Precision imaging biomarkers for gout: artifact-specific spectral CT parameters for personalized differentiation of tophi in a prospective study.

IF 3.3 2区医学 Q2 RHEUMATOLOGY

Therapeutic Advances in Musculoskeletal Disease Pub Date : 2026-06-23 eCollection Date: 2026-01-01 DOI:10.1177/1759720X261458947

Yiteng Zhang, Yu Zhang, Yi Liu, Hanyu Li, Zejun Liang, Jianrong He, Jun Xie, Zhenlin Li, Jing Tang

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引用次数: 0

Abstract

Background: Spectral computed tomography (CT) enables non-invasive visualization and quantification of monosodium urate deposits and has an important role in gout diagnosis and monitoring. However, artifact-related false-positive findings may reduce diagnostic confidence, particularly when artifacts show attenuation features overlapping with tophi.

Objectives: To evaluate advanced spectral CT parameters as quantitative imaging biomarkers for differentiating tophi from common artifacts.

Design: Prospective cross-sectional study.

Methods: Consecutive participants with suspected foot gout were prospectively recruited from May 2023 to May 2024 and underwent foot spectral CT scans. Participants were classified into gout and non-gout groups. Regions of interest (ROIs) were delineated on index tophi in the gout group and on artifact regions in the non-gout group, including nail bed, skin, beam-hardening, vascular, and tendon artifacts. Conventional attenuation (HU_120-kV) and three advanced spectral parameters (effective atomic number (Zeff), electron density (ED), and dual-energy ratio (DER)) were measured and compared. Diagnostic performance of each parameter was assessed using receiver operating characteristic curves and the area under the curve (AUC).

Results: The final analysis included 82 tophus ROIs and 243 artifact ROIs. Tophi differed significantly from beam-hardening, vascular, and tendon artifacts across all parameters (p < 0.001). ED (AUC = 0.848-0.939) and HU_120-kV (AUC = 0.819-0.935) showed the most consistent performance for overall artifacts, beam-hardening, vascular, and tendon artifacts, with no significant difference between them. In contrast, discrimination of nail bed and skin artifacts was more limited. DER (AUC = 0.728) and Zeff (AUC = 0.722) provided complementary values for nail bed artifacts, while ED showed the highest AUC for skin artifacts (AUC = 0.740).

Conclusion: Spectral CT parameters may support artifact-specific tophus differentiation in gout. An artifact-specific parameter selection approach may help reduce false-positive interpretations and improve confidence in spectral CT-based gout assessment.

Trial registration: Chinese Clinical Trial Registry, ChiCTR2300069114, https://www.chictr.org.cn/showproj.html?proj=185804.

查看原文本刊更多论文

痛风的精确成像生物标志物：一项前瞻性研究中痛风个性化分化的伪迹特异性光谱CT参数。

背景：光谱计算机断层扫描（CT）能够实现尿酸钠沉积的无创可视化和量化，在痛风诊断和监测中具有重要作用。然而，伪影相关的假阳性结果可能会降低诊断的可信度，特别是当伪影显示与tophi重叠的衰减特征时。目的：评价高级光谱CT参数作为定量成像生物标志物在鉴别石蜡和常见伪影中的应用价值。设计:前瞻性横断面研究。方法：从2023年5月至2024年5月前瞻性招募疑似痛风的连续参与者，并进行足部频谱CT扫描。参与者被分为痛风组和非痛风组。感兴趣的区域（roi）在痛风组的指数tophi和在非痛风组的人工区域划定，包括甲床，皮肤，梁硬化，血管和肌腱人工。测量并比较了常规衰减（HU120-kV）和三个高级光谱参数（有效原子序数（Zeff）、电子密度（ED）和双能比（DER））。使用受试者工作特征曲线和曲线下面积（AUC）评估各参数的诊断性能。结果：最终分析得到地形roi 82个，人工roi 243个。Tophi在所有参数上都与波束硬化、血管和肌腱伪影存在显著差异（p值120-kV (AUC = 0.819-0.935)），在整体伪影、波束硬化、血管和肌腱伪影方面表现最为一致，两者之间没有显著差异。相比之下，对甲床和皮肤伪影的辨别更为有限。DER （AUC = 0.728）和Zeff （AUC = 0.722）为甲床伪影提供互补值，ED为皮肤伪影显示最高的AUC （AUC = 0.740）。结论：谱CT参数可能支持痛风的伪迹特异性痛风辨证。一个特定的人工参数选择方法可能有助于减少假阳性的解释和提高谱ct为基础的痛风评估的信心。试验注册：中国临床试验注册中心，ChiCTR2300069114, https://www.chictr.org.cn/showproj.html?proj=185804。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Therapeutic Advances in Musculoskeletal Disease Medicine-Rheumatology

CiteScore

6.80

自引率

4.80%

发文量

132

审稿时长

18 weeks

期刊介绍： Therapeutic Advances in Musculoskeletal Disease delivers the highest quality peer-reviewed articles, reviews, and scholarly comment on pioneering efforts and innovative studies across all areas of musculoskeletal disease.