Abstract
Over the past two decades, multidetector computed tomography (CT) has become a powerful diagnostic tool in emergency medicine relied upon for a variety of conditions. More recently, the development of dual-energy CT technology has enhanced the ability of radiologists to diagnose and distinguish between a variety of conditions, improving accuracy and patient care. The ability to separate material density pairs allows for highly specific observations, and helps to avoid diagnostic pitfalls. Dual-energy CT has benefits in diagnosing conditions of the liver, gallbladder, kidneys, adrenals, pancreas, large and small bowel, as well as vascular structures. It also has benefits in diagnostic evaluation of patients in the setting of trauma. When its benefits are harnessed, dual-energy CT has the potential to significantly improve patient care in the emergency department.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Scales CD Jr, Smith AC, Hanley JM, Saigal CS, Urologic Diseases in America. Prevalence of kidney stones in the United States. Eur Urol. 2012;62(1):160–5.
Larson DB, Johnson LW, Schnell BM, Salisbury SR, Forman HP. National trends in CT use in the emergency department: 1995-2007. Radiology. 2011;258(1):164–73.
Uyeda JW, Sahani DV. Dual-energy CT in the acute abdomen. Curr Radiol Rep. 2015;3:20.
Silva AC, Morse BG, Hara AK, Paden RG, Hongo N, Pavlicek W. Dual-energy (spectral) CT: applications in abdominal imaging. Radiographics. 2011;31(4):1031–46. discussion 1047-1050
Karcaaltincaba M, Aktas A. Dual-energy CT revisited with multidetector CT: review of principles and clinical applications. Diagn Interv Radiol. 2011;17(3):181–94.
Vlahos I, Chung R, Nair A, Morgan R. Dual-energy CT: vascular applications. AJR Am J Roentgenol. 2012;199(5 Suppl):S87–97.
Patino M, Prochowski A, Agrawal MD, Simeone FJ, Gupta R, Hahn PF, et al. Material separation using dual-energy CT: current and emerging applications. Radiographics. 2016;36(4):1087–105.
Heye T, Nelson RC, Ho LM, Marin D, Boll DT. Dual-energy CT applications in the abdomen. AJR Am J Roentgenol. 2012;199(5 Suppl):S64–70.
Marin D, Boll DT, Mileto A, Nelson RC. State of the art: dual-energy CT of the abdomen. Radiology. 2014;271(2):327–42.
Grajo JRPM, Prochowski A, Sahani DV. Dual energy CT in practice: basic principles and applications. Appl Radiol. 2016;45(7):6–12.
Agrawal MD, Oliveira GR, Kalva SP, Pinho DF, Arellano RS, Sahani DV. Prospective comparison of reduced-iodine-dose virtual monochromatic imaging dataset from dual-energy CT angiography with standard-iodine-dose single-energy ct angiography for abdominal aortic aneurysm. AJR Am J Roentgenol. 2016;207(6):W125–32.
Foley WD, Shuman WP, Siegel MJ, Sahani DV, Boll DT, Bolus DN, et al. White paper of the society of computed body tomography and magnetic resonance on dual-energy CT, Part 2: radiation dose and iodine sensitivity. J Comput Assist Tomogr. 2016;40(6):846–50.
Shuman WP, Chan KT, Busey JM, Mitsumori LM, Koprowicz KM. Dual-energy CT aortography with 50% reduced iodine dose versus single-energy CT aortography with standard iodine dose. Acad Radiol. 2016;23(5):611–8.
Aran S, Daftari Besheli L, Karcaaltincaba M, Gupta R, Flores EJ, Abujudeh HH. Applications of dual-energy CT in emergency radiology. AJR Am J Roentgenol. 2014;202(4):W314–24.
Lewis M, Reid K, Toms AP. Reducing the effects of metal artefact using high keV monoenergetic reconstruction of dual energy CT (DECT) in hip replacements. Skelet Radiol. 2013;42(2):275–82.
Yeh BM, Shepherd JA, Wang ZJ, Teh HS, Hartman RP, Prevrhal S. Dual-energy and low-kVp CT in the abdomen. AJR Am J Roentgenol. 2009;193(1):47–54.
Kim JE, Lee JM, Baek JH, Han JK, Choi BI. Initial assessment of dual-energy CT in patients with gallstones or bile duct stones: can virtual nonenhanced images replace true nonenhanced images? AJR Am J Roentgenol. 2012;198(4):817–24.
Shoheiber O, Biskupiak JE, Nash DB. Estimation of the cost savings resulting from the use of ursodiol for the prevention of gallstones in obese patients undergoing rapid weight reduction. Int J Obes Relat Metab Disord. 1997;21(11):1038–45.
Uyeda JW, Richardson IJ, Sodickson AD. Making the invisible visible: improving conspicuity of noncalcified gallstones using dual energy CT. Abdom Radiol. 2017;42(12):2933–9.
Barakos JA, Ralls PW, Lapin SA, Johnson MB, Radin DR, Colletti PM, et al. Cholelithiasis: evaluation with CT. Radiology. 1987;162(2):415–8.
Hickman MS, Schwesinger WH, Bova JD, Kurtin WE. Computed tomographic analysis of gallstones. An in vitro study. Arch Surg. 1986;121(3):289–91.
Bennett GL, Rusinek H, Lisi V, Israel GM, Krinsky GA, Slywotzky CM, et al. CT findings in acute gangrenous cholecystitis. AJR Am J Roentgenol. 2002;178(2):275–81.
Chen AL, Liu AL, Wang S, Liu JH, Ju Y, Sun MY, et al. Detection of gallbladder stones by dual-energy spectral computed tomography imaging. World J Gastroenterol. 2015;21(34):9993–8.
Pearle MS, Goldfarb DS, Assimos DG, Curhan G, Denu-Ciocca CJ, Matlaga BR, et al. Medical management of kidney stones: AUA guideline. J Urol. 2014;192(2):316–24.
Boridy IC, Nikolaidis P, Kawashima A, Sandler CM, Goldman SM. Noncontrast helical CT for ureteral stones. World J Urol. 1998;16(1):18–21.
Ather MH, Jafri AH, Sulaiman MN. Diagnostic accuracy of ultrasonography compared to unenhanced CT for stone and obstruction in patients with renal failure. BMC Med Imaging. 2004;4(1):2.
Ulusan S, Koc Z, Tokmak N. Accuracy of sonography for detecting renal stone: comparison with CT. J Clin Ultrasound. 2007;35(5):256–61.
Scheffel H, Stolzmann P, Frauenfelder T, Schertler T, Desbiolles L, Leschka S, et al. Dual-energy contrast-enhanced computed tomography for the detection of urinary stone disease. Investig Radiol. 2007;42(12):823–9.
Duan X, Li Z, Yu L, Leng S, Halaweish AF, Fletcher JG, et al. Characterization of urinary stone composition by use of third-generation dual-source dual-energy CT with increased spectral separation. AJR Am J Roentgenol. 2015;205(6):1203–7.
Kulkarni NM, Eisner BH, Pinho DF, Joshi MC, Kambadakone AR, Sahani DV. Determination of renal stone composition in phantom and patients using single-source dual-energy computed tomography. J Comput Assist Tomogr. 2013;37(1):37–45.
Leng S, Huang A, Cardona JM, Duan X, Williams JC, McCollough CH. Dual-energy CT for quantification of urinary stone composition in mixed stones: a phantom study. AJR Am J Roentgenol. 2016;207(2):321–9.
Matlaga BR, Kawamoto S, Fishman E. Dual source computed tomography: a novel technique to determine stone composition. Urology. 2008;72(5):1164–8.
Ogawa N, Sato S, Ida K, Kato K, Ariyoshi Y, Wada K, et al. Evaluation of urinary stone composition and differentiation between urinary stones and phleboliths using single-source dual-energy computed tomography. Acta Med Okayama. 2017;71(2):91–6.
Zhang GM, Sun H, Xue HD, Xiao H, Zhang XB, Jin ZY. Prospective prediction of the major component of urinary stone composition with dual-source dual-energy CT in vivo. Clin Radiol. 2016;71(11):1178–83.
Zilberman DE, Ferrandino MN, Preminger GM, Paulson EK, Lipkin ME, Boll DT. In vivo determination of urinary stone composition using dual energy computerized tomography with advanced post-acquisition processing. J Urol. 2010;184(6):2354–9.
Aran S, Shaqdan KW, Abujudeh HH. Dual-energy computed tomography (DECT) in emergency radiology: basic principles, techniques, and limitations. Emerg Radiol. 2014;21(4):391–405.
Silverman SG, Israel GM, Herts BR, Richie JP. Management of the incidental renal mass. Radiology. 2008;249(1):16–31.
Neville AM, Gupta RT, Miller CM, Merkle EM, Paulson EK, Boll DT. Detection of renal lesion enhancement with dual-energy multidetector CT. Radiology. 2011;259(1):173–83.
Ascenti G, Mileto A, Gaeta M, Blandino A, Mazziotti S, Scribano E. Single-phase dual-energy CT urography in the evaluation of haematuria. Clin Radiol. 2013;68(2):e87–94.
Chen CY, Hsu JS, Jaw TS, Shih MC, Lee LJ, Tsai TH, et al. Split-bolus portal venous phase dual-energy CT urography: protocol design, image quality, and dose reduction. AJR Am J Roentgenol. 2015;205(5):W492–501.
Berland LL, Silverman SG, Gore RM, Mayo-Smith WW, Megibow AJ, Yee J, et al. Managing incidental findings on abdominal CT: white paper of the ACR incidental findings committee. J Am Coll Radiol. 2010;7(10):754–73.
Song JH, Chaudhry FS, Mayo-Smith WW. The incidental adrenal mass on CT: prevalence of adrenal disease in 1,049 consecutive adrenal masses in patients with no known malignancy. AJR Am J Roentgenol. 2008;190(5):1163–8.
Glazer DI, Maturen KE, Kaza RK, Francis IR, Keshavarzi NR, Parker RA, et al. Adrenal Incidentaloma triage with single-source (fast-kilovoltage switch) dual-energy CT. AJR Am J Roentgenol. 2014;203(2):329–35.
Gnannt R, Fischer M, Goetti R, Karlo C, Leschka S, Alkadhi H. Dual-energy CT for characterization of the incidental adrenal mass: preliminary observations. AJR Am J Roentgenol. 2012;198(1):138–44.
Botsikas D, Triponez F, Boudabbous S, Hansen C, Becker CD, Montet X. Incidental adrenal lesions detected on enhanced abdominal dual-energy CT: can the diagnostic workup be shortened by the implementation of virtual unenhanced images? Eur J Radiol. 2014;83(10):1746–51.
Slebocki K, Kraus B, Chang DH, Hellmich M, Maintz D, Bangard C. Incidental findings in abdominal dual-energy computed tomography: correlation between true noncontrast and virtual noncontrast images considering renal and liver cysts and adrenal masses. J Comput Assist Tomogr. 2017;41(2):294–7.
Mileto A, Nelson RC, Marin D, Roy Choudhury K, Ho LM. Dual-energy multidetector CT for the characterization of incidental adrenal nodules: diagnostic performance of contrast-enhanced material density analysis. Radiology. 2015;274(2):445–54.
Ernst O, Bulois P, Saint-Drenant S, Leroy C, Paris JC, Sergent G. Helical CT in acute lower gastrointestinal bleeding. Eur Radiol. 2003;13(1):114–7. https://doi.org/10.1007/s00330-002-1442-y.
Yamaguchi T, Yoshikawa K. Enhanced CT for initial localization of active lower gastrointestinal bleeding. Abdom Imaging. 2003;28(5):634–6.
Rajan R, Dhar P, Praseedom RK, Sudhindran S, Moorthy S. Role of contrast CT in acute lower gastrointestinal bleeding. Dig Surg. 2004;21(4):293–6.
Yoon W, Jeong YY, Shin SS, Lim HS, Song SG, Jang NG, et al. Acute massive gastrointestinal bleeding: detection and localization with arterial phase multi-detector row helical CT. Radiology. 2006;239(1):160–7.
Jaeckle T, Stuber G, Hoffmann MH, Jeltsch M, Schmitz BL, Aschoff AJ. Detection and localization of acute upper and lower gastrointestinal (GI) bleeding with arterial phase multi-detector row helical CT. Eur Radiol. 2008;18(7):1406–13.
Sodhi JS, Zargar SA, Rashid W, Shaheen F, Singh M, Javid G, et al. 64-section multiphase CT enterography as a diagnostic tool in the evaluation of obscure gastrointestinal bleeding. Indian J Gastroenterol. 2012;31(2):61–8.
Fulwadhva UP, Wortman JR, Sodickson AD. Use of dual-energy CT and iodine maps in evaluation of bowel disease. Radiographics. 2016;36(2):393–406.
Firetto MC, Lemos AA, Marini A, Avesani EC, Biondetti PR. Acute bowel ischemia: analysis of diagnostic error by overlooked findings at MDCT angiography. Emerg Radiol. 2013;20(2):139–47.
Potretzke TA, Brace CL, Lubner MG, Sampson LA, Willey BJ, Lee FT Jr. Early small-bowel ischemia: dual-energy CT improves conspicuity compared with conventional CT in a swine model. Radiology. 2015;275(1):119–26.
Soto JA, Anderson SW. Multidetector CT of blunt abdominal trauma. Radiology. 2012;265(3):678–93.
Hong C, Heiken JP, Sicard GA, Pilgram TK, Bae KT. Clinical significance of endoleak detected on follow-up CT after endovascular repair of abdominal aortic aneurysm. AJR Am J Roentgenol. 2008;191(3):808–13.
Chandarana H, Godoy MC, Vlahos I, Graser A, Babb J, Leidecker C, et al. Abdominal aorta: evaluation with dual-source dual-energy multidetector CT after endovascular repair of aneurysms--initial observations. Radiology. 2008;249(2):692–700. https://doi.org/10.1148/radiol.2492080359.
Nicolaou S, Eftekhari A, Sedlic T, Hou DJ, Mudri MJ, Aldrich J, et al. The utilization of dual source CT in imaging of polytrauma. Eur J Radiol. 2008;68(3):398–408.
Feldman F, Staron R, Zwass A, Rubin S, Haramati N. MR imaging: its role in detecting occult fractures. Skelet Radiol. 1994;23(6):439–44.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG, part of Springer Nature
About this chapter
Cite this chapter
Yu, H., Bates, D.D.B., Sahani, D.V. (2018). Dual-Energy CT in Patients with an Acute Abdomen. In: Patlas, M., Katz, D., Scaglione, M. (eds) MDCT and MR Imaging of Acute Abdomen. Springer, Cham. https://doi.org/10.1007/978-3-319-70778-5_3
Download citation
DOI: https://doi.org/10.1007/978-3-319-70778-5_3
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-70777-8
Online ISBN: 978-3-319-70778-5
eBook Packages: MedicineMedicine (R0)