Material decomposition with dual- and multi-energy computed tomography
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Prospective Article
Material decomposition with dual- and multi-energy computed tomography Rajesh Bhayana , Anushri Parakh, and Avinash Kambadakone, Division of Abdominal Imaging, Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, USA Address all correspondence to Rajesh Bhayana at [email protected] (Received 3 August 2020; accepted 13 November 2020)
Abstract Conventional computed tomography (CT) remains the workhorse of cross-sectional medical imaging. But dual- and multi-energy CT allows for more specific material decomposition, enabling distinct advantages in the clinical setting. In this review, we describe the basic principles behind material decomposition in dual- and multi-energy CT, outline the techniques used to acquire images, and explore how enhanced material decomposition leads to improved patient care. We also explore areas of active research and future directions, including photon-counting CT, that have the potential to revolutionize CT in clinical use.
Introduction Dual-energy computed tomography (CT) allows for more specific material decomposition than conventional single-energy CT. Conventional CT, which remains the cross-sectional imaging workhorse in most clinical settings, differentiates tissues based on their attenuation of a single x-ray spectrum (“single energy”). This allows the differentiation of materials that attenuate x-rays very differently, including tissues composed mostly of air, fat, water, soft tissue, or bone. But different materials, depending on mass density, can have similar or identical attenuation of x-rays on single-energy CT, making it difficult to differentiate them accurately. For example, iodinated contrast and calcium may have an identical appearance on single-energy CT, despite very different atomic numbers (Ca = 20, I = 53), which can lead to diagnostic uncertainty in a variety of clinical situations. Dual-energy CT attempts to overcome this limitation in material decomposition by using multiple attenuation measurements of different x-ray energy spectra. The basic principle behind dual-energy CT for material decomposition is not new. In 1973, Godfrey Hounsfield suggested that the atomic number of a material could be approximated using two pictures of the same slice at different energies.[1] This was demonstrated to be feasible in the literature shortly after.[2–5] Owing to technical limitations of scanners, dual-energy CT was not prevalent in clinical settings until over 30 years later, when a dual-source CT system was introduced that overcame certain key technical obstacles.[6] Subsequent developments in hardware and software have rendered dual-energy CT suitable for routine clinical use.[7–13] In this review of dual-energy CT, we will describe the underlying principle that enables material decomposition, review technical approaches to image acquisition, and provide
examples of current clinical applications. We also explore areas of active research and future directions.
Dual-energy CT and material decomposition: basic princip
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