Future of Low-Dose Computed Tomography and Dual-Energy Computed Tomography in Axial Spondyloarthritis

Overview

Journal Curr Rheumatol Rep

Publisher Current Science

Specialty Rheumatology

Date 2022 Apr 9

PMID 35397047

Authors

Torsten Diekhoff

Kay Geert A Hermann

Robert G Lambert

Affiliations

Soon will be listed here.

Abstract

Purpose Of Review: Recent technical advances in computed tomography (CT) such as low-dose CT and dual-energy techniques open new applications for this imaging modality in clinical practice and for research purposes. This article will discuss the latest innovations and give a perspective on future developments.

Recent Findings: Low-dose CT has increasingly been used for assessing structural changes at the sacroiliac joints and the spine. It has developed into a method with similar or even lower radiation exposure than radiography while outperforming radiography for lesion detection. Despite being incompatible with low-dose scanning, some studies have shown that dual-energy CT can provide additional information that is otherwise only assessable with magnetic resonance imaging (MRI). However, it is unclear whether this additional information is reliable enough and if it would justify the additional radiation exposure, i.e. whether the performance of dual-energy CT is close enough to MRI to replace it in clinical practice. While the role of dual-energy CT in patients with axial spondyloarthritis remains to be established, low-dose CT has developed to an appropriate modality that should replace radiography in many circumstances and might supplement MRI.

Citing Articles

Automated segmentation of the sacro-iliac joints, posterior spinal joints and discovertebral units on low-dose computed tomography for Na[F]F PET lesion detection in spondyloarthritis patients.

van der Heijden W, van Velden F, Hemke R, Doorschodt T, Boellaard R, van der Laken C EJNMMI Phys. 2025; 12(1):20.

PMID: 40059265 PMC: 11891110. DOI: 10.1186/s40658-025-00734-7.

Distribution of spinal damage in patients with axial spondyloarthritis as assessed by MRI: a prospective and blinded study.

Haidmayer A, Adelsmayr G, Spreizer C, Klocker E, Quehenberger F, Fuchsjaeger M Arthritis Res Ther. 2025; 27(1):8.

PMID: 39810235 PMC: 11730832. DOI: 10.1186/s13075-024-03465-9.

Axial Imaging in Spondyloarthritis.

Mohan V, Hwang M Rheum Dis Clin North Am. 2024; 50(4):581-602.

PMID: 39415369 PMC: 11493334. DOI: 10.1016/j.rdc.2024.07.002.

Precision medicine in axial spondyloarthritis: current opportunities and future perspectives.

So J, Tam L Ther Adv Musculoskelet Dis. 2024; 16:1759720X241284869.

PMID: 39376594 PMC: 11457172. DOI: 10.1177/1759720X241284869.

Prevalence and location of inflammatory and structural lesions in patients with rheumatoid arthritis and radiographic axial spondyloarthritis with chronic neck pain evaluated by magnetic resonance imaging.

Kiefer D, Soltani M, Damirchi P, Kiltz U, Buehring B, Andreica I Arthritis Res Ther. 2024; 26(1):138.

PMID: 39054458 PMC: 11270841. DOI: 10.1186/s13075-024-03377-8.

References

Cheraya G, Sharma S, Chhabra A . Dual energy CT in musculoskeletal applications beyond crystal imaging: bone marrow maps and metal artifact reduction. Skeletal Radiol. 2022; 51(8):1521-1534. DOI: 10.1007/s00256-021-03979-2. View

Crema M, Miquel A, Gouvion A, Phan C, Li L, Menu Y . Improved detection of subchondral erosions in the sacroiliac joints with T1-weighted fat-suppressed MRI. Eur Radiol. 2021; 31(9):6810-6815. DOI: 10.1007/s00330-021-07785-1. View

Shenkman Y, Qutteineh B, Joskowicz L, Szeskin A, Yusef A, Mayer A . Automatic detection and diagnosis of sacroiliitis in CT scans as incidental findings. Med Image Anal. 2019; 57:165-175. DOI: 10.1016/j.media.2019.07.007. View

Willemink M, Takx R, de Jong P, Budde R, Bleys R, Das M . Computed tomography radiation dose reduction: effect of different iterative reconstruction algorithms on image quality. J Comput Assist Tomogr. 2014; 38(6):815-23. DOI: 10.1097/RCT.0000000000000128. View

Deppe D, Hermann K, Proft F, Poddubnyy D, Radny F, Protopopov M . CT-like images of the sacroiliac joint generated from MRI using susceptibility-weighted imaging (SWI) in patients with axial spondyloarthritis. RMD Open. 2021; 7(2). PMC: 8166621. DOI: 10.1136/rmdopen-2021-001656. View

Hsieh J, Flohr T . Computed tomography recent history and future perspectives. J Med Imaging (Bellingham). 2021; 8(5):052109. PMC: 8356941. DOI: 10.1117/1.JMI.8.5.052109. View

Pumberger M, Fuchs M, Engelhard N, Hermann K, Putzier M, Makowski M . Disk injury in patients with vertebral fractures-a prospective diagnostic accuracy study using dual-energy computed tomography. Eur Radiol. 2019; 29(8):4495-4502. PMC: 6610270. DOI: 10.1007/s00330-018-5963-4. View

Niehoff J, Woeltjen M, Saeed S, Michael A, Boriesosdick J, Borggrefe J . Assessment of hepatic steatosis based on virtual non-contrast computed tomography: Initial experiences with a photon counting scanner approved for clinical use. Eur J Radiol. 2022; 149:110185. DOI: 10.1016/j.ejrad.2022.110185. View

Diekhoff T, Engelhard N, Fuchs M, Pumberger M, Putzier M, Mews J . Single-source dual-energy computed tomography for the assessment of bone marrow oedema in vertebral compression fractures: a prospective diagnostic accuracy study. Eur Radiol. 2018; 29(1):31-39. DOI: 10.1007/s00330-018-5568-y. View

10.

Patro S, Chakraborty S, Sheikh A . The use of adaptive statistical iterative reconstruction (ASiR) technique in evaluation of patients with cervical spine trauma: impact on radiation dose reduction and image quality. Br J Radiol. 2016; 89(1060):20150082. PMC: 4846189. DOI: 10.1259/bjr.20150082. View

11.

Diekhoff T, Eshed I, Radny F, Ziegeler K, Proft F, Greese J . Choose wisely: imaging for diagnosis of axial spondyloarthritis. Ann Rheum Dis. 2021; 81(2):237-242. PMC: 8762031. DOI: 10.1136/annrheumdis-2021-220136. View

12.

Diekhoff T, Ulas S, Poddubnyy D, Schneider U, Hermann S, Biesen R . Ultra-low-dose CT detects synovitis in patients with suspected rheumatoid arthritis. Ann Rheum Dis. 2018; 78(1):31-35. PMC: 6317443. DOI: 10.1136/annrheumdis-2018-213904. View

13.

Jans L, De Kock I, Herregods N, Verstraete K, Van den Bosch F, Carron P . Dual-energy CT: a new imaging modality for bone marrow oedema in rheumatoid arthritis. Ann Rheum Dis. 2018; 77(6):958-960. DOI: 10.1136/annrheumdis-2018-213152. View

14.

Gruenewald L, Koch V, Martin S, Yel I, Eichler K, Gruber-Rouh T . Diagnostic accuracy of quantitative dual-energy CT-based volumetric bone mineral density assessment for the prediction of osteoporosis-associated fractures. Eur Radiol. 2021; 32(5):3076-3084. PMC: 9038932. DOI: 10.1007/s00330-021-08323-9. View

15.

Hermann K, Ziegeler K, Kreutzinger V, Poddubnyy D, Proft F, Deppe D . What amount of structural damage defines sacroiliitis: a CT study. RMD Open. 2022; 8(1). PMC: 8785200. DOI: 10.1136/rmdopen-2021-001939. View

16.

Calvert C, Strauss K, Mooney D . Variation in computed tomography radiation dose in community hospitals. J Pediatr Surg. 2012; 47(6):1167-9. DOI: 10.1016/j.jpedsurg.2012.03.021. View

17.

Jans L, Chen M, Elewaut D, Van den Bosch F, Carron P, Jacques P . MRI-based Synthetic CT in the Detection of Structural Lesions in Patients with Suspected Sacroiliitis: Comparison with MRI. Radiology. 2020; 298(2):343-349. DOI: 10.1148/radiol.2020201537. View

18.

de Koning A, de Bruin F, van den Berg R, Ramiro S, Baraliakos X, Braun J . Low-dose CT detects more progression of bone formation in comparison to conventional radiography in patients with ankylosing spondylitis: results from the SIAS cohort. Ann Rheum Dis. 2017; 77(2):293-299. DOI: 10.1136/annrheumdis-2017-211989. View

19.

Ye L, Liu Y, Xiao Q, Dong L, Wen C, Zhang Z . MRI compared with low-dose CT scanning in the diagnosis of axial spondyloarthritis. Clin Rheumatol. 2019; 39(4):1295-1303. DOI: 10.1007/s10067-019-04824-7. View

20.

de Bruin F, de Koning A, van den Berg R, Baraliakos X, Braun J, Ramiro S . Development of the CT Syndesmophyte Score (CTSS) in patients with ankylosing spondylitis: data from the SIAS cohort. Ann Rheum Dis. 2017; 77(3):371-377. DOI: 10.1136/annrheumdis-2017-212553. View