Benefits of single-source dual-energy CT over MRI in osteitis detection

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Benefits of single-source dual-energy CT over MRI in osteitis detection

Dual-energy computed tomography (CT) can detect tophi in patients with chronic gout. Nevertheless, other information that can be obtained from the same scan was not the focus of the research by  Diekhoff and colleagues, e.g., the detection of bone marrow edema (BME) via virtual bone marrow imaging (VBMI). The study was focused on estimating whether if BME in patients with acute arthritis can be solved with VBMI using magnetic resonance imaging (MRI) as the standard of reference.

Eleven patients were included in this retrospective study. These patients underwent both MRI and dual-energy computed tomography (mean interval of 40 days). Two different blinded readers independently determined the BME in MRI (standard of reference) and VBMI. For statistical analysis, φ-correlation coefficient and Cohen’s κ were executed.

On MRI and VBMI, osteitis was revealed in two patients with a final diagnosis of RA and one with septic arthritis. However, there were individual bones in each case recognized with osteitis on MRI, but not VBMI. Additionally, three patients with the final diagnosis of RA were recognized correctly as negative for BME and a good correlation was observed between both modalities (φ = 0.8; κ = 0.8). The inter-rater reliability was superior for both modalities (κ = 0.9).

It was concluded that detecting osteitis using VBMI is suitable for patients with inflammatory arthritis. Although, further studies are required on larger, more-targeted populations to better define the indications, accuracy, and added value of this method.


Skeletal radiology

Link to the source:

The original title of the article:

Osteitis: a retrospective feasibility study comparing single-source dual-energy CT to MRI in selected patients with suspected acute gout


Torsten Diekhoff et al.

Diagnostic, Osteitis, Magnetic resonance imaging (MRI), Virtual bone marrow imaging (VBMI), Gout, RA, Arthritis, Joints, Chronic, Retrospective study
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