Dual-Energy CT in Head and Neck Imaging

Abstract

Purpose of ReviewTo explain the technique of Dual-energy CT (DECT) and highlight its applications and advantages in head and neck radiology.Recent FindingsUsing DECT, additional datasets can be created next to conventional images. In head and neck radiology, three material decomposition algorithms can be used for improved lesion detection and delineation of the tumor. Iodine concentration measurements can aid in differentiating malignant from nonmalignant lymph nodes and benign posttreatment changes from tumor recurrence. Virtual non-calcium images can be used for detection of bone marrow edema. Virtual mono-energetic imaging can be useful for improved iodine conspicuity at lower keV and for reduction of metallic artifacts and increase in signal-to-noise ratio at higher keV.SummaryDECT and its additional reconstructions can play an important role in head and neck cancer patients, from initial diagnosis and staging, to therapy planning, evaluation of treatment response and follow-up. Moreover, it can be helpful in imaging of infections and inflammation and parathyroid imaging as supplementary reconstructions can be obtained at lower or equal radiation dose compared with conventional single energy scanning.

Clinical application of multi-material artifact reduction (MMAR) technique in Revolution CT to reduce metallic dental artifacts

“…Improved image quality, better lesion detection, and quantitative calculation of the degree of enhancement are immediate well-recognized benefits [11]. VMI and iodine characterization of DECT may play a major role in patients with head and neck cancer in the detection and delineation of the tumor, resulting in more accurate staging [12], equivalent to the perfusion map of perfusion CT of head and neck cancer [13]. It can differentiate normal, inflammatory, and metastatic squamous cell carcinoma cervical lymph nodes based on iodine concentration [14], as well as between benign post-treatment changes from the primary or recurrent head and neck malignancies [15].…”

Utility of CT and MRI in assessment of mandibular involvement in oral cavity cancer

“…However, a more conservative approach may be prudent intraoperatively in cases where radiology is not definitive for bone invasion. Further studies, including new imaging techniques as dual energy CT are needed to determine the gold standard preoperative imaging method/s for oral SCC 23, 24…”

Virtual monoenergetic imaging in rapid kVp-switching dual-energy CT (DECT) of the abdomen: impact on CT texture analysis

“…Texture parameters are quantitative entities and certain parameters are less prone to variations due to DECT image specifications rather than actual pathological process. Second and more importantly, there has been an increase in utilization of CTTA for the response assessment in various malignancies (29-35)with a simultaneous increase in performance of DECT for oncological applications (40)(41)(42)(43)(44). Thus, it is important to be aware of the impact of DECT post processing on image texture to ensure the comparability of imaging studies acquired at different time points.…”