Dual-energy derived virtual nonenhanced computed tomography imaging: current status and applications

Area of Science:

• Radiology
• Medical Imaging
• Radiation Oncology

Background:

• Computed tomography (CT) is a significant source of radiation exposure for patients.
• Multiphase CT studies often require a nonenhanced phase, increasing overall radiation dose.
• Dual-energy CT (DECT) technology presents an opportunity to mitigate this dose.

Purpose of the Study:

• To review the current capabilities and clinical applications of virtual nonenhanced (VNE) imaging using DECT.
• To identify the technical feasibility and clinical relevance of VNE imaging across various anatomical regions.
• To discuss the challenges hindering the widespread adoption and future development of VNE imaging.

Main Methods:

• Review of existing literature on virtual nonenhanced imaging techniques in dual-energy CT.
• Analysis of reported clinical applications and feasibility studies in different organs (kidney, liver, lung, brain, aorta).
• Assessment of current hardware limitations and postprocessing challenges associated with VNE imaging.

Main Results:

• Virtual nonenhanced (VNE) imaging via DECT is technically feasible and clinically relevant for multiphase studies.
• Successful applications of VNE imaging have been demonstrated in the kidney, liver, lung, brain, and aorta.
• Consistent reports highlight the potential of VNE to reduce cumulative radiation dose in CT examinations.

Conclusions:

• DECT-based VNE imaging is a promising technique for reducing patient radiation exposure.
• Clinical utility is established, but further advancements in hardware and postprocessing are necessary.
• Overcoming current challenges will facilitate broader implementation of VNE imaging in routine CT protocols.