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Updated: Nov 30, 2025

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Pulmonary Embolism Versus Mimics on Dual-energy Spectral Computed Tomography: An Algorithmic Approach
Elias George Kikano1, Kai Roman Laukamp, Samuel Azeze1
1From the Department of Radiology, University Hospitals Cleveland Medical Center/Case Western Reserve University, Cleveland, OH.
Abstract:
Pulmonary embolism is a commonly encountered diagnosis that is traditionally identified on conventional computed tomography angiography. Dual-energy computed tomography (DECT) is a new technology that may aid the initial identification and differential diagnosis of pulmonary embolism. In this review, we present an algorithmic approach for assessing pulmonary embolism on DECT, including acute versus chronic pulmonary embolism, relationship to conventional computed tomography angiography, surrogate for likelihood of hemodynamic significance, and alternative diagnoses for DECT perfusion defects.
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