CT is the cornerstone investigation for many acute and non-acute pathologies considering its availability and rapidity of acquisition. Dual-energy CT (DECT) has been clinically introduced in the last decade and has been shown to have many advantages over single energy CT imaging by allowing identification of abnormality not depicted on conventional CT and by being able to characterize the composition of body constituents.
In this educational exhibit, basic principles of CT and DECT imaging will be reviewed. Then, the top 10 applications of DECT will be presented. 
Specifically, the participant will review the iodine specific applications, useful to assess for enhancement in case of solid organ lesions, assess ischemic changes in bowel or organ ischemia, and depict subtle areas of contrast extravasation. The utilization of virtual non-contrast images will be discussed, specifically for lesion characterization and as way to decrease the radiation dose delivered to the patient by avoiding the acquisition of a true unenhanced acquisition during multiphasic imaging. 
Moreover, material specific applications in diagnosis of gout and determination or urolithiasis composition will be presented, especially important in depicting uric acid urolithiasis, medically treatable. 
Utilization of post-processing virtual monoenergetic imaging (VMI) application to reduce metal artifacts at high-keV level, and to optimize contrast opacification of vascular studies and increase conspicuity of solid organ injuries or lesions at low-keV level will be shown. Similarly, the use of VMI images at high and low energy level to depict gallstones isoattenuating to bile will be demonstrated. 
Finally, the use of virtual non-calcium images to assess for bone marrow edema in musculoskelettal trauma.

Top-10 Applications of Dual-Energy CT