DUAL-ENERGY COMPUTER TOMOGRAPHY IN CLINICAL PRACTICE. POSSIBILITIES AND CURRENT SITUATION OF THE PROBLEM

 

Postanogov R.A., Belokhov N.V., Glebov S.G., Malekov D.A., Marchenko N.V.

 

Saint Petersburg State Pediatric Medical University. Saint Petersburg, Russia.

S

pectral dual-energy computed tomography is currently being introduced into Russian clinical practice. Unlike conventional (single-energy) computed tomography, spectral imaging involves acquiring two sets of diagnostic data at high and low X-ray energies, i.e., in two energy spectra. Using specialized post-processing algorithms, spectral scanning allows for significantly more diagnostic information to be obtained than with conventional computed tomography.

The concept of spectral dual-energy computed tomography was introduced in the 1970s, but only in the last two decades has it become widely used in practice thanks to improvements in computed tomography scanners and the development of post-processing algorithms. Dual-energy computed tomography is used in emergency radiology, including imaging of cerebrovascular accidents and pulmonary embolism, in the examination of patients with metal structures, for the differentiation of urinary calculi, and the quantitative assessment of salt crystal deposits. Depending on the clinical task, various data postprocessing algorithms can be used to obtain spectral results, such as virtual monoenergetic imaging, effective atomic number and electron density maps, virtual non-contrast imaging and iodine mapping, and virtual non-calcium imaging.

This scientific review covers the current state of the art in the application of spectral imaging in clinical practice. The first part of the review is devoted to the physical foundations and principles of dual-energy computed tomography, including the dose load aspect compared to conventional computed tomography. The second part focuses on spectral imaging techniques. The third part focuses on postprocessing methods, spectral results, and their clinical application, supplemented by the authors' own observations.

The authors believe that certain spectral data postprocessing algorithms, such as effective atomic number maps and virtual non-calcium images, hold promise for the diagnosis of musculoskeletal pathologies, particularly for the detection and assessment of bone marrow changes of various origins.

 

Keywords: spectral dual-energy computed tomography, post-processing, effective atomic number map, virtual non-calcium imaging, iodine map, muscular-skeletal system, bone marrow.

 

Corresponding author: Postanogov R.A., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript .

 

For citation: Postanogov R.A., Belokhov N.V., Glebov S.G., Malekov D.A., Marchenko N.V. Dual-energy computer tomography in clinical practice. Possibilities and current situation of the problem. REJR 2025; 15(4):239-258. DOI: 10.21569/2222-7415-2025-15-4-239-258.

Received:        13.10.25                 Accepted:       10.11.25