Establish whether virtual non-contrast images can replace real non-contrast images, avoiding the preliminary scan, thus saving the patient dose. Forty-one patients were studied on a second-generation dual-source scanner, triphasic were applied on all patients, arterial and venous phase was acquired in dual-energy. HU values of TNC and VNC scans were compared through ROI on liver, spleen, kidneys, aorta, muscle, and fat. Qualitative analysis of the data sets was performed by four readers and the values from 1 to 4 (1. poor, 2. fair, 3. good, 4. excellent.) were assigned to define the diagnostic quality of the images. Then the absorbed dose ratios between the virtual images and the pre-contrast and portal phase images were compared. HU values were analyzed with the t-test and the difference was statistically significant P<0.0001. Image quality was evaluated as excellent or good in 91,3% of TNC and 81,6% of VNC. At last, VNC showed a sensitive dose reduction -46% compared to conventional triphasic protocol. Overall VNC has shown a good image quality comparable to TNC. The dose reduction obtained from the extraction of images without iodine, avoiding further scans, suggests the use of the dual-energy protocol in many exams.
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