Dual-Energy CT for Pediatric Thoracic Imaging: A Review.

Dual-energy CT has expanded the potential of thoracic imaging in both children and adults. Data processing allows material- and energy-specific reconstructions, which improve material differentiation and tissue characterization compared to single-energy CT. Material-specific reconstructions include iodine, virtual non-enhanced, perfusion blood volume, and lung vessel images, which can improve assessment of vascular, mediastinal, and parenchymal abnormalities. The energy-specific reconstruction algorithm allows virtual mono-energetic reconstructions, including low-energy images to increase iodine conspicuity and high-energy images to reduce beam-hardening and metal artifacts. This article highlights dual-energy CT principles, hardware, post-processing algorithms; the clinical applications of dual-energy CT; as well as the potential benefits of photon counting (the most recently introduced iteration of spectral imaging), in pediatric thoracic imaging.