Current and Future Applications of Thoracic Dual-Energy CT in Children: Pearls and Pitfalls of Technique and Interpretation

Semin Ultrasound CT MR. 2020 Oct;41(5):433-441. doi: 10.1053/j.sult.2020.05.008. Epub 2020 May 28.


Dual-energy computer tomography (DECT) technology has experienced rapid growth in recent years, now allowing for the collection of 2 CT data sets and opening the potential for functional data acquisition. Data from a single postcontrast phase are deconstructed and Iodine can be subtracted to create a virtual noncontrast image, or selectively represented as a contrast map that allows for the qualification and quantification of lung perfusion. Virtual monoenergetic images can also be used to reduce beam-hardening artifact from concentrated contrast or metal implants. In children, DECT is of particular interest because it has been shown to be dose neutral in most applications, dose-reducing in multiphase studies, and to increase the contrast to noise ratio in suboptimal studies. We review the basics of acquisition, postprocessing, and thoracic applications of DECT with a focus on pulmonary blood volumes as a surrogate for perfusion imaging. The discussed applications include pulmonary embolism, hypoplastic lung, pulmonary hypertension in bronchopulmonary dysplasia, and pediatric lung masses.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Lung
  • Lung Diseases / diagnostic imaging*
  • Male
  • Radiography, Dual-Energy Scanned Projection / methods*
  • Radiography, Thoracic / methods*
  • Tomography, X-Ray Computed / methods*