Split-bolus CT-urography using dual-energy CT: feasibility, image quality and dose reduction

Area of Science:

• Radiology
• Medical Imaging
• Urology

Background:

• Dual-energy (DE) CT-urography (CTU) offers potential for improved diagnostic accuracy and radiation dose reduction.
• Virtual non-enhanced images (VNEI) reconstructed from DE data aim to replace true non-enhanced images (TNEI), potentially lowering radiation exposure.

Purpose of the Study:

• To assess the feasibility of DE split-bolus CTU.
• To evaluate the image quality of VNEI and DE combined nephrographic-excretory phase images (CNEPI).
• To estimate radiation dose savings by omitting TNEI.

Main Methods:

• Prospective evaluation of 30 patients undergoing DE CT.
• Acquisition of single-energy TNEI and DE CNEPI.
• Reconstruction of VNEI from CNEPI and assessment of image quality and urine attenuation.
• Measurement of CT dose index volume (CTDIvol) for both TNEI and CNEPI.

Main Results:

• DE split-bolus CTU was technically feasible.
• Mean image quality scores for CNEPI and VNEI were 4.7 and 3.3, respectively.
• Omission of TNEI could reduce total radiation dose by 52%.

Conclusions:

• DE split-bolus CTU is feasible and reduces radiation exposure.
• Additional TNEI scans are necessary if VNEI quality is suboptimal or quantitative urine attenuation assessment is required.