Purpose or Case Report: Spectral or multi-energy CT (MECT), obtains raw data at more than one energy spectra which allows the decomposition of materials into their constituent elements. As opposed to conventional CT which yields data based on linear attenuation, MECT yields both structural and material-specific information. Only limited experience and literature are available regarding use and applications of MECT in the pediatric patient population. Our institution has recently installed a spectral MECT scanner which uses a single x-ray source modified multilayered detector CT, in our emergency department (ED). It is currently the only such scanner used for routine clinical pediatric imaging in the US, and 4^th such unit in a children’s hospital in the world. In this educational exhibit we will review the basic physics of MECT, the benefits and limitations of the single-source multi-layered detector geometry, and clinical applications of MECT and our experience to date in the pediatric population.
Methods & Materials: A Philips IQon Spectral MECT (Philips Healthcare, Cleveland, OH) was installed in our facility in October, 2017. Though positioned in the ED, routine inpatients and outpatients are also examined.
Results: We present cases in which MECT aided in diagnosis through use of spectral data and propose areas of further clinical diagnoses and research. Clinical cases thus far examined include children suffering acute trauma, abdominal pain, renal stones, congenital heart disease, headache, and tumor.
Features of MECT advantageous to pediatric patients include reconstruction of virtual non-contrast images, perfusion imaging, mitigation of beam-hardening artifact with high mono-energetic imaging, the use of low mono-energetic imaging to boost iodine density to improve angiographic images which may be limited by contrast or bolus timing, and urinary stone analysis and renal mass characterization.
Conclusions: The use of Spectral MECT at our institution has provided a significant advance in our ability to confidently diagnose various disease processes. As we gain more experience in the use of MECT in the pediatric population, we will be able to better define its role and uncover further areas of research.