Korean J Radiol.  2017 ;18(4):555-569. 10.3348/kjr.2017.18.4.555.

Dual-Energy CT: New Horizon in Medical Imaging

  • 1Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. hwgoo@amc.seoul.kr
  • 2Department of Radiology, Seoul National University College of Medicine, Seoul 03080, Korea.


Dual-energy CT has remained underutilized over the past decade probably due to a cumbersome workflow issue and current technical limitations. Clinical radiologists should be made aware of the potential clinical benefits of dual-energy CT over single-energy CT. To accomplish this aim, the basic principle, current acquisition methods with advantages and disadvantages, and various material-specific imaging methods as clinical applications of dual-energy CT should be addressed in detail. Current dual-energy CT acquisition methods include dual tubes with or without beam filtration, rapid voltage switching, dual-layer detector, split filter technique, and sequential scanning. Dual-energy material-specific imaging methods include virtual monoenergetic or monochromatic imaging, effective atomic number map, virtual non-contrast or unenhanced imaging, virtual non-calcium imaging, iodine map, inhaled xenon map, uric acid imaging, automatic bone removal, and lung vessels analysis. In this review, we focus on dual-energy CT imaging including related issues of radiation exposure to patients, scanning and post-processing options, and potential clinical benefits mainly to improve the understanding of clinical radiologists and thus, expand the clinical use of dual-energy CT; in addition, we briefly describe the current technical limitations of dual-energy CT and the current developments of photon-counting detector.


Dual-energy CT; CT imaging techniques; Spectral CT; Virtual monoenergetic imaging; Effective atomic number; Material decomposition; Photon-counting detector

MeSH Terms

Gout/diagnostic imaging
Hodgkin Disease/diagnostic imaging
Phantoms, Imaging
Scoliosis/diagnostic imaging
Thorax/diagnostic imaging
Tomography, X-Ray Computed/instrumentation/*methods
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