Dual-energy CT of the lung

The introduction of dual-energy CT (DECT) has ushered in the ability of material differentiation and tissue characterization beyond the traditional CT attenuation scale. This quality has been exploited for visualizing and quantifying the specific tissue content using radiographic contrast agents, such as iodine-based contrast media or inhaled xenon gas. Applications of this paradigm in the thorax include characterization of the pulmonary blood pool in the setting of acute or chronic pulmonary embolism (PE) and characterization of diseases of the lung parenchyma. Selective xenon detection is being explored for imaging of lung ventilation. In addition, the usefulness of DECT-based selective iodine uptake measurements has been described for the diagnosis and surveillance of thoracic malignancies. This article reviews the current applications of DECT-based imaging techniques in the chest with an emphasis on the diagnosis and characterization of pulmonary thromboembolic disorders.

DECT can provide both anatomic and functional information about the lungs in a variety of pulmonary disease states based on a single contrast-enhanced CT examination. This quality has been shown to improve the diagnosis of acute and chronic PEs, other vascular disorders, lung malignancies, and parenchymal diseases. Further developments in DECT techniques and CT scanner technology will further foster and enhance the utility of this application and open new avenues in lung imaging.