Dual-Energy CT with Single- and Dual-Source Scanners: Current Appli-cations in Evaluating the Genitourinary Tract
RadioGraphics 2012; 32:353-369
Ravi K. Kaza, MD , Joel F. Platt, MD , Richard H. Cohan, MD , Elaine M. Caoili, MD , Mahmoud M. Al-Hawary, MD ,Ashish Wasnik, MD
Several promising clinical applications for dual-energy computed tomography (CT) in genitourinary imaging have been reported. Dual-energy CT not only provides excellent morphologic detail but also can supply material-specific and quantitative information that may be particularly useful in genitourinary imaging. Dual-energy CT has unique capabilities for characterizing renal lesions by quantifying iodine content and helping identify the mineral contents of renal stones, information that is important for patient care. Virtual unenhanced images reconstructed from dual-energy CT datasets can be useful for detecting calculi within the iodine-filled urinary collecting system, potentially reducing the need for an unenhanced scanning phase at CT urography. Although the underlying principles of dual-energy CT are the same regardless of scanner type, single-source dual-energy scanners with fast kilovoltage switching differ from dual-source dual-energy scanners both in image data acquisition and in processing methods; an understanding of these differences may help optimize dual-energy CT genitourinary protocols. Dual-energy CT performed with a dual-source scanner or with a single-source scanner with fast kilovoltage switching also has some important limitations. Further advances in scanning protocols and refinement of processing techniques to reduce image noise may lead to more widespread use of dual-energy CT.