Optimization of dual energy computed tomography post-processing to reduce lower limb artifacts in gout

Area of Science:

• Medical Imaging
• Radiology
• Gout Diagnosis

Background:

• Dual-energy CT (DECT) in gout diagnosis can be affected by artifacts like beam hardening and submillimeter types.
• These artifacts may lead to misdiagnosis and overdiagnosis of gout.
• Optimizing DECT post-processing is crucial for accurate gout assessment.

Purpose of the Study:

• To identify optimal DECT post-processing settings.
• To reduce the frequency of common artifacts in suspected gout patients.
• To improve the diagnostic accuracy of DECT for gout.

Main Methods:

• Seventy-seven patients with suspected gout underwent DECT scans.
• Nine post-processing settings were evaluated using Syngovia software.
• Settings varied in attenuation coefficient (120-170 HU) and ratio (1.28-1.55).

Main Results:

• The R2 setting (170 HU, ratio 1.28) significantly reduced artifacts in ankles, feet, and knees.
• A substantial decrease in beam hardening and clumpy artifacts was observed (P<0.001).
• This setting improved specificity while slightly decreasing sensitivity for gout detection.

Conclusions:

• A DECT post-processing ratio of 1.28 and minimum attenuation of 170 HU effectively minimizes lower limb artifacts.
• This optimized setting is particularly effective against clumpy and beam hardening artifacts.
• The findings support improved DECT utility in gout diagnosis.