Semin Musculoskelet Radiol 2015; 19(05): 431-437
DOI: 10.1055/s-0035-1569253
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Dual-Energy CT: Basic Principles, Technical Approaches, and Applications in Musculoskeletal Imaging (Part 1)

Patrick Omoumi
1   Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland
,
Fabio Becce*
1   Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland
,
Damien Racine
2   Institute of Radiation Physics, Lausanne University Hospital, Lausanne, Switzerland
,
Julien G. Ott
2   Institute of Radiation Physics, Lausanne University Hospital, Lausanne, Switzerland
,
Gustav Andreisek
3   Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
,
Francis R. Verdun*
2   Institute of Radiation Physics, Lausanne University Hospital, Lausanne, Switzerland
› Author Affiliations
Further Information

Publication History

Publication Date:
22 December 2015 (online)

Abstract

In recent years, technological advances have allowed manufacturers to implement dual-energy computed tomography (DECT) on clinical scanners. With its unique ability to differentiate basis materials by their atomic number, DECT has opened new perspectives in imaging. DECT has been used successfully in musculoskeletal imaging with applications ranging from detection, characterization, and quantification of crystal and iron deposits; to simulation of noncalcium (improving the visualization of bone marrow lesions) or noniodine images. Furthermore, the data acquired with DECT can be postprocessed to generate monoenergetic images of varying kiloelectron volts, providing new methods for image contrast optimization as well as metal artifact reduction. The first part of this article reviews the basic principles and technical aspects of DECT including radiation dose considerations. The second part focuses on applications of DECT to musculoskeletal imaging including gout and other crystal-induced arthropathies, virtual noncalcium images for the study of bone marrow lesions, the study of collagenous structures, applications in computed tomography arthrography, as well as the detection of hemosiderin and metal particles.

* F. Becce and F.R. Verdun contributed equally to this work.


 
  • References

  • 1 Hounsfield GN. Computerized transverse axial scanning (tomography). 1. Description of system. Br J Radiol 1973; 46 (552) 1016-1022
  • 2 Fleischmann D, Boas FE. Computed tomography—old ideas and new technology. Eur Radiol 2011; 21 (3) 510-517
  • 3 Genant HK, Boyd D. Quantitative bone mineral analysis using dual energy computed tomography. Invest Radiol 1977; 12 (6) 545-551
  • 4 Kan WC, Wiley Jr AL, Wirtanen GW , et al. High Z elements in human sarcomata: assessment by multienergy CT and neutron activation analysis. AJR Am J Roentgenol 1980; 135 (1) 123-129
  • 5 Van Abbema JK, Van der Schaaf A, Kristanto W, Groen JM, Greuter MJW. Feasibility and accuracy of tissue characterization with dual source computed tomography. Phys Med 2012; 28 (1) 25-32
  • 6 Chinnaiyan KM, McCullough PA, Flohr TG, Wegner JH, Raff GL. Improved noninvasive coronary angiography in morbidly obese patients with dual-source computed tomography. J Cardiovasc Comput Tomogr 2009; 3 (1) 35-42
  • 7 Kalender WA, Buchenau S, Deak P , et al. Technical approaches to the optimisation of CT. Phys Med 2008; 24 (2) 71-79
  • 8 Flohr TG, McCollough CH, Bruder H , et al. First performance evaluation of a dual-source CT (DSCT) system. Eur Radiol 2006; 16 (2) 256-268
  • 9 National Institute of Standards and Technology (NIST). NIST XCOM: Photon Cross Sections Database. Available at: http://www.nist.gov/pml/data/xcom/ . Accessed December 3, 2015
  • 10 Manohara SR, Hanagodimath SM, Thind KS, Gerward L. On the effective atomic number and electron density: a comprehensive set of formulas for all types of materials and energies above 1 keV. Nucl Instrum Methods Phys Res B 2008; 266 (18) 3906-3912
  • 11 Yang M, Virshup G, Clayton J, Zhu X, Mohan R, Dong L. WE-C-BRB-01: In vivo measurement of proton stopping power ratios in patients using dual energy computed tomography. Med Phys 2009; 36: 2757
  • 12 Yang M, Virshup G, Clayton J, Zhu XR, Mohan R, Dong L. Theoretical variance analysis of single- and dual-energy computed tomography methods for calculating proton stopping power ratios of biological tissues. Phys Med Biol 2010; 55 (5) 1343-1362
  • 13 McCullough EC. Photon attenuation in computed tomography. Med Phys 1975; 2 (6) 307-320
  • 14 Hawkes DJ, Jackson DF. An accurate parametrisation of the x-ray attenuation coefficient. Phys Med Biol 1980; 25 (6) 1167-1171
  • 15 Henson PW. Determination of electron density, mass density and calcium fraction by mass of soft and osseous tissues by dual energy CT. Australas Phys Eng Sci Med 1989; 12 (1) 3-10
  • 16 Johnson TRC. Dual-energy CT: general principles. AJR Am J Roentgenol 2012; 199 (5, Suppl): S3-S8
  • 17 Omoumi P, Verdun F, Guggenberger R, Andreisek G, Becce F. Dual-energy CT: basic principles, technical approaches, and applications in musculoskeletal imaging (Part 2). Semin Musculoskelet Radiol 2015; 19 (5) 438-445
  • 18 Schoepf UJ, Colletti PM. New dimensions in imaging: the awakening of dual-energy CT. AJR Am J Roentgenol 2012; 199 (5, Suppl): S1-S2
  • 19 Henzler T, Fink C, Schoenberg SO, Schoepf UJ. Dual-energy CT: radiation dose aspects. AJR Am J Roentgenol 2012; 199 (5, Suppl): S16-S25
  • 20 Pache G, Bulla S, Baumann T , et al. Dose reduction does not affect detection of bone marrow lesions with dual-energy CT virtual noncalcium technique. Acad Radiol 2012; 19 (12) 1539-1545
  • 21 Guggenberger R, Gnannt R, Hodler J , et al. Diagnostic performance of dual-energy CT for the detection of traumatic bone marrow lesions in the ankle: comparison with MR imaging. Radiology 2012; 264 (1) 164-173
  • 22 Biswas D, Bible JE, Bohan M, Simpson AK, Whang PG, Grauer JN. Radiation exposure from musculoskeletal computerized tomographic scans. J Bone Joint Surg Am 2009; 91 (8) 1882-1889
  • 23 Ho LM, Yoshizumi TT, Hurwitz LM , et al. Dual energy versus single energy MDCT: measurement of radiation dose using adult abdominal imaging protocols. Acad Radiol 2009; 16 (11) 1400-1407
  • 24 Li B, Yadava G, Hsieh J. Quantification of head and body CTDI(VOL) of dual-energy x-ray CT with fast-kVp switching. Med Phys 2011; 38 (5) 2595-2601
  • 25 Tobalem F, Dugert E, Verdun FR , et al. MDCT arthrography of the hip: value of the adaptive statistical iterative reconstruction technique and potential for radiation dose reduction. AJR Am J Roentgenol 2014; 203 (6) W665-W673
  • 26 Omoumi P, Verdun FR, Ben Salah Y , et al. Low-dose multidetector computed tomography of the cervical spine: optimization of iterative reconstruction strength levels. Acta Radiol 2014; 55 (3) 335-344
  • 27 Becce F, Ben Salah Y, Verdun FR , et al. Computed tomography of the cervical spine: comparison of image quality between a standard-dose and a low-dose protocol using filtered back-projection and iterative reconstruction. Skeletal Radiol 2013; 42 (7) 937-945
  • 28 Omoumi P, Becce F, Ott J, Racine D, Verdun F. Optimization of radiation dose and image quality in musculoskeletal CT: emphasis on iterative reconstruction techniques (Part 1). Semin Musculoskelet Radiol 2015; 19 (5) 415-421
  • 29 Omoumi P, Verdun F, Becce F. Optimization of radiation dose and image quality in Musculoskeletal CT: emphasis on iterative reconstruction techniques (Part 2). Semin Musculoskelet Radiol 2015; 19 (5) 422-430