Factors Associated with Bone Erosion in Patients with Gout: A Dual-Energy Gemstone Spectral Imaging Computed Tomography Study

ABSTRACT Objective This study aimed to assess the factors influencing bone erosion in patients with gout using dual-energy gemstone spectral imaging CT. Methods We compared the clinical data, laboratory indices, and tissue urate levels at the monosodium urate (MSU)-bone interface measured by dual-energy gemstone spectral imaging computed tomography of 87 gout patients with (n=41) and without (n=46) bone erosion. Logistic regression analysis was used to investigate the risk factors associated with bone erosion. Results In total, 47.1% of patients with gout had bone erosion. The disease duration, serum uric acid, tissue urate levels, and the presence of tophi were significantly higher (p<0.05) in gout patients with bone erosion than in those without bone erosion. Longer disease duration (OR=1.11, 95% CI: 1.00–1.24, p<0.05) and increased tissue urate levels (OR=1.01, 95% CI: 1.00–1.02, p<0.05) were independently associated with bone erosion. Tissue urate levels at the MSU-bone interface were correlated with the presence of tophi (r=0.62, p<0.001), bone erosion (r=0.51, p<0.001), renal calculus (r=0.24, p=0.03), and serum uric acid levels (r=0.23, p=0.03). Conclusion This study found that longer disease duration and elevated tissue urate concentrations at the MSU-bone interface were associated with bone erosion in patients with gout.

Differentiation of Vulnerable Carotid Plaques by Analysis of Calcium Content and Spectral Curve Slope using Gemstone Spectral Imaging

Growing evidence indicates that vulnerable carotid plaque rupture is an important cause of stroke. However, fewer studies have been conducted to investigate the role of a novel gemstone spectral imaging (GSI) in assessment of vulnerable carotid plaque. In this study, we analyzed GSI data including calcium content of carotid atherosclerotic plaque and spectral curve slope, as well as serum high-sensitivity C-reactive protein (Hs-CRP), monocyte chemotactic protein-1 (MCP-1) levels in patients with carotid atherosclerotic plaque using the GSI-computed tomographic angiography (CTA) and immunoturbidimetry. The patients with unstable plaques demonstrated a significantly lower calcium content and higher spectral curve slope than the stable plaques group. In addition, the patients with unstable plaque showed an increase in Hs-CRP levels and MCP-1 levels compared with the stable plaque and normal controls (NC) group. The alternation in GSI calcium content and spectral curve slope reflects a close link between calcification and plaque instability, while derangement of Hs-CRP and MCP-1 is involved in the formation or development of vulnerable plaques. Taken together, our results strongly support the feasibility of using these serological and newly discovered imaging parameters as multiple potential biomarkers relevant to plaque vulnerability or stroke progression.

Comparison of the image quality and radiation dose of different scanning modes in head-neck CT angiography

Objectives: To analyze and compare the radiation dose and image quality of different CT scanning modes on head-neck CT angiography. Methods: A total of 180 patients were divided into Group A and Group B. The groups were further subdivided according to different scanning modes: subgroups A1, A2, A3, B1, B2, and B3. Subgroups A1 and B1 used conventional CT protocol, subgroups A2 and B2 used the kV-Assist scan mode, and subgroups A3 and B3 used the dual-energy gemstone spectral imaging protocol. The CT dose index and dose–length product were recorded. The objective image quality and subjective image evaluation was conducted by two independent radiologists. Results: The signal-to-noise ratios, contrast-to-noise ratios, and subjective scores of subgroups A3 and B3 were higher than the other subgroups. In subgroups B1 and B2, the subjective scores of 9 patients and 12 patients were lower than 3, respectively. The subjective scores of subgroups B1 and B2 were lower than the other subgroups. There was no statistically significant difference in signal-to-noise ratios, contrast-to-noise ratios, and subjective scores between subgroups A1 and A2. The effective dose of subgroup A2 was 41.7 and 36.4% lower than that in subgroups A1 and A3, respectively (p < 0.05). In Group B, there were no statistically significant differences in CT dose indexvol, dose–length product, and ED among the subgroups (p > 0.05). Conclusion: In the head-neck CT angiography, the kV-Assist scan mode is recommended for patients with body mass index between 18.5 and 34.9 kg m−2; gemstone spectral imaging scanning mode is recommended for patients with body mass index ≥34.9 kg m−2.

The differentiation between solitary pulmonary inflammatory lesion and solitary cancer using gemstone spectral imaging (GSI): the correlation with lesion size

The authors have requested that this preprint be withdrawn due to erroneous posting.

Application of Gemstone CT Spectroscopy in the Evaluation of Abnormal Enhancement of Lesion Margin After Radiofrequency Ablation of Hepatocellular Carcinoma

Background: Accurately assessing the efficacy of radiofrequency ablation for hepatocellular carcinoma (HCC), and early detection of tumor residues or recurrence after radiofrequency ablation is important to improve the prognosis of patients with HCC. Objectives: To investigate the application of gemstone spectral imaging in the evaluation of abnormal enhancement of the edge of HCC after radiofrequency ablation. Patients and Methods: From November 2013 to April 2019, patients with HCC admitted to the department underwent regular gemstone spectral imaging and energy spectrum analysis after radiofrequency ablation. The abnormal enhancement within and around the radiofrequency ablation lesion was observed, and the energy spectrum data of the radiofrequency ablation lesion and the abnormal enhancement focus were measured. Results: A total of 133 lesions with marginal enhancement following radiofrequency ablation were included. Of these lesions, 62 were eventually diagnosed as inflammatory reaction zone, and 71 were diagnosed as residual or recurrent HCC. The results of energy spectrum analysis showed that there was a statistically significant difference in the iodine concentration between the inflammatory reaction zone and the residual or recurrent HCC (P < 0.001). The iodine concentration in the inflammatory reaction zone was lower than the iodine concentration in the residual or recurrent HCC (9.70±3.00 100 µg/mL vs. 13.24 ± 4.51 100 µg/mL). In the enhanced arterial and portal venous phases, the difference between the slope of the energy spectrum curve of the inflammatory reaction zone and the residual or recurrent HCC was statistically significant (P < 0.001). Conclusion: Gemstone spectral imaging can effectively differentiate residual or recurrent HCC from the inflammatory reaction zone after radiofrequency ablation. It is conducive to early detection of residual or recurrent tumors, helps clinicians formulate the next treatment plan, and improves the prognosis of patients.