Dual-energy CT (clinical applications)

Last revised by Joachim Feger on 10 Sep 2023

Dual-energy CT or multispectral CT is becoming increasingly common in clinical practice due to the rapid rise in computer technology and expanding literature exhibiting vast advantages over conventional single-energy CT. 

Clinical applications

The clinical practice, adaptation and techniques of dual-energy CT are broken into individual articles:

  • virtual non-contrast imaging 

  • vascular 

    • automated bone removal in CT angiography 2

    • decrease metal device artifact 7

    • detection of endoleaks 7 

    • blood pool imaging 2

      • detection of pulmonary embolism

      • detection of myocardial ischemia 

  • urinary system

    • characterization of renal stones 2

    • characterization of renal cysts and masses 2-4

  • neuroimaging

    • differentiation of hemorrhage from iodinated contrast

    • quantification of iodine leak in traumatic hemorrhagic contusions

    • bone removal

    • optimizing imaging

  • female breast

    • identification of silicone leaks from breast implants 2

    • improved tumor conspicuity of breast cancers relative to conventional CT, with the potential determination of prognostic biomarkers such as ER and PR status 6

  • musculoskeletal

    • detection of bone marrow edema

    • detection and quantification of urate crystals in gout

    • reduction of metal artifact 7

  • abdominal imaging

    • pancreatic diseases 5

    • detection of acute bowel ischemia 9

    • determine the composition of gallstones and urinary tract calculi 9

    • increase the conspicuity of enhancement in inflammatory conditions such as appendicitis 9

  • thoracic imaging

    • detection of pulmonary thromboembolism; structural as well as functional information is obtained through iodine maps of pulmonary perfusion 7

    • assessment of a solitary pulmonary nodule to determine malignancy status 7,8

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