Abstract
Dual-energy computed tomography (DECT) is an emerging CT technique based on data acquisition
at two different settings. Various postprocessing techniques generate different sets
of images, each with unique advantages. With DECT, it is possible to obtain virtual
unenhanced images from monochromatic reconstructions and attenuation maps of different
elements, thereby improving the detection and characterization of a variety of lesions.
Presently, DECT is widely used to evaluate pulmonary embolism, characterize abdominal
masses, determine the composition of urinary calculi, and detect tophi in gout. CT
angiography is an essential prerequisite for endovascular intervention. DECT allows
a better quality of angiographic images with a lesser dose of contrast. Various postprocessing
techniques in DECT also help in a better evaluation of response to locoregional therapy.
Virtual noncontrast images and iodine map differentiate residual or recurrent tumors
from intrinsically hyperdense materials. Superior metallic artifact reduction allows
better evaluation of vascular injuries adjacent to bony fractured fragments or previously
deployed embolization coils. In addition to metal artifacts reduction, virtual monochromatic
spectral imaging could further mitigate metal artifacts during CT-guided biopsy, providing
an improved depiction of lesions and safe and versatile access for long puncture pathways.
This article reviews and illustrates the different applications of DECT in various
abdominal interventions. Familiarity with the capabilities of DECT may help interventional
radiologists to improve their practice and ameliorate patient care.
Keywords
dual-energy CT - abdominal interventions - transarterial chemoembolization - transjugular
intrahepatic portosystemic shunt - CT-guided interventions
