title: A pilot study on dual-energy computed tomography for detection of urate deposits in renal transplant patients with asymptomatic hyperuricemia.
abstract: BACKGROUND
  An increasing role of dual-energy computed tomography (DECT) scan in tophaceous gout assessment is recognized, whereas its role in asymptomatic hyperuricemia is unknown.
  
  
  OBJECTIVE
  The objective of this study was to assess the prevalence of joint and renal monosodium urate deposits by DECT in asymptomatic hyperuricemia.
  
  
  METHODS
  Among a renal transplant population with at least 1 year of follow-up, we included 27 patients with sustained hyperuricemia and 11 with normal serum uric acid (SUA) levels. We excluded patients with gout or history of monoarthritis or oligoarthritis. We registered demographic data, drugs, hyperuricemia onset, comorbidities, renal function, and SUA. We used a 128-slice dual-source CT system, and the acquisition protocol included the pelvis and imaging of elbows, wrists, hands, knees, ankles, and feet. The reading process was performed by 2 radiologists.
  
  
  RESULTS
  The mean age was 43.7 ± 12 years, 57.8% were males, and median follow-up was 7 years. Hyperuricemia presented after a median time of 0.61 years after transplantation and had persisted for a median of 3.2 years (0.5-16.8 years). For the hyperuricemic group, the median SUA at the DECT scan and the maximum SUA levels were 7.9 and 8.9 mg/dL, respectively. Groups were similar in most of the clinical variables. We did not find any articular or renal deposit; conversely, we demonstrated a quadriceps tendon deposition in 1 patient with hyperuricemia (prevalence of 0.03%; 95% confidence interval, 0.006%-0.17%).
  
  
  CONCLUSIONS
  In these patients with asymptomatic hyperuricemia, the prevalence of monosodium urate deposition assessed by DECT was low; however, larger studies need to be performed for further validation.
authors.affiliation: From the *Department of Radiology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico; †Department of Emergency/Trauma Imaging, Vancouver General Hospital, Vancouver, British Columbia, Canada; and Departments of ‡Immunology and Rheumatology and §Transplant, Instituto Nacional de Ciencias Médicas y Nutrición SZ, Mexico City, Mexico.
authors.forename: Eric
authors.initials: E
authors.lastname: Kimura-Hayama
authors.forename: Sergio
authors.initials: S
authors.lastname: Criales-Vera
authors.forename: Savvas
authors.initials: S
authors.lastname: Nicolaou
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Betanzos
authors.forename: Yahaira
authors.initials: Y
authors.lastname: Rivera
authors.forename: Josefina
authors.initials: J
authors.lastname: Alberú
authors.forename: Marina
authors.initials: M
authors.lastname: Rull-Gabayet
authors.forename: Gabriela
authors.initials: G
authors.lastname: Hernández-Molina
mesh_terms: D000328:Adult; D001175:Arthrography; D005260:Female; D005500:Follow-Up Studies; D006073:Gout / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000378:metabolism; D006801:Humans; D033461:Hyperuricemia / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000378:metabolism*; D007596:Joints / Q000378:metabolism*; D007668:Kidney / Q000000981:diagnostic imaging / Q000378:metabolism*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D015995:Prevalence; D036542:Tomography, Spiral Computed; D014527:Uric Acid / Q000378:metabolism*
chemical_list: D014527:Uric Acid