Dual-energy CT imaging of thoracic malignancies

Abstract

Computed tomography (CT) plays a pivotal role in the detection, characterization, and staging of lung cancer and other thoracic malignancies. Since the introduction of clinically viable dual-energy CT techniques, substantial evidence has accumulated on the use of this modality for imaging chest malignancies. This article describes the principles of dual-energy CT along with suitable image acquisition, reconstruction, and postprocessing strategies for oncologic applications in the chest. The potential of dual-energy CT techniques for the detection, characterization, staging, and surveillance of chest malignancy, as well as the limitations of this modality are discussed.

Evaluation of locoregional invasiveness of small-sized non-small cell lung cancers by enhanced dual-energy computed tomography

“…Contrast-enhanced CT has been used in functional imaging to evaluate intratumoral necrosis, vascularity, and fibrosis, which are associated with invasiveness and prognosis [ 6 – 8 ]. A dual-energy CT (DE-CT) technique using two types of tube voltage has enabled quantification of the iodine-related attenuation of iodinated contrast material in the tumor after intravenous injection, without the need for an additional non-contrast CT scan [ 9 – 12 ]. It leads to radiation exposure reduction of a patient in a CT examination.…”

Evaluation of lung cancer by enhanced dual-energy CT: association between three-dimensional iodine concentration and tumour differentiation

“…However, recently, a dual-energy CT (DECT) technique using two types of tube voltage has enabled quantification of the iodine-related attenuation of iodinated contrast material in the tumour after intravenous injection without the need for an additional unenhanced CT scan. [13][14][15] Furthermore, novel computer application software (syngo ® lung nodules application; Siemens Healthcare, Tokyo, Japan) attached to a DECT scanner can automatically evaluate a threedimensional segment of a tumour and calculate iodinerelated concentration (iodine volume) of the entire tumour. 16 This computer-aided segmentation can decrease measurement error by manually illustrating the region of interest (ROI) in the tumour.…”

Dual-energy snap-shot perfusion CT in suspect pulmonary nodules and masses and for lung cancer staging

“…The third approach is to acquire dual-energy data by means of a dual-layer technique, where photons from a single X-ray source are simultaneously and energy-selectively registered by the detector. The physical background of all these currently available DECT image acquisition techniques have been detailed explained previously [20][21][22][23].…”