Diagnostic efficacy of joint ultrasonography, dual-energy computed tomography and minimally invasive arthroscopy on knee gouty arthritis, a comparative study

2021 ◽  
pp. 20200493
Author(s):  
Yuesheng Xie ◽  
Ling Li ◽  
Riqiang Luo ◽  
Ting Xu ◽  
Lin Yang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Knee Joint ◽  
Minimally Invasive ◽  
Sensitivity And Specificity ◽  
Gold Standard ◽  
Diagnostic Performance ◽  
Gouty Arthritis ◽  
High Sensitivity ◽  
Dual Energy ◽  
Double Contour

Objective: This study aimed to investigate the diagnostic performance of minimally invasive arthroscopy for knee gout when comparing with joint ultrasonography and dual-energy computed tomography (DECT). Methods: From January 2016 to December 2018, 121 inpatients with knee joint swelling and pain were prospectively enrolled, including 63 gout patients and 58 non-gout patients. All patients underwent pre-operative ultrasonography and DECT to evaluate knee joint monosodium urate (MSU) deposits, followed by minimally invasive arthroscopy. The gold-standard for gout diagnosis was defined as the detection of MSU crystals in the synovial fluid under polarizing microscopic or pathological analysis. Results: The diagnostic results of ultrasonic double contour sign, hyperechogenic foci, MSU deposition (detected by DECT), MSU deposition (detected by arthroscopy) and MSU deposition in cartilage (detected by arthroscopy) were significantly associated with that of the gold-standard. Except for hyperechogenic foci, the other four indexes had high sensitivity and specificity (approximately or over 80%) and a large odds ratio (OR) (14.73 to 36.56), indicating good diagnostic performance. Detection of MSU deposition in cartilage by arthroscopy had a good diagnostic agreement with the ultrasonic double contour sign (κ = 0.711, p < 0.001). Conclusion: Joint ultrasonography, DECT, and minimally invasive arthroscopy had high sensitivity and specificity for the diagnosis of knee gouty arthritis. Minimally invasive arthroscopy was superior to joint ultrasonography and DECT, which can be a useful supplement for the diagnosis of gout. Advances in knowledge: This is the first study comparing the diagnostic performance for knee gout among the joint ultrasonography, DECT, and minimally invasive arthroscopy.

scholarly journals OP0318 THE ROLE OF DUAL ENERGY COMPUTED TOMOGRAPHY (DECT) IN THE DIFFERENTIATION OF GOUT AND CALCIUM PYROPHOSPHATE DEPOSITION DISEASE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 196.2-196 ◽  
Author(s):  
D. Kravchenko ◽  
P. Karakostas ◽  
P. Brossart ◽  
C. Behning ◽  
C. Meyer ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Uric Acid ◽  
Sensitivity And Specificity ◽  
Gold Standard ◽  
Calcium Pyrophosphate ◽  
Dual Energy ◽  
Laboratory Parameters ◽  
Dual Energy Computed Tomography ◽  
Non Invasive ◽  
Calcium Pyrophosphate Deposition Disease

Background:Differentiation of gout and calcium pyrophosphate deposition disease (CPPD) is sometimes difficult as patients often present with a similar clinical picture. Arthrocentesis and subsequent polarization microscopy (PM) remains the gold standard but novel diagnostic approaches such as non-invasive dual energy computed tomography (DECT) have recently been validated for gout. Currently, limited data is available on DECT in patients with CPPD.Objectives:To analyse the diagnostic impact of DECT in gout and CPPD when compared to the gold standard of PM. We further compared the results of PM to ultrasound (US), conventional radiographs (CR), and suspected clinical diagnosis (SCD). Additionally, 15 laboratory parameters were analysed.Methods:Twenty-six patients diagnosed with gout (n = 18) or CPPD (n = 8) who received a DECT and underwent arthrocentesis were included. Two independent readers assessed colour coded, as well as 80 and 120 kV DECT images for signs of monosodium urate (MSU) crystals or CPP deposition. US and CR from the patient’s initial visit along with the SCD were also compared to PM. US examinations were performed by certified musculoskeletal ultrasound specialists. The association of up to 15 laboratory parameters such as uric acid, thyroid stimulating hormone, and C-reactive protein (CRP) with the PM results was analysed.Results:Sensitivity of DECT for gout was 67% (95% CI 0.41-0.87) with a specificity of 88% (95% CI 0.47-1.0). Concerning CPPD, the sensitivity and specificity of DECT was 63% (95% CI 0.25-0.91) and 83% (95% CI 0.59-0.96) respectively. US had the highest sensitivity of 89% (95% CI 0.65-0.99) with a specificity of 75% (95% CI 0.35-0.97) for gout, while the sensitivity and specificity for CPPD were 88% (95% CI 0.47-1.0) and 89% (95% CI 0.65-0.99) respectively. The SCD had the second highest sensitivity for gout at 78% (95% CI 0.52-0.94) with a comparable sensitivity of 63% (95% CI 0.25-0.92) for CPPD. Uric acid levels were elevated in 33% of gout patients and 25% of CPPD patients. While elevated CRP levels were observed in 59% of gout patients and in 88% of CPPD patients, none of the 15 analysed laboratory parameters were found to be significantly linked.Conclusion:DECT provides a non-invasive diagnostic tool for gout but might have a lower sensitivity than suggested by previous studies (67% vs 90%1). DECT sensitivity for CPPD was 63% (95% CI 0.25-0.91) in a sample group of eight patients. Both US and the SCD had higher sensitivities than DECT for gout and CPPD. Further studies with larger patient cohorts are needed in order to determine the diagnostic utility of DECT in CPPD.References:[1]Bongartz, Tim; Glazebrook, Katrina N.; Kavros, Steven J.; Murthy, Naveen S.; Merry, Stephen P.; Franz, Walter B. et al. (2015): Dual-energy CT for the diagnosis of gout: an accuracy and diagnostic yield study. InAnnals of the rheumatic diseases74 (6), pp. 1072–1077. DOI: 10.1136/annrheumdis-2013-205095.Disclosure of Interests:None declared

Pearls and Pitfalls of Interpretation in CT Colonography

2020 ◽  
Vol 71 (2) ◽  
pp. 140-148
Author(s):  
Michael Schonberger ◽  
Philippe Lefere ◽  
Abraham H. Dachman
Keyword(s):  
Computed Tomography ◽  
Sensitivity And Specificity ◽  
False Positive ◽  
Ct Colonography ◽  
False Negative ◽  
High Sensitivity ◽  
Negative Results ◽  
False Negative Results ◽  
The Common

The accuracy of computed tomography (CT) colonography (CTC) requires that the radiologist be well trained in the recognition of pitfalls of interpretation. In order to achieve a high sensitivity and specificity, the interpreting radiologist must be well versed in the causes of both false-positive and false-negative results. In this article, we review the common and uncommon pitfalls of interpretation in CTC.

scholarly journals Dual-energy computed tomography for monitoring the effect of urate-lowering therapy in gouty arthritis

2015 ◽  
Vol 18 (8) ◽  
pp. 880-885 ◽  
Author(s):  
Ying Sun ◽  
Huiyong Chen ◽  
Zhuojun Zhang ◽  
Lili Ma ◽  
Jianjun Zhou ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Gouty Arthritis ◽  
Dual Energy ◽  
Dual Energy Computed Tomography ◽  
Lowering Therapy

New urate depositions on dual-energy computed tomography in gouty arthritis during urate-lowering therapy

2017 ◽  
Vol 37 (8) ◽  
pp. 1365-1372 ◽  
Author(s):  
Zhuojun Zhang ◽  
Xiaojie Zhang ◽  
Ying Sun ◽  
Huiyong Chen ◽  
Xiufang Kong ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Gouty Arthritis ◽  
Dual Energy ◽  
Dual Energy Computed Tomography ◽  
Lowering Therapy

Breast Scintigraphy with 199Tl in Diagnosis of Breast Cancer

2015 ◽  
Vol 1084 ◽  
pp. 361-364
Author(s):  
Anna Titskaya ◽  
Vladimir Chernov ◽  
Elena Slonimskaya ◽  
Ivan Sinilkin ◽  
Roman Zelchan
Keyword(s):  
Breast Cancer ◽  
Computed Tomography ◽  
Sensitivity And Specificity ◽  
Single Photon ◽  
High Sensitivity ◽  
Breast Diseases ◽  
Morphological Studies ◽  
Diagnostic Capabilities ◽  
Diagnostic Criterion ◽  
Breast Scintigraphy

To study the diagnostic capabilities of emission single photon computed tomography with 199Tl in imaging of breast cancer 90 women with breast diseases were included in the study. During the research high indications of specificity 96.7% were obtained in the detection of breast cancer. The sensitivity of breast cancer visualization was 95%, while in the detection of tumors smaller than 10mm, the sensitivity was 75%, in detecting tumors more than 10mm - 98%. Considering the high sensitivity and specificity of SPECT with 199Tl, we can recommend the use of this method as an additional diagnostic criterion in cases where other methods of radiation diagnosis and the results of morphological studies do not provide a clear answer.

scholarly journals Clinical performance of lung ultrasound in predicting ARDS morphology

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Andrea Costamagna ◽  
Emanuele Pivetta ◽  
Alberto Goffi ◽  
Irene Steinberg ◽  
Pietro Arina ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Gold Standard ◽  
Diagnostic Performance ◽  
Lung Ultrasound ◽  
Clinical Performance ◽  
Training Set ◽  
Mechanically Ventilated ◽  
Validation Set ◽  
Lung Ct ◽  
B Lines

Abstract Background To assess diagnostic performance of lung ultrasound (LUS) in identifying ARDS morphology (focal vs non-focal), compared with the gold standard computed tomography. Methods Mechanically ventilated ARDS patients undergoing lung computed tomography and ultrasound were enrolled. Twelve fields, were evaluated. LUS score was graded from 0 (normal) to 3 (consolidation) according to B-lines extent. Total and regional LUS score as the sum of the four ventral (LUSV), intermediate (LUSI) or dorsal (LUSD) fields, were calculated. Based on lung CT, ARDS morphology was defined as (1) focal (loss of aeration with lobar distribution); (2) non-focal (widespread loss of aeration or segmental loss of aeration distribution associated with uneven lung attenuation areas), and diagnostic accuracy of LUS in discriminating ARDS morphology was determined by AU-ROC in training and validation set of patients. Results Forty-seven patients with ARDS (25 training set and 22 validation set) were enrolled. LUSTOT, LUSV and LUSI but not LUSD score were significantly lower in focal than in non-focal ARDS morphologies (p < .01). The AU-ROC curve of LUSTOT, LUSV, LUSI and LUSD for identification of non-focal ARDS morphology were 0.890, 0.958, 0.884 and 0.421, respectively. LUSV value ≥ 3 had the best predictive value (sensitivity = 0.95, specificity = 1.00) in identifying non-focal ARDS morphology. In the validation set, an LUSV score ≥ 3 confirmed to be highly predictive of non-focal ARDS morphology, with a sensitivity and a specificity of 94% and 100%. Conclusions LUS had a valuable performance in distinguishing ARDS morphology.

Diagnostic Performance Of Radiology Residents In Thoracic Ct Imaging In Emergency Radiology During The Covid-19 Pandemic

2021 ◽  
Vol 17 ◽  
Author(s):  
Vefa Cakmak ◽  
Duygu Herek ◽  
Pinar Cakmak
Keyword(s):  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Diagnostic Performance ◽  
High Sensitivity ◽  
Ct Images ◽  
Roc Curve Analysis ◽  
Thoracic Ct ◽  
Thoracic Computed Tomography ◽  
Radiology Residents ◽  
And Gender

Background: During the COVID-19 pandemic, the workload of all radiologists and radiology residents, as well as other clinical physicians, has increased. Introduction: This study aims to determine the diagnostic performance of radiology residents, who effectively contribute to the diagnosis of COVID-19. Methods: The thoracic computed tomography (CT) images of 135 patients aged 20–83 diagnosed with COVID-19 were evaluated retrospectively by five radiology residents and a radiologist with 10 years of experience. The diagnostic performance of the radiology residents in evaluating COVID-19 was assessed according to their year of residency and the patients’ age and gender. Receiver operating characteristic (ROC) curve analysis was performed to determine the sensitivity and specificity of radiology residents. Results: The radiology residents’ performance in determining COVID-19 using CT findings was evaluated as follows: sensitivity 97.22%, specificity 88.89%, positive predictive value 90.91%, negative predictive value 96.55%, and accuracy 93.33%. According to the year of residency, the sensitivity and specificity of the radiology residents in determining COVID-19 using CT images were between 92.3% and 100%, and 71.43% and 100%, respectively. Conclusion: The high sensitivity and specificity of radiology residents in evaluating thoracic CT images for COVID-19 diagnosis indicate that radiologists are as important as clinical physicians in the diagnosis of COVID-19.

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