Teixeira, Joe

Lakes, Richard D

International Research Conference on Adolescence, Oshkosh, Wis., 1973

Crnobrnja, Mihailo

Anglin, Douglas George

Scherer, Manual

Spencer, Scott, 1975-

Pickover, Clifford A

Sawyer, R. Keith (Robert Keith)

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.

The disappearance of inflammatory communal slogans from political speeches suggests development is the agenda for 2014.

Black, Maggie, 1945- author

Dinar, Shlomi, author

Hansen, Shirley J., 1928- author

Sverdrup, Keith A., author

Lusher, Amy, author

Archer, John, 1941-

Goods train runs over people sleeping on the tracks killing 16 and injuring one

Hughes, Michael Pycraft, 1970-