Browne, Naima

Vågnes, Øyvind, 1972-

To the Editor We read the recent article by Klauser et al with great interest. While the potential implications of the findings are exciting, we have several concerns. First, the authors do not explicitly state whether electrocardiogram gating was used in their study. This is an important detail because cardiac motion artifact is a source of artifactual coloration with dual-energy computed tomography (DECT), particularly with dual-source scanners given the approximately 80-millisecond temporal difference between the 2 radiography beams. Furthermore, beam hardening artifact from calcified atheromas and partial volume effect, known sources of artifacts in the 2-material decomposition algorithm of DECT, may largely explain the findings. While patients with gout had higher prevalence of coronary calcification (55 of 59 patients [93%]) and cardiovascular monosodium urate (MSU) deposition (51 of 59 patients [86%]) than controls, the authors do not report whether the 4 patients with gout without coronary calcifications exhibited MSU deposition nor the number of controls or cadaveric hearts with coronary calcification. The images from the article show areas of green pixelization occurring adjacent to calcified plaques on grayscale computed tomography images (eg, Figure 2A and D, left anterior descending artery [yellow arrowhead]), which would favor this artifact hypothesis without additional data.

In Reply We appreciate the valuable comments of Becce et al on our article. We applied prospective electrocardiography gating using a thin-slice cardiac protocol to ensure highest spatial resolution with minimal motion artifact. A noncontrast electrocardiography-gated computed tomography (CT) examination with standardized scan parameters was performed using a 128-slice dual-source CT (SOMATOM Definition Flash; Siemens) with a detector collimation of 2 × 64 × 0.6 mm, rotation time of 0.28 seconds, and prospective electrocardiography triggering for heart rates less than 65 beats per minute (diastolic padding, 70% of RR interval) and more than 65 beats per minute (systolic padding, 40% of RR interval). Axial images were reconstructed with 0.75-mm slice width, increment of 0.5, and a medium-smooth convolution kernel (B26f). When motion artifact was present, it was distinguished by visual analysis of an experienced observer and colorized pixels related to motion were excluded.

Murray-Darling Basin Authority (Australia)

Lindsay, David

Ganguli, Prabuddha

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Dewey Library - TP370.9.C64 H57 2019

Tonstad, Linn Marie, 1978- author

Moore, Terri (New Testament teacher), author

Turley, Stephen Richard, author

Hollier, Joel, author

Inmon, William H

Charantimath, Poornima M., author

Kaynak, Hale, 1956-

Kiran, D. R., author

Bose, Tapan K., author

Edmonds, Mike, author

Sherwin, David, author

Runion, Meryl

Huggett, Cindy, author

Frisendal, Thomas. author

Geraldi, Joana G., 1979- author

Interview with Suzanne V. Arnold, MD, MHA, author of Association of Transcatheter Mitral Valve Repair With Quality of Life Outcomes at 30 Days and 1 Year: Analysis of the Transcatheter Valve Therapy Registry

Interview with Alison J. Huang, MD, MAS, author of Changes in Sexual Functioning in Women and Men in the 5 Years After Bariatric Surgery

Interview with George F. Sawaya, MD, author of Estimated Quality of Life and Economic Outcomes Associated With 12 Cervical Cancer Screening Strategies: A Cost-effectiveness Analysis, and Sarah Feldman, M.D. M.P.H., author of Screening Options for Preventing Cervical Cancer

Interview with Michael X. Repka, MD, MBA, author of Visual Acuity and Ophthalmic Outcomes in the Year After Cataract Surgery Among Children Younger Than 13 Years