Benjamin Böttcher, Emese Zsarnoczay, Akos Varga-Szemes, Uwe Joseph Schoepf, Felix G Meinel, Marly van Assen, Carlo N De Cecco
Radiol Clin North Am . 2023 Nov;61(6):995-1009. doi: 10.1016/j.rcl.2023.05.004. Epub 2023 Jun 18.
Dual-energy computed tomography (DECT) acquires images using two energy spectra and offers a variation of reconstruction techniques for improved cardiac imaging. Virtual monoenergetic images decrease artifacts improving coronary plaque and stent visualization. Further, contrast attenuation is increased allowing significant reduction of contrast dose. Virtual non-contrast reconstructions enable coronary artery calcium scoring from contrast-enhanced scans. DECT provides advanced plaque imaging with detailed analysis of plaque components, indicating plaque stability. Extracellular volume assessment using DECT offers noninvasive detection of myocardial fibrosis. This review aims to outline the current cardiac applications of DECT, summarize recent literature, and discuss their findings.