Dual-energy computed tomography in children: Technique and clinical applications

Dual-energy CT (DECT) is an advancement in CT technology that allows for the acquisition of images at two different energy levels. Two main post-processing tools, which form the backbone of DECT, include material decomposition and virtual monoenergetic images. Material decomposition helps in the generation of virtual nonenhanced, iodine, pulmonary lung blood volume, lung vessel, automated bone removal, and renal stone characterization images. DECT offers a broad spectrum of clinical applications in pediatric imaging, including vascular, neurological, thoracic, abdominal, skeletal, and oncologic assessments. Additionally, it contributes to shorter scan times and enables the use of lower contrast media volumes while maintaining diagnostic image quality. This technique provides unique qualitative and quantitative information about the composition of the tissue, allowing differentiation of materials, including iodinated contrast agents. The radiation dose of DECT is equivalent to or lower than that of a single-energy CT, adding to the advantages of DECT, especially in children who are more sensitive to the harmful effects of radiation. In this minireview we outlined the basic principles of the DECT technique and its post-processing techniques with emphasis on clinical applications in pediatric imaging.