Abstract
Objectives
Dual-energy computed tomography (DECT) is an emerging imaging technique for examining patients with suspected gout. Single-source dual-energy CT (S-DECT) is a new way of obtaining DECT information on conventional CT scanners rather than using special dual-source CT systems.
Methods
We tested the feasibility of S-DECT (320-row CT; Aquilion ONE, Toshiba Medical Systems, Otawara, Japan) in 6 patients (5 men, 1 woman; mean age 61.3, range 48 to 69 years) with acute arthralgia and suspected gout, and compared the S-DECT findings with the results of joint aspiration.
Results
Three patients had a diagnosis of gouty arthritis with negatively birefringent crystals in synovial fluid, in addition to gouty tophi in S-DECT. Three patients had no detectable crystals by polarization microscopy and no tophi on DECT. Their final diagnoses were rheumatoid arthritis, activated osteoarthritis, and septic arthritis in one case each.
Conclusion
This initial experience suggests that S-DECT might be a valuable alternative to dual-source CT. Hence, more patients may benefit from its additional diagnostic abilities in the future.

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Conflict of interest
This work was supported by Toshiba Medical Systems. JM is an employee of Toshiba Medical Systems Europe and took part in the study design and the writing of the manuscript.
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Diekhoff, T., Ziegeler, K., Feist, E. et al. First experience with single-source dual-energy computed tomography in six patients with acute arthralgia: a feasibility experiment using joint aspiration as a reference. Skeletal Radiol 44, 1573–1577 (2015). https://doi.org/10.1007/s00256-015-2204-7
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DOI: https://doi.org/10.1007/s00256-015-2204-7