"With a decrease in attenuation at 80 kVp as an indicator of intracellular lipid within an adenoma, dual energy has 50% sensitivity, 100% specificity, 100% positive predictive value, and 28% negative predictive value in the diagnosis of adenoma."

Dual-Energy CT for Characterization of Adrenal Nodules: Initial Experience
Gupta RT et al.
AJR 2010; 1941479-1483

"The mean attenuation change between 140 kVp and 80 kVp was 0.4 ± 7.1 HU for adenomas and 9.2 ± 4.3 HU for metastatic lesions. Fifty percent of adenomas had an attenuation decrease at 80 kVp. All metastatic lesions had an attenuation increase at 80 kVp. With a decrease in attenuation at 80 kVp as an indicator of intracellular lipid within an adenoma, dual energy has 50% sensitivity, 100% specificity, 100% positive predictive value, and 28% negative predictive value in the diagnosis of adenoma."

Dual-Energy CT for Characterization of Adrenal Nodules: Initial Experience
Gupta RT et al.
AJR 2010; 1941479-1483

"A decrease in attenuation of an adrenal lesion between 140 kVp and 80 kVp is a highly specific sign of an adrenal adenoma. However, because an increase in attenuation at 80 kVp is seen with metastatic lesions and some adenomas, the sensitivity of this test is low."

Dual-Energy CT for Characterization of Adrenal Nodules: Initial Experience
Gupta RT et al.
AJR 2010; 1941479-1483