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Meer E, Patel M, Chan D, Sheikh AM, Nicolaou S. Dual-Energy Computed Tomography and Beyond: Musculoskeletal System. Radiol Clin North Am 2023; 61:1097-1110. [PMID: 37758359 DOI: 10.1016/j.rcl.2023.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
Traditional monoenergetic computed tomography (CT) scans in musculoskeletal imaging provide excellent detail of bones but are limited in the evaluation of soft tissues. Dual-energy CT (DECT) overcomes many of the traditional limitations of CT and offers anatomical details previously seen only on MR imaging. In addition, DECT has benefits in the evaluation and characterization of arthropathies, bone marrow edema, and collagen applications in the evaluation of tendons, ligaments, and vertebral discs. There is current ongoing research in the application of DECT in arthrography and bone mineral density calculation.
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Affiliation(s)
- Emtenen Meer
- Vancouver General Hospital-University of British Columbia, Vancouver, British Columbia, Canada; King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia.
| | - Mitulkumar Patel
- Vancouver General Hospital-University of British Columbia, Vancouver, British Columbia, Canada
| | - Darren Chan
- Vancouver General Hospital-University of British Columbia, Vancouver, British Columbia, Canada
| | - Adnan M Sheikh
- Vancouver General Hospital-University of British Columbia, Vancouver, British Columbia, Canada
| | - Savvas Nicolaou
- Vancouver General Hospital-University of British Columbia, Vancouver, British Columbia, Canada
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Simonetti I, Verde F, Palumbo L, Di Pietto F, Puglia M, Scaglione M, Ragozzino A, Romano S. Dual energy computed tomography evaluation of skeletal traumas. Eur J Radiol 2020; 134:109456. [PMID: 33302030 DOI: 10.1016/j.ejrad.2020.109456] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 11/10/2020] [Accepted: 11/28/2020] [Indexed: 12/27/2022]
Abstract
Skeletal traumas are among the most common routine challenges faced by Emergency Radiologists, in particular in case of radiographically occult nondisplaced fractures or in case of soft tissue injuries. With the development of Dual Energy Computed Tomography (DECT) technology, new post-processing applications have gained a useful diagnostic role in many fields of musculoskeletal imaging including acute skeletal trauma imaging. In addition to conventional CT images, DECT allows for the generation of virtual calcium-suppressed images subtracting calcium from unenhanced CT images based on the fact that material attenuation varies at different energy levels. In this way, virtual-non-calcium (VNC) images can precisely characterize traumatic bone marrow edema in both axial and appendicular skeleton, facilitating prompt clinical decision, especially when magnetic resonance method is contraindicated or unavailable. Other DECT emerging applications in the trauma setting include metal artifact reduction and collagen mapping for the evaluation of injuries affecting ligament, tendon, and intervertebral disk. This review focuses on the basic principles of DECT and related post-processing algorithms, highlighting the current advantages and limitations of these new imaging advances in the Emergency Department related to skeletal traumas.
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Affiliation(s)
- Igino Simonetti
- Department of Radiology, S. Maria delle Grazie Hospital, Pozzuoli, Italy.
| | - Francesco Verde
- Department of Radiology, S. Maria delle Grazie Hospital, Pozzuoli, Italy; Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy.
| | - Luigi Palumbo
- Department of Radiology, S. Maria delle Grazie Hospital, Pozzuoli, Italy.
| | - Francesco Di Pietto
- Department of Radiology, Pineta Grande Hospital, Castel Volturno, CE, Italy.
| | - Marta Puglia
- Department of Radiology, S. Maria delle Grazie Hospital, Pozzuoli, Italy.
| | - Mariano Scaglione
- Department of Radiology, Pineta Grande Hospital, Castel Volturno, CE, Italy.
| | - Alfonso Ragozzino
- Department of Radiology, S. Maria delle Grazie Hospital, Pozzuoli, Italy.
| | - Stefania Romano
- Department of Radiology, S. Maria delle Grazie Hospital, Pozzuoli, Italy.
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Dual-Energy CT in Musculoskeletal Imaging: What Is the Role Beyond Gout? AJR Am J Roentgenol 2019; 213:493-505. [DOI: 10.2214/ajr.19.21095] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Jeon JY, Lee SW, Jeong YM, Yu S. The utility of dual-energy CT collagen material decomposition technique for the visualization of tendon grafts after knee ligament reconstruction. Eur J Radiol 2019; 116:225-230. [DOI: 10.1016/j.ejrad.2019.03.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 11/29/2018] [Accepted: 03/17/2019] [Indexed: 11/29/2022]
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Mallinson PI, Coupal TM, McLaughlin PD, Nicolaou S, Munk PL, Ouellette HA. Dual-Energy CT for the Musculoskeletal System. Radiology 2017; 281:690-707. [PMID: 27870622 DOI: 10.1148/radiol.2016151109] [Citation(s) in RCA: 163] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The principal advantages of dual-energy computed tomography (CT) over conventional CT in the musculoskeletal setting relate to the additional information provided regarding tissue composition, artifact reduction, and image optimization. This article discusses the manifestations of these in clinical practice-urate and bone marrow edema detection, metal artifact reduction, and tendon analysis, with potential in arthrography, bone densitometry, and metastases surveillance. The basic principles of dual-energy CT physics and scanner design will also be discussed. © RSNA, 2016.
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Affiliation(s)
- Paul I Mallinson
- From the Department of Radiology, Vancouver General Hospital/University of British Columbia, Jim Pattison Pavilion, 899 W 12th Ave, Vancouver, BC, Canada V5Z 1M9
| | - Tyler M Coupal
- From the Department of Radiology, Vancouver General Hospital/University of British Columbia, Jim Pattison Pavilion, 899 W 12th Ave, Vancouver, BC, Canada V5Z 1M9
| | - Patrick D McLaughlin
- From the Department of Radiology, Vancouver General Hospital/University of British Columbia, Jim Pattison Pavilion, 899 W 12th Ave, Vancouver, BC, Canada V5Z 1M9
| | - Savvas Nicolaou
- From the Department of Radiology, Vancouver General Hospital/University of British Columbia, Jim Pattison Pavilion, 899 W 12th Ave, Vancouver, BC, Canada V5Z 1M9
| | - Peter L Munk
- From the Department of Radiology, Vancouver General Hospital/University of British Columbia, Jim Pattison Pavilion, 899 W 12th Ave, Vancouver, BC, Canada V5Z 1M9
| | - Hugue A Ouellette
- From the Department of Radiology, Vancouver General Hospital/University of British Columbia, Jim Pattison Pavilion, 899 W 12th Ave, Vancouver, BC, Canada V5Z 1M9
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Nery C, Baumfeld D, Umans H, Yamada AF. MR Imaging of the Plantar Plate. Magn Reson Imaging Clin N Am 2017; 25:127-144. [DOI: 10.1016/j.mric.2016.08.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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McLaughlin PD, Mallinson P, Lourenco P, Nicolaou S. Dual-Energy Computed Tomography: Advantages in the Acute Setting. Radiol Clin North Am 2015; 53:619-38, vii. [PMID: 26046502 DOI: 10.1016/j.rcl.2015.02.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The aim of this article is to inform and update emergency radiologists in respect of the clinically relevant benefits that dual-energy computed tomography (CT) contributes over conventional single-energy CT in the emergency setting using practical imaging examples. Particular emphasis will be placed on acute gout, bone marrow edema, acute renal colic, acute cardiovascular and neurovascular emergencies aswell as characterization of abdominal incidentalomas. The relevant scientific literature will be summarized and limitations of the technique also will be emphasized to provide the reader with a rounded concept of the current state of technology.
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Affiliation(s)
- Patrick D McLaughlin
- Department of Radiology, Vancouver General Hospital, University of British Columbia, 899 West 12th Avenue, Vancouver V5Z 1M9, Canada.
| | - Paul Mallinson
- Department of Radiology, Vancouver General Hospital, University of British Columbia, 899 West 12th Avenue, Vancouver V5Z 1M9, Canada
| | - Pedro Lourenco
- Department of Radiology, Vancouver General Hospital, University of British Columbia, 899 West 12th Avenue, Vancouver V5Z 1M9, Canada
| | - Savvas Nicolaou
- Department of Radiology, Vancouver General Hospital, University of British Columbia, 899 West 12th Avenue, Vancouver V5Z 1M9, Canada
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