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Use of dual-energy CT for renal mass assessment

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Abstract

Although dual-energy CT (DECT) may prove useful in a variety of abdominal imaging tasks, renal mass evaluation represents the area where this technology can be most impactful in abdominal imaging compared to routinely performed contrast-enhanced–only single-energy CT exams. DECT post-processing techniques, such as creation of virtual unenhanced and iodine density images, can help in the characterization of incidentally discovered renal masses that would otherwise remain indeterminate based on post-contrast imaging only. The purpose of this article is to review the use of DECT for renal mass assessment, including its benefits and existing limitations.

Key Points

• If DECT is selected as the scanning mode for most common abdominal protocols, many incidentally found renal masses can be fully triaged within the same exam.

• Virtual unenhanced and iodine density DECT images can provide additional information when renal masses are discovered in the post-contrast–only setting.

• For renal mass evaluation, virtual unenhanced and iodine density DECT images should be interpreted side-by-side to troubleshoot pitfalls that can potentially lead to erroneous interpretation.

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Abbreviations

DECT:

Dual-energy CT

DL-DECT:

Dual-layer dual-energy CT

DS-DECT:

Dual-source dual-energy CT

IVP:

Intravenous pyelography

KVS-DECT:

Rapid kilovoltage-peak switching dual-energy CT

PACS:

Picture archiving and communication system

RCC:

Renal cell carcinoma

SECT:

Single-energy CT

SF-DECT:

Split-filter dual-energy CT

SS-DECT:

Sequential scanning dual-energy CT

VMCI:

Virtual monochromatic images

VUE:

Virtual unenhanced

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Authors and Affiliations

  1. Department of Radiology, University of Washington School of Medicine, 1959 NE Pacific Street, Box 357115, Seattle, WA, 98195, USA

    Shanigarn Thiravit, Christina Brunnquell, Larry M. Cai, Mena Flemon & Achille Mileto

  2. Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand

    Shanigarn Thiravit

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  1. Shanigarn Thiravit
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Correspondence to Achille Mileto.

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Achille Mileto has a research grant from GE Healthcare and receives research support from Philips Healthcare.

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Thiravit, S., Brunnquell, C., Cai, L.M. et al. Use of dual-energy CT for renal mass assessment. Eur Radiol 31, 3721–3733 (2021). https://doi.org/10.1007/s00330-020-07426-z

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