Updates on the Applications of Spectral Computed Tomography for Musculoskeletal Imaging

Abstract

Spectral CT represents a novel imaging approach that can noninvasively visualize, quantify, and characterize many musculoskeletal pathologies. This modality has revolutionized the field of radiology by capturing CT attenuation data across multiple energy levels and offering superior tissue characterization while potentially minimizing radiation exposure compared to traditional enhanced CT scans. Despite MRI being the preferred imaging method for many musculoskeletal conditions, it is not viable for some patients. Moreover, this technique is time-consuming, costly, and has limited availability in many healthcare settings. Thus, spectral CT has a considerable role in improving the diagnosis, characterization, and treatment of gout, inflammatory arthropathies, degenerative disc disease, osteoporosis, occult fractures, malignancies, ligamentous injuries, and other bone-marrow pathologies. This comprehensive review will delve into the diverse capabilities of dual-energy CT, a subset of spectral CT, in addressing these musculoskeletal conditions and explore potential future avenues for its integration into clinical practice.

Meta-analysis of the value of dual-energy computed tomography in the diagnosis of anterior cruciate ligament injuries of the knee

“…While MRI is widely recognized as the diagnostic modality of choice for a multitude of musculoskeletal disorders, accessibility to this method is not universally attainable for all patient populations [ 12 ]. Additionally, MRI is characterized by its protracted procedural duration, economic exigency, and constrained applicability within the spectrum of medical institutions.…”

“…Magnetic resonance imaging (MRI) is recognized as a non-invasive diagnostic tool for the detection of ACL injuries [ 7 , 11 ], however, have limitations in certain situations, particularly in the context of acute trauma and for participants with specific contraindications [ 7 ]. Spectral computed tomography (CT) represents a novel imaging approach that can noninvasively visualize, quantify, and characterize many musculoskeletal pathologies [ 12 ]. Dual-energy computed tomography (DECT), as a subset of spectral CT imaging, has revolutionized radiology by enabling material differentiation, superior tissue characterization, robust quantification, and a marked reduction in iodine dosage [ 13 ].…”