Imaging Pearls ❯ Dual Energy ❯ CT Angiography
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- “Although overall promising, dual-energy CT has several limitations, the most critical being the cumbersome workflow, which has so far prevented this technology from becoming widely adopted outside of academic centers.”
Computed Tomography Angiography A Review and Technical Update Fleischmann D et al. Radiol Clin N Am 54 (2016) 1–12 - “The theoretic benefits of dual-energy CT include the possibility of reconstructing virtual images at very low photon energy (kiloelectron volt), with benefits similar to and possibly better than low kilovolt (peak) CT acquisitions. The increased sensitivity to iodine might be exploited for low- contrast dose acquisitions, or might translate into improved detectability of sources of bleeds. Dual-energy CT also allows the reconstruction of virtual noncontrast images by subtracting the iodine signal from the data. This can obviate acquisition of nonenhanced images. The ability to separate iodine from calcium has been used to help subtract bone or calcified plaque in CTA datasets.”
Computed Tomography Angiography A Review and Technical Update Fleischmann D et al. Radiol Clin N Am 54 (2016) 1–12
- “ An optimal analysis of thoracic circulation can be achieved on virtual monochromatic spectral images at 60 keV and 100 keV and on the original polychromatic images at 80 kV and 140 kV.”
Spectral Optimization of Chest CT Angiography with Reduced Iodine Load: Experience in 80 Patients Evaluated with Dual-Source, Dual Energy CT
Delesalle MA et al
Radiology 2013; 267:256-266 - “ The use of low concentration contrast media for dual-source, dual energy CT angiography enables suppression of streak artifacts around systemic veins on high energy images while providing satisfactory central arterial enhancement on low energy images; the additional advantage of this scanning mode is the considerable reduction in the amount of iodine administered to patients.”
Spectral Optimization of Chest CT Angiography with Reduced Iodine Load: Experience in 80 Patients Evaluated with Dual-Source, Dual Energy CT
Delesalle MA et al
Radiology 2013; 267:256-266
- CT Angiography
- Improved contrast profile (less contrast needed)
- Bone subtraction
- Calcified plaque subtraction
- Less radiation dose (pseudo-non contrast scans)