Dual-energy CT applications in musculoskeletal disorders

Abstract

Dual-energy computed tomography (DECT) is an exciting application in CT technology conferring many advantages over conventional single energy CT at no additional with comparable radiation dose to the patient. Various emerging and increasingly established clinical DECT applications in musculoskeletal (MSK) imaging such as bone marrow edema detection, metal artifact reduction, monosodium urate (MSU) analysis, as well as collagen analysis for ligamentous, meniscal and disc injuries are made possible through its advanced DECT post processing capabilities. These provide superior information on tissue composition, artifact reduction and image optimisation. Newer DECT applications to evaluate fat fraction for sarcopenia, Rho/Z application for soft tissue calcification differentiation, 3D rendering, and AI integration are being assessed for future use. In this article we will discuss the established and developing applications of DECT in the setting of MSK radiology as well as the basic principles of dual-energy CT which facilitate them.