Purpose or Case Report: Dual-energy CT (DECT) refers to the acquisition of CT datasets at two different energy spectra, which allows differentiation and classification of tissues. The purpose of this this poster is to describe post-processing algorithms and clinical applications of DECT in children on a dual-source CT system.
Methods & Materials: This is a descriptive, retrospective study. DECT studies performed over the last two years were reviewed for case examples of the common post-processing algorithms (Material Selective and Energy Selective) and their clinical utilization in a pediatric population.
Results: Material Selective Algorithm. These include virtual non-contrast (VNC), automated bone removal, color-coded iodine, and renal stone characterization images.

VNC Images: Allow measurements of lesion density on contrast-enhanced CT scans without acquisition of non-contrast images, improving lesion characterization (Fig 1A and 1B)

Automated Bone Subtraction Images: Improve bone removal and visualization of vascular structures (Fig. 1C and 1D)

Iodine Images: DECT Pulmonary CT Angiography (CTA) enhances visualization of iodine content in vessels, which can be useful in diagnosis of pulmonary embolism. DECT Lung Pulmonary Blood volume can analyze the lung iodine distribution in CTA and thus reflects lung perfusion in cyanotic heart disease and pulmonary embolism (Fig. 1E and 1F)

Stone Characterization Images: Stones are displayed with different colors Calcium oxalate (blue) / uric acid stone (red). This knowledge may impact stone management (alkalinzation versus lithotripsy) (Fig. 2).

Energy Selective or Virtual Monoenergetic (VM) Algorithm. VM reconstructions enable generation of an image with a single keV (40-190 keV). Low keV images improve iodine visualization, increasing conspicuity of subtle lesions (Fig. 3A) and compensating for poor venous access from slow injection rates. High keV images reduce noise from metal artifacts (Fig. 3B)

Radiation Exposure in Dual-energy CT are comparable with single-energy CT.
Conclusions: DECT provides multiple studies in one and can improve diagnosis and characterization of diseases without additional dose in pediatric population.