Timely and accurate diagnosis of focal lesions of the liver, despite the existing arsenal of of radiation examination modalities, still remains a challenge. Particular difficulty is caused by foci of small diameter, an atypical character of contrasting; a combination of multiple formations of different genesis; focus against the background of diffuse liver damage; liver damage, mimicking tumors. DECT method givesnew analysis algorithms that are different from traditional CT. The article presents a review of the literature on the use of qualitative and quantitative parameters of spectral scanning in different phases of contrast enhancement in the differential diagnosis of liver focal lesions. The use of low-energy monochromatic images and the quantitative analysis of iodine content contribute to a better detection of liver foci and greater confidence in differential diagnosis.