Dual-energy computed tomography in calcium pyrophosphate deposition: initial clinical experience.
- Pascart T Department of Rheumatology, Lille Catholic Hospitals, University of Lille, F-59160 Lomme, France; EA 4490, PMOI, Physiopathologie des Maladies Osseuses Inflammatoires, University of Lille, Lille, France. Electronic address: pascart.tristan@ghicl.net.
- Norberciak L Department of Medical Research, Biostatistics, Lille Catholic Hospitals, University of Lille, Lomme, France. Electronic address: norberciak.laurene@ghicl.net.
- Legrand J Department of Diagnostic and Interventional Radiology, Lille Catholic Hospitals, University of Lille, Lomme, France. Electronic address: legrand.julie@ghicl.net.
- Becce F Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. Electronic address: fabio.becce@chuv.ch.
- Budzik JF EA 4490, PMOI, Physiopathologie des Maladies Osseuses Inflammatoires, University of Lille, Lille, France; Department of Diagnostic and Interventional Radiology, Lille Catholic Hospitals, University of Lille, Lomme, France. Electronic address: budzik.jean-francois@ghicl.net.
- 2019-05-31
Published in:
- Osteoarthritis and cartilage. - 2019
Calcium hydroxyapatite
Calcium pyrophosphate deposition
Chondrocalcinosis
Dual-energy computed tomography
Knee
Meniscus
Aged
Calcinosis
Calcium Pyrophosphate
Cartilage Diseases
Case-Control Studies
Durapatite
Female
Gout
Humans
Male
Meniscus
Middle Aged
Osteoarthritis, Knee
Tomography, X-Ray Computed
English
OBJECTIVE
To determine the dual-energy computed tomography (DECT) attenuation properties of meniscal calcifications in calcium pyrophosphate deposition (CPPD) in vivo, and assess whether DECT was able to discriminate meniscal CPP deposits from calcium hydroxyapatite (HA) in subchondral and trabecular bone.
METHOD
Patients with clinical suspicion of crystal-related arthropathy (gout and/or CPPD) and knee DECT scans were retrospectively assigned to CPPD (n = 19) or control (n = 21) groups depending on the presence/absence of chondrocalcinosis on DECT. Two observers drew standardized regions of interest (ROI) in meniscal calcifications, non-calcified menisci, as well as subchondral and trabecular bone. Five DECT parameters were obtained: CT numbers (HU) at 80 and 140 kV, dual-energy index (DEI), electron density (ρe), and effective atomic number (Zeff). The four different knee structures were compared within/between patients and controls using linear mixed models, adjusting for confounders.
RESULTS
Meniscal calcifications (n = 89) in CPPD patients had mean ± SD CT numbers at 80 and 140 kV of 257 ± 64 and 201 ± 48 HU, respectively; with a DEI of 0.023 ± 0.007, and ρe and Zeff of 140 ± 35 and 8.8 ± 0.3, respectively. Meniscal CPP deposits were readily distinguished from calcium HA in subchondral and trabecular bone (p ≤ 0.001), except at 80 kV separately (p = 0.74). Zeff and ρe both significantly differed between CPP deposits and calcium HA in subchondral and trabecular bone (p < 0.0001).
CONCLUSION
This proof-of-concept study shows that DECT has the potential to discriminate meniscal CPP deposits from calcium HA in subchondral and trabecular bone in vivo, paving the way for the non-invasive biochemical signature assessment of intra- and juxta-articular calcium crystal deposits.
To determine the dual-energy computed tomography (DECT) attenuation properties of meniscal calcifications in calcium pyrophosphate deposition (CPPD) in vivo, and assess whether DECT was able to discriminate meniscal CPP deposits from calcium hydroxyapatite (HA) in subchondral and trabecular bone.
METHOD
Patients with clinical suspicion of crystal-related arthropathy (gout and/or CPPD) and knee DECT scans were retrospectively assigned to CPPD (n = 19) or control (n = 21) groups depending on the presence/absence of chondrocalcinosis on DECT. Two observers drew standardized regions of interest (ROI) in meniscal calcifications, non-calcified menisci, as well as subchondral and trabecular bone. Five DECT parameters were obtained: CT numbers (HU) at 80 and 140 kV, dual-energy index (DEI), electron density (ρe), and effective atomic number (Zeff). The four different knee structures were compared within/between patients and controls using linear mixed models, adjusting for confounders.
RESULTS
Meniscal calcifications (n = 89) in CPPD patients had mean ± SD CT numbers at 80 and 140 kV of 257 ± 64 and 201 ± 48 HU, respectively; with a DEI of 0.023 ± 0.007, and ρe and Zeff of 140 ± 35 and 8.8 ± 0.3, respectively. Meniscal CPP deposits were readily distinguished from calcium HA in subchondral and trabecular bone (p ≤ 0.001), except at 80 kV separately (p = 0.74). Zeff and ρe both significantly differed between CPP deposits and calcium HA in subchondral and trabecular bone (p < 0.0001).
CONCLUSION
This proof-of-concept study shows that DECT has the potential to discriminate meniscal CPP deposits from calcium HA in subchondral and trabecular bone in vivo, paving the way for the non-invasive biochemical signature assessment of intra- and juxta-articular calcium crystal deposits.
- Language
-
- English
- Open access status
- bronze
- Identifiers
-
- DOI 10.1016/j.joca.2019.05.007
- PMID 31146015
- Persistent URL
- https://folia.unifr.ch/global/documents/77260
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