated photon-counting detector was used for SPCR, whereas validation scans were obtained on a clinical dual-energy computed tomography (DECT) scanner. Regions of interest were placed on SPCR images and consecutive DECT images to measure x-ray attenuation characteristics, including effective atomic numbers (Zeff). Statistical tests were performed for differentiation of Zeff between concentrations, materials, and imaging modalities. In addition, a third toe from a patient with chronic gouty arthritis was scanned with SPCR and DECT for differentiation of MSU from HA. In both SPCR and DECT, significant differences in attenuation and Zeff values were found for different concentrations among (P < 0.001) and between different materials (P < 0.001). Overall, quantitative measurements of Zeff did not differ significantly between SPCR- and DECT-derived measurements (P = 0.054-0.412). In the human cadaver toe, gouty bone erosions were visible on standard grayscale radiographic images; however, spectral image decomposition revealed the nature and extent of MSU deposits and was able to separate it from bone HA by Zeff. Identification and differentiation of different crystals related to arthropathies are possible with SPCR at comparable diagnostic accuracy to DECT. Further research is needed to assess diagnostic accuracy and clinical usability in vivo.
Identifiants
pubmed: 32852444
pii: 00004424-202103000-00003
doi: 10.1097/RLI.0000000000000717
doi:
Substances chimiques
Calcium Pyrophosphate
X69NU20D19
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
147-152Informations de copyright
Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
S.G. and T.T. are full-time employees of Dectris Ltd, a company with headquarters in Switzerland that supported us with the detector prototype used for this investigation. The remainder of the authors have no conflicts of interest. All experimental settings and the study conduct were initiated by the scientific guarantor (R.G.) and by F.A.H. who have no affiliation with the aforementioned company.
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