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Dual-Energy and Spectral CT in Clinical Practice: 2nd Edition

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Nuclear Medicine & Radiology".

Deadline for manuscript submissions: 19 September 2025 | Viewed by 463

Special Issue Editor


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Guest Editor
Department of Radiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, 37042 Verona, Italy
Interests: MSK imaging; CT; DECT; MRI; shoulder; hip; adrenal; liver; pancreas; lung; infectious diseases; endometriosis
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Special Issue Information

Dear Colleagues,

We are excited to announce the second volume of our Special Issue, “Dual-Energy and Spectral CT in Clinical Practice: 2nd Edition”. The first volume is available at the following link: https://www.mdpi.com/journal/jcm/special_issues/EQDSQ646AJ.

Spectral CT systems, including dual-energy computed tomography (DECT) and photon-counting CT, represent powerful imaging tools in clinical practice. Due to its intrinsic high spatial and contrast resolution, DECT can be utilized to diagnose brain, body and skeletal disorders in both acute and elective settings. In particular, DECT has been widely employed to improve the identification of substances from different spectral information by using dedicated algorithms. DECT has been proposed as an alternative to MRI in musculo-skeletal radiology. Additionally, monoenergetic reconstructions can be employed in order to reduce metal-induced artifacts, or to increase the conspicuity of contrast material within the arterial and venous vessels or to increase the contrast in the abdominal parenchyma. In addition, DECT and spectral CT systems has been used to image oncologic patients via a qualitative and quantitative approach. In recent years, photon-counting CT has proven to be a reliable method in the complex diagnosis of cardiovascular diseases, not only for the detailed evaluation of coronary arteries but also for functional assessments. Additionally, it represents an extremely promising technique in the fields of oncology and musculoskeletal imaging.

The aim of this Special Issue is to provide a comprehensive overview of the role of dual-energy and spectral CT applications in clinical practice. Therefore, researchers working in the field of DECT, spectral CT or photon-counting CT are encouraged to submit their findings as original research articles or reviews to this Special Issue.

Dr. Giovanni Foti
Guest Editor

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Keywords

  • dual-energy CT
  • spectral CT
  • photon counting CT
  • oncology
  • bone marrow edema
  • prosthesis
  • liver
  • pancreas
  • lung
  • kidney
  • adrenal
  • brain
  • abdomen
  • cardiac
  • coronary arteries
  • arthritis

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Published Papers (1 paper)

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Research

12 pages, 2478 KB  
Article
Diagnostic Accuracy of Dual-Energy CT Parameters for Discrimination of Hypodense Liver Lesions in Patients Affected by Colorectal Cancer
by Tommaso D’Angelo, Ludovica R. M. Lanzafame, Timo Steinert, Silvio Mazziotti, Manuela França, Ahmed E. Othman, Mirela Dimitrova, Scherwin Mahmoudi, Ibrahim Yel, Leona S. Alizadeh, Leon D. Grünewald, Vitali Koch, Simon S. Martin, Thomas J. Vogl and Christian Booz
J. Clin. Med. 2025, 14(17), 5929; https://doi.org/10.3390/jcm14175929 - 22 Aug 2025
Viewed by 228
Abstract
Objective: The aim of this study was to evaluate the diagnostic accuracy of conventional CT values and the dual-energy computed tomography (DECT)-derived effective atomic number (Zeff), fat fraction (FF) and iodine concentration (IC) for the differentiation of hypodense liver lesions in patients [...] Read more.
Objective: The aim of this study was to evaluate the diagnostic accuracy of conventional CT values and the dual-energy computed tomography (DECT)-derived effective atomic number (Zeff), fat fraction (FF) and iodine concentration (IC) for the differentiation of hypodense liver lesions in patients with colorectal cancer (CRC). Methods: One hundred and twenty patients (mean age: 65 ± 12 years) affected by CRC who underwent dual-source DECT as part of tumor staging between December 2015 and June 2023 were retrospectively evaluated. Spectral datasets were reconstructed for each patient and regions of interest were applied at the level of hypodense liver lesions to collect CT, Zeff, FF and IC values. To assess diagnostic accuracy, receiver operating characteristic (ROC) curves were constructed to evaluate the area under the curve (AUC), sensitivity, and specificity using biopsy or MRI (in cases when biopsy was not indicated or feasible) as a reference standard. The Youden index was used to identify optimal cut-off values for potential clinical applications. Results: A total of 223 lesions (147 metastases and 76 cysts) were evaluated. CT, FF and IC values differed significantly between metastases and cysts (p < 0.0001), showing high diagnostic accuracy. FF showed significantly higher diagnostic accuracy compared to all other parameters (all p ≤ 0.0074), with an AUC value of 0.97 (95% CI: 0.94–0.99). For a cut-off > 15.9, the sensitivity reached 91.8% (95% CI: 86.2–95.7) and the specificity reached 98.7% (95% CI: 92.9–100). Zeff numbers did not differ considerably (p = 0.781) between the two entities and demonstrated a lower AUC (0.511; 95% CI: 0.44–0.58). Conclusions: FF measurements proved to have high diagnostic accuracy compared to CT values, IC, and Zeff in the evaluation of hypodense liver lesions in patients suffering from colorectal carcinoma. Full article
(This article belongs to the Special Issue Dual-Energy and Spectral CT in Clinical Practice: 2nd Edition)
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