Development of a Dual-Energy Computed Tomography Scoring System for Measurement of Urate Deposition in Gout
Development of a Dual-Energy Computed Tomography Scoring System for Measurement of Urate Deposition in Gout
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DOI：
10.1002/acr.22754
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发表时间：
2016-06-01
影响因子：
4.7
通讯作者：
Dalbeth, Nicola
中科院分区：
文献类型：
--
作者：
Bayat, Sara;Aati, Opetaia;Dalbeth, Nicola
Objective.目的：建立一种半定量双能量CT（DECT）评分系统，用于测量痛风患者尿酸盐沉积。在对图像进行结构化审查后，开发了用于足部/踝关节扫描的半定量DECT尿酸盐评分方法进行测试。该方法包括4个区域，每个区域评分为0-3，最大总DECT尿酸盐评分为12。224例患者（182例痛风，42例无痛风）的DECT扫描由2名独立的阅片者评分。还测量了自动尿酸盐体积。分析了8例接受pegloticase治疗的患者的配对扫描，并进行了定时练习。根据流变学结果测量（OMERACT）过滤器分析DECT尿酸盐评分的特性。DECT尿酸盐评分的阅片者间组内相关系数（95%置信区间）为0.98（0.97-0.98）。所有评分区域均对DECT尿酸盐总评分有贡献。DECT评分与尿量高度相关（r = 0.91，P < 0.0001）。DECT尿酸盐评分和体积区分痛风和非痛风对照组参与者和痛风石性痛风，非痛风石性痛风和对照组之间。与尿酸量相比，DECT尿酸评分更能区分pegloticase治疗的应答者和非应答者（量P < 0.001 for DECT urate score and P >0.05）。DECT尿酸盐评分所需的平均+/- SD时间为121 2秒，尿酸盐量所需的平均+/- SD时间为240 2秒（P = 2 x 10（-31））。我们开发了一种新的半定量DECT评分方法，用于测量足部/踝部的尿酸盐沉积。该方法实现了OMERACT滤波器的许多方面。
Objective. To develop a semiquantitative dual-energy computed tomography (DECT) scoring system for measurement of urate deposition in gout.Methods. Following a structured review of images, a semiquantitative DECT urate scoring method for foot/ankle scans was developed for testing. This method included 4 regions, each scored 0-3, with a maximum total DECT urate score of 12. DECT scans from 224 patients (182 with gout, 42 without gout) were scored by 2 independent readers. Automated urate volumes were also measured. Paired scans from 8 patients receiving pegloticase were analyzed, and a timing exercise was undertaken. The properties of the DECT urate score were analyzed according to the Outcome Measures in Rheumatology (OMERACT) filter.Results. The interreader intraclass correlation coefficient (95% confidence interval) for the DECT urate score was 0.98 (0.97-0.98). All scored regions contributed to the total DECT urate score. DECT urate scores and volumes were highly correlated (r = 0.91, P < 0.0001). Both DECT urate scores and volumes discriminated between gout and nongout control participants and between the tophaceous gout, nontophaceous gout, and control groups. Compared with urate volume, the DECT urate score had greater ability to discriminate between responders and nonresponders to pegloticase therapy (P < 0.001 for DECT urate score and P > 0.05 for volume). The mean +/- SD time required for the DECT urate score was 121 2 seconds and for urate volume was 240 2 seconds (P = 2 x 10(-31))Conclusion. We have developed a novel semiquantitative DECT scoring method for measurement of urate deposition in the feet/ankles. This method fulfills many aspects of the OMERACT filter.