Dual Energy Computed Tomography (DECT) Applications In Abdominal Imaging
Eslam Mahmoud Taha Mohamed;
Abstract
Dual-energy CT is gradually changing the way CT is practiced today. By interrogating the unique characteristics of different materials at different x-ray energies, dual-energy CT provides quantitative information about tissue composition, overcoming the limitations of attenuation based conventional single energy CT imaging.
Recent technology improvements have facilitated the maturation of DECT into a reliable clinical tool that can be applied to various tasks in abdominal CT. The principle of imaging at two distinctly different photon energies allows separation of substances with sufficiently different K-edges, in particular soft tissue, iodine, and calcium.
DECT of the liver has so far been evaluated for the visualization and detection of three different materials, i.e., the detection of iodinated contrast media as well as the assessment hepatic fat infiltration and iron overload.
Imaging at lower energies (80 kVp) optimizes conspicuity of hypervascular lesions in solid organs, and iodine maps can be superimposed on morphologic imaging to show contrast enhancement. Similar to iodine, other elements with a high atomic number, such as iron, are well suited for DECT imaging. Therefore, DECT has been proposed for non-invasive assessment of iron storage disease.
Implementation of DECT in abdominal CT provides a variety of applications to improve tissue characterization. Reconstruction of virtual unenhanced series can be used in the assessment of renal or adrenal lesions incidentally detected by single-phase contrast-enhanced DECT while considerably reducing radiation dose compared with a dual-phase, single-energy CT protocol with true unenhanced acquisition.
Advanced postprocessing DECT applications include the discrimination of various renal stone types, identifying renal calculi within contrast material-filled renal collecting systems and the ability to distinguish hyperattenuating renal cysts from renal cell carcinoma.
Dual-energy CT has the potential of improving the diagnostic accuracy of CT for the detection of pancreatic cancer. It also may have a role in de¬lineating organ perfusion in the setting of severe acute pancreatitis, helping clarify which regions show diminished perfusion and which ones show necrosis and thereby aiding patient care and prognosis
Dual-energy vascular imaging is a versatile tool for the evaluation of the aortic vasculature. Most pathologies of the aorta require multiphase MSCT-protocols, which leads to high radiation doses. Especially in patients who routinely have to undergo MSCT, like patients after endovascular aneurysm repair, dose reduction strategies are desirable Dual Energy CT offers the possibility to create virtual non-contrast images from arterial or venous datasets and therefore can save radiation dose, decrease interpretation time, or improve diagnostic accuracy.
In the future, patients may be scanned in the dual-energy mode by default because it will add more diagnostic information to what can be achieved by the single-energy mode especially if there is no penalty of additional radiation dose by using the dual-energy mode.
Continuing rapid technical developments will improve the acquisition and post processing of dual-energy CT image data and clinical evaluation of this exciting new technology across a spectrum of abdominal diseases will be required.
Recent technology improvements have facilitated the maturation of DECT into a reliable clinical tool that can be applied to various tasks in abdominal CT. The principle of imaging at two distinctly different photon energies allows separation of substances with sufficiently different K-edges, in particular soft tissue, iodine, and calcium.
DECT of the liver has so far been evaluated for the visualization and detection of three different materials, i.e., the detection of iodinated contrast media as well as the assessment hepatic fat infiltration and iron overload.
Imaging at lower energies (80 kVp) optimizes conspicuity of hypervascular lesions in solid organs, and iodine maps can be superimposed on morphologic imaging to show contrast enhancement. Similar to iodine, other elements with a high atomic number, such as iron, are well suited for DECT imaging. Therefore, DECT has been proposed for non-invasive assessment of iron storage disease.
Implementation of DECT in abdominal CT provides a variety of applications to improve tissue characterization. Reconstruction of virtual unenhanced series can be used in the assessment of renal or adrenal lesions incidentally detected by single-phase contrast-enhanced DECT while considerably reducing radiation dose compared with a dual-phase, single-energy CT protocol with true unenhanced acquisition.
Advanced postprocessing DECT applications include the discrimination of various renal stone types, identifying renal calculi within contrast material-filled renal collecting systems and the ability to distinguish hyperattenuating renal cysts from renal cell carcinoma.
Dual-energy CT has the potential of improving the diagnostic accuracy of CT for the detection of pancreatic cancer. It also may have a role in de¬lineating organ perfusion in the setting of severe acute pancreatitis, helping clarify which regions show diminished perfusion and which ones show necrosis and thereby aiding patient care and prognosis
Dual-energy vascular imaging is a versatile tool for the evaluation of the aortic vasculature. Most pathologies of the aorta require multiphase MSCT-protocols, which leads to high radiation doses. Especially in patients who routinely have to undergo MSCT, like patients after endovascular aneurysm repair, dose reduction strategies are desirable Dual Energy CT offers the possibility to create virtual non-contrast images from arterial or venous datasets and therefore can save radiation dose, decrease interpretation time, or improve diagnostic accuracy.
In the future, patients may be scanned in the dual-energy mode by default because it will add more diagnostic information to what can be achieved by the single-energy mode especially if there is no penalty of additional radiation dose by using the dual-energy mode.
Continuing rapid technical developments will improve the acquisition and post processing of dual-energy CT image data and clinical evaluation of this exciting new technology across a spectrum of abdominal diseases will be required.
Other data
| Title | Dual Energy Computed Tomography (DECT) Applications In Abdominal Imaging | Other Titles | تطبيقات الأشعة المقطعية ثنائية الطاقة في تصوير البطن | Authors | Eslam Mahmoud Taha Mohamed | Issue Date | 2015 |
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