Virtual non-calcium dual-energy CT: clinical applications

Abstract

Dual-energy CT (DECT) has emerged into clinical routine as an imaging technique with unique postprocessing utilities that improve the evaluation of different body areas. The virtual non-calcium (VNCa) reconstruction algorithm has shown beneficial effects on the depiction of bone marrow pathologies such as bone marrow edema. Its main advantage is the ability to substantially increase the image contrast of structures that are usually covered with calcium mineral, such as calcified vessels or bone marrow, and to depict a large number of traumatic, inflammatory, infiltrative, and degenerative disorders affecting either the spine or the appendicular skeleton. Therefore, VNCa imaging represents another step forward for DECT to image conditions and disorders that usually require the use of more expensive and time-consuming techniques such as magnetic resonance imaging, positron emission tomography/CT, or bone scintigraphy. The aim of this review article is to explain the technical background of VNCa imaging, showcase its applicability in the different body regions, and provide an updated outlook on the clinical impact of this technique, which goes beyond the sole improvement in image quality.

Dual-Energy CT, Virtual Non-Calcium Bone Marrow Imaging of the Spine: An AI-Assisted, Volumetric Evaluation of a Reference Cohort with 500 CT Scans

“…Abdullayev et al also made use of the identical SDCT scanner to successfully identify metastatic spine disease on contrast-enhanced VNCa images, which might serve as well as a practical proof of concept [12]. Several further authors consider this approach promising and warrant further investigation [13,14].…”

“…By now, dual-energy CT (DECT) is a widely available technology, which holds the potential to narrow the diagnostic uncertainty of conventional CT concerning metastatic spine disease [12][13][14]. DECT exploits the physical phenomenon that the interaction of an X-ray beam with any absorbing material depends on a material-specific combination of the photoelectric effect and Compton scattering.…”

Bowel obstruction and perforation secondary to progressive heterotopic mesenteric ossificans

“…This case illustrates the importance of recognizing the incipient stages of HMO since the ossification was initially mistaken by the radiologist as surgical material. However, new advanced imaging techniques like dual energy CT can help confirm the presence of calcium/ossification with high specificity based on the unique spectral properties of calcium [12] . Second, the patient presented multiple times with recurrent bowel obstruction, each time being treated conservatively.…”

Artificial intelligence, machine learning and deep learning in musculoskeletal imaging: Current applications

“…In this context, various ML and DL algorithms have been developed to assess bone fragility more precisely than existing methods through the analysis of the geometry and texture of the bone trabeculation 22,96–98 . Yang et al evaluated bone characteristics in multi‐detector computed tomography (MDCT), dual‐energy computed tomography (DECT), and BMD using DL algorithms to establish the maximum resistance load of the proximal femur 96,99,100 . Throughout their study period, they extracted volumes of interest from the head, neck, and trochanter of 146 ex vivo proximal femurs from multidetector tomography.…”