Quantitative Dual-Energy CT in Abdominal Imaging: Technical Considerations and Emerging Clinical Applications

Dual-energy CT (DECT) has increased the diagnostic capabilities of CT in abdominal imaging, overcoming many of the limitations of conventional CT by leveraging information about radiation beam energy and material composition to generate multiple datasets. Exploiting DECT-derived energy- and material-specific datasets has improved CT image quality and expanded its clinical applications in abdominal imaging. DECT makes it possible to noninvasively detect, characterize, and quantify clinically relevant materials, improving tissue characterization and providing multiple quantitative parameters that expand the role of CT in abdominal imaging and support development of imaging biomarkers. Nevertheless, implementing these advanced CT applications and quantitative parameters in clinical practice remains challenging. The authors provide an overview of various applications of quantitative clinical DECT parameters in abdominal imaging. First, they describe the basic principles underlying DECT, reviewing the fundamentals and challenges of DECT material characterization and derived quantitative parameters. They then examine current applications of DECT-based quantitative imaging in abdominal disease, discussing their strengths and limitations. Finally, they explore potential applications of DECT in abdominal imaging, including artificial intelligence and DECT-derived radiomics and imaging biomarkers. ^©RSNA, 2026 Supplemental material is available for this article.