Dual energy MDCT assessment of renal lesions: an overview

With the expansion of cross-sectional imaging, the number of renal lesions that are incidentally discovered has increased. Multidetector CT (MDCT) is the investigation of choice for characterising and staging renal lesions. Although a definitive diagnosis can be confidently posed for most of them, a number of renal lesions remain indeterminate following MDCT. Further imaging tests are therefore needed, with subsequent increase of healthcare costs, radiation exposure, and patient anxiety. By addressing most of the issues with conventional MDCT imaging, dual-energy MDCT can improve the diagnosis of renal lesions and, potentially, may represent a paradigm shift from a merely attenuation-based to a material-specific spectral imaging investigation. The purpose of this review is to provide an overview of current clinical applications of dual-energy CT in the evaluation of renal lesions. Key Points • As MDCT expands, an increasing number of renal lesions are serendipitously discovered. • With conventional MDCT, technical issues affect the diagnosis of renal lesions. • Dual-energy CT addresses some of the drawbacks of conventional MDCT. • Dual-energy CT may represent a paradigm shift for renal lesions imaging.