Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Impact of Dual-Energy Computed Tomography (DECT) Postprocessing Protocols in Detection of Monosodium Urate (MSU) Deposits in Foot Tendons of Cadavers

Version 1 : Received: 2 June 2023 / Approved: 2 June 2023 / Online: 2 June 2023 (14:58:10 CEST)

A peer-reviewed article of this Preprint also exists.

Klauser, A.S.; Strobl, S.; Schwabl, C.; Kremser, C.; Klotz, W.; Vasilevska Nikodinovska, V.; Stofferin, H.; Scharll, Y.; Halpern, E. Impact of Dual-Energy Computed Tomography (DECT) Postprocessing Protocols on Detection of Monosodium Urate (MSU) Deposits in Foot Tendons of Cadavers. Diagnostics 2023, 13, 2208. Klauser, A.S.; Strobl, S.; Schwabl, C.; Kremser, C.; Klotz, W.; Vasilevska Nikodinovska, V.; Stofferin, H.; Scharll, Y.; Halpern, E. Impact of Dual-Energy Computed Tomography (DECT) Postprocessing Protocols on Detection of Monosodium Urate (MSU) Deposits in Foot Tendons of Cadavers. Diagnostics 2023, 13, 2208.

Abstract

Objective: To evaluate two different DECT postprocessing protocols for detection of MSU deposits in foot tendons of cadavers with verification by polarizing light microscopy as gold standard.Material and Methods: A total of 40 embalmed cadavers (15 male; 25 female; median age, 82 years; mean, 80 years; range, 52 - 99; SD ± 10.9) underwent DECT to assess MSU deposits in foot tendons.Two postprocessing DECT protocols with different Hounsfield unit (HU) thresholds 150/500 (=established) versus 120/500 (= modified) HU were applied to dual source acquisition with 80 kV for tube A and 140 kV for tube B.Six fresh cadavers (4 male; 2 female; median age, 78; mean, 78,5; range 61 - 95 ) were examined by DECT. Tendon dissection of 2/6 fresh cadavers with positive DECT 120 and negative DECT 150 studies were used to verify MSU deposits by polarizing light microscopy.Results: The tibialis anterior tendon was found positive in 57.5%/100% (DECT 150/120), peroneus tendon in 35%/100%, achilles tendon in 25%/90%, flexor halluces longus tendon in 10%/100%, and tibialis posterior tendon in 12.5%/97.5%. DECT 120 resulted in increased tendon MSU deposit detection, when DECT 150 was negative, with an overall agreement between DECT 150 and DECT 120 of 80 % (P = 0.013). Polarizing light microscope confirmed MSU deposits detected only by DECT 120 in tibialis anterior, achilles, flexor halluces longus and peroneal tendons.Conclusion: The DECT 120 protocol showed a higher sensitivity when compared to DECT 150.

Keywords

Dual-energy computed tomography; gout; tendon; foot; monosodium urate deposits

Subject

Medicine and Pharmacology, Anatomy and Physiology

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