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Dual energy CT iodine map for delineating inflammation of inflammatory arthritis

  • Musculoskeletal
  • Published:
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Abstract

Iodine mapping is an image-processing technique used with dual-energy computed tomography (DECT) to improve iodine contrast resolution. CT, because of its high spatial resolution and thin slice reconstruction, is well suited to the evaluation of the peripheral joints. Recent developments in the treatment of inflammatory arthritis that require early diagnosis and precise therapeutic assessment encourage radiological evaluation. To facilitate such assessment, we describe DECT iodine mapping as a novel modality for evaluating rheumatoid arthritis and psoriatic arthritis of the hands and feet.

Key Points

• Dual-energy CT iodine mapping can delineate inflammation of peripheral inflammatory arthritis.

• DECT iodine mapping has high spatial resolution compared with MRI.

• DECT iodine mapping has a high iodine contrast resolution.

• DECT iodine mapping may reflect therapeutic effects.

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References

  1. Johnson TR, Krauss B, Sedlmair M et al (2007) Material differentiation by dual energy CT: initial experience. Eur Radiol 17:1510–1517

    Article  PubMed  Google Scholar 

  2. Finkenstaedt T, Manoliou A, Toniolo M et al (2016) Gouty arthritis: the diagnostic and therapeutic impact of dual-energy CT. Eur Radiol 26:3989–3999

    Article  PubMed  Google Scholar 

  3. Pl M, Coupal TM, Mclaughlin PD, Nicolaou S, Munk PL, Ouellette HA (2016) Dual-Energy CT for the Musculoskeletal System. Radiology 281:690–707

    Article  Google Scholar 

  4. Nicolaou S, Liang T, Murphy DT, Korzan JR, Ouellette H, Munk P (2012) Dual-energy CT: a promising new technique for assessment of the musculoskeletal system. AJR Am J Roentgenol 199:S78–S86

    Article  PubMed  Google Scholar 

  5. Omoumi P, Verdun FR, Guggenberger R, Andreisek G, Becce F (2015) Dual-Energy CT: basic principles, technical approaches, and applications in musculoskeletal imaging (Part 2). Semin Musculoskelet Radiol 19:438–445

    Article  PubMed  Google Scholar 

  6. Otrakji A, Digumarthy SR, Lo Gullo R, Flores EJ, Shepard JA, Kalra MK (2016) Dual-Energy CT: spectrum of thoracic abnormalities. Radiographics 36:38–52

    Article  PubMed  Google Scholar 

  7. Zhang LJ, Zhou CS, Schoepf UJ et al (2013) Dual-energy CT lung ventilation/perfusion imaging for diagnosing pulmonary embolism. Eur Radiol 23:2666–2675

    Article  PubMed  Google Scholar 

  8. Hellbach K, Sterzik A, Sommer W et al (2016) Dual energy CT allows for improved characterization of response to antiangiogenic treatment in patients with metastatic renal cell cancer. Eur Radiol. doi:10.1007/s00330-016-4597-7

    PubMed  Google Scholar 

  9. De Cecco CN, Darnell A, Rengo M et al (2012) Dual-energy CT: oncologic applications. AJR Am J Roentgenol 199:S98–S105

    Article  PubMed  Google Scholar 

  10. Lam S, Gupta R, Kelly H, Curtin HD, Forghani R (2015) Multiparametric evaluation of head and neck squamous cell carcinoma using a single-source dual-energy CT with Fast kVp switching: state of the art. Cancers 7:2201–2216

    Article  PubMed  PubMed Central  Google Scholar 

  11. Fukuda T, Umezawa Y, Tojo S et al (2016) Initial Experience of Using Dual-Energy CT with Iodine Overlay Image for Hand Psoriatic. Comparison Study with Contrast-enhanced MR Imaging. Radiology, Arthritis. doi:10.1148/radiol.2016161671

    Google Scholar 

  12. Combe B, Landewe R, Daien CI et al (2016) 2016 update of the EULAR recommendations for the management of early arthritis. Ann Rheum Dis. doi:10.1136/annrheumdis-2016-210602

    Google Scholar 

  13. Han J, Geng Y, Deng X, Zhang Z (2016) Subclinical synovitis assessed by ultrasound predicts flare and progressive bone erosion in rheumatoid arthritis patients with clinical remission: a systematic review and metaanalysis. J Rheumatol 43:2010–2018

    Article  PubMed  Google Scholar 

  14. Faustini F, Simon D, Oliveira I et al (2016) Subclinical joint inflammation in patients with psoriasis without concomitant psoriatic arthritis: a cross-sectional and longitudinal analysis. Ann Rheum Dis. doi:10.1136/annrheumdis-2015-208821

    Google Scholar 

  15. Haugen IK, Hammer HB (2016) A need for new imaging modality to detect inflammation in rheumatoid arthritis and osteoarthritis? Ann Rheum Dis 75:479–480

    Article  CAS  PubMed  Google Scholar 

  16. Colebatch AN, Edwards CJ, Ostergaard M et al (2013) EULAR recommendations for the use of imaging of the joints in the clinical management of rheumatoid arthritis. Ann Rheum Dis 72:804–814

    Article  PubMed  Google Scholar 

  17. Polster JM, Winalski CS, Sundaram M et al (2009) Rheumatoid arthritis: evaluation with contrast-enhanced CT with digital bone masking. Radiology 252:225–231

    Article  PubMed  Google Scholar 

  18. McGonagle D, Lories RJ, Tan AL, Benjamin M (2007) The concept of a "synovio-entheseal complex" and its implications for understanding joint inflammation and damage in psoriatic arthritis and beyond. Arthritis Rheum 56:2482–2491

    Article  PubMed  Google Scholar 

  19. Narvaez J, Narvaez JA, de Albert M, Gomez-Vaquero C, Nolla JM (2012) Can magnetic resonance imaging of the hand and wrist differentiate between rheumatoid arthritis and psoriatic arthritis in the early stages of the disease? Semin Arthritis Rheum 42:234–245

    Article  PubMed  Google Scholar 

  20. Ostergaard M, Edmonds J, Mcquees F et al (2005) An introduction to the EULAR-OMERACT rheumatoid arthritis MRI reference image atlas. Ann Rheum Dis 64:i3–i7

    Article  PubMed  PubMed Central  Google Scholar 

  21. Veale D, Yanni G, Rogers S, Barnes L, Bresnihan B, Fitzgerald O (1993) Reduced synovial membrane macrophage numbers, ELAM-1 expression, and lining layer hyperplasia in psoriatic arthritis as compared with rheumatoid arthritis. Arthritis Reumatol 36:893–900

    Article  CAS  Google Scholar 

  22. Nieuwenhuis WP, Krabben A, Stomp W et al (2015) Evaluation of magnetic resonance imaging-detected tenosynovitis in the hand and wrist in early arthritis. Arthritis Rheumatol 67:869–876

    Article  PubMed  Google Scholar 

  23. Krabben A, Stomp W, Huizinga TW et al (2015) Concordance between inflammation at physical examination and on MRI in patients with early arthritis. Ann Rheum Dis 74:506–512

    Article  CAS  PubMed  Google Scholar 

  24. Tan AL, Fukuba E, Halliday NA, Tanner SF, Emery P, McGonagle D (2015) High-resolution MRI assessment of dactylitis in psoriatic arthritis shows flexor tendon pulley and sheath-related enthesitis. Ann Rheum Dis 74:185–189

    Article  PubMed  Google Scholar 

  25. McGonagle D, Marzo-Ortega H, Benjamin M, Emery P (2003) Report on the Second international Enthesitis Workshop. Arthritis Rheum 48:896–905

    Article  PubMed  Google Scholar 

  26. Gutierrez M, Filippucci E, Salaffi F, Di Geso L, Grassi W (2011) Differential diagnosis between rheumatoid arthritis and psoriatic arthritis: the value of ultrasound findings at metacarpophalangeal joints level. Ann Rheum Dis 70:1111–1114

    Article  PubMed  Google Scholar 

  27. Ostergaard M, McQueen F, Wiell C et al (2009) The OMERACT psoriatic arthritis magnetic resonance imaging scoring system (PsAMRIS): definitions of key pathologies, suggested MRI sequences, and preliminary scoring system for PsA Hands. J Rheumatol 36:1816–1824

    Article  PubMed  Google Scholar 

  28. Tan AL, Benjamin M, Toumi H et al (2007) The relationship between the extensor tendon enthesis and the nail in distal interphalangeal joint disease in psoriatic arthritis--a high-resolution MRI and histological study. Rheumatology (Oxford) 46:253–256

    Article  CAS  Google Scholar 

  29. Kievit W, Adang EM, Fransen J et al (2008) The effectiveness and medication costs of three anti-tumour necrosis factor alpha agents in the treatment of rheumatoid arthritis from prospective clinical practice data. Ann Rheum Dis 67:1229–1234

    Article  CAS  PubMed  Google Scholar 

  30. Lahiri M, Dixon WG (2015) Risk of infection with biologic antirheumatic therapies in patients with rheumatoid arthritis. Best Pract Res Clin Rheumatol 29:290–305

    Article  PubMed  Google Scholar 

  31. Conaghan P, Bird P, Ejbjerg B et al (2005) The EULAR-OMERACT rheumatoid arthritis MRI reference image atlas: the metacarpophalangeal joints. Ann Rheum Dis 64:i11–i21

    Article  PubMed  PubMed Central  Google Scholar 

  32. Peterfy C, Emery P, Tak PP et al (2016) MRI assessment of suppression of structural damage in patients with rheumatoid arthritis receiving rituximab: results from the randomized, placebo-controlled, double-blind RA-SCORE study. Ann Rheum Dis 75:170–177

    Article  CAS  PubMed  Google Scholar 

  33. Haavardsholm EA, Ostergaard M, Ejbjerg BJ et al (2005) Reliability and sensitivity to change of the OMERACT rheumatoid arthritis magnetic resonance imaging score in a multireader, longitudinal setting. Arthritis Rheum 52:3860–3867

    Article  PubMed  Google Scholar 

  34. Glinatsi D, Bird P, Gandjbakhch F et al (2015) Validation of the OMERACT psoriatic arthritis magnetic resonance imaging score (PsAMRIS) for the hand and foot in a randomized placebo-controlled trial. J Rheumatol 42:2473–2479

    Article  PubMed  Google Scholar 

  35. Boyesen P, McQueen FM, Gandjbakhch F et al (2011) The OMERACT psoriatic arthritis magnetic resonance imaging score (PsAMRIS) is reliable and sensitive to change: results from an OMERACT workshop. J Rheumatol 38:2034–2038

    Article  PubMed  Google Scholar 

  36. Pache G, Krauss B, Strohm P et al (2010) Dual-enerrgy CT virtual noncalcium technique: detecting posttraumatic bone marrow lesions—feasibility study. Radiology 256:617–624

    Article  PubMed  Google Scholar 

  37. Wang CK, Tsai JM, Chuang MT, Wang MT, Huang KY, Lin RM (2013) Bone marrow edema in vertebral compression fractures: detection with dual-energy CT. Radiology 269:525–533

    Article  PubMed  Google Scholar 

  38. Guggenberger R, Gnannt R, Hodler J et al (2012) Diagnostic performance of dual-energy CT for the detection of traumatic bone marrow lesions in the ankle: comparison with MR imaging. Radiology 264:164–173

    Article  PubMed  Google Scholar 

  39. Diekhoff T, Scheel M, Hermann S, Mews J, Hamm B, Hermann KA (2017) Osteitis: a retrospective feasibility study comparing single-source dual-energy CT to MRI in selected patients with suspected acute gout. Skeletal Radiol 46:185–190

    Article  PubMed  Google Scholar 

  40. Stomp W, Krabben A, van der Heijde D et al (2015) Aiming for a simpler early arthritis MRI protocol: can Gd contrast administration be eliminated? Eur Radiol 25:1520–1527

    Article  PubMed  Google Scholar 

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Acknowledgements

We presented a comparison study between contrast-enhanced MRI and DECT iodine mapping at the annual congress of European League Against Rheumatism (EULAR) in 2016. The contents were also published in Radiology (doi: 10.1148/radiol.2016161671).

Author information

Authors and Affiliations

  1. Department of Radiology, The Jikei University School of Medicine, 3-19-18, Nishi-shimbashi, Minato-ku, Tokyo, 1058471, Japan

    Takeshi Fukuda & Kunihiko Fukuda

  2. Department of Dermatology, The Jikei University School of Medicine, 3-19-18, Nishi-shimbashi, Minato-ku, Tokyo, 1058471, Japan

    Yoshinori Umezawa, Akihiko Asahina & Hidemi Nakagawa

  3. Division of Rheumatology Department of Internal Medicine, The Jikei University School of Medicine, 3-19-18, Nishi-shimbashi, Minato-ku, Tokyo, 1058471, Japan

    Kazuhiro Furuya

Authors
  1. Takeshi Fukuda
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  2. Yoshinori Umezawa
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  3. Akihiko Asahina
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  4. Hidemi Nakagawa
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  5. Kazuhiro Furuya
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  6. Kunihiko Fukuda
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Corresponding author

Correspondence to Takeshi Fukuda.

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Guarantor

The scientific guarantor of this publication is Takeshi Fukuda.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

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The authors state that this work has not received any funding.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• retrospective

• observational

• performed at one institution

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Fukuda, T., Umezawa, Y., Asahina, A. et al. Dual energy CT iodine map for delineating inflammation of inflammatory arthritis. Eur Radiol 27, 5034–5040 (2017). https://doi.org/10.1007/s00330-017-4931-8

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  • DOI: https://doi.org/10.1007/s00330-017-4931-8

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