Dual-Energy Computed Tomography in Thoracic Imaging-Current Practices and Utility: Survey of the Society of Thoracic Radiology.

Abstract

The purpose of this study was to determine the current practice patterns of utilization of dual-energy computed tomography (DECT) in thoracic imaging. In this IRB-approved study, the URL link for an anonymous 26-question survey was sent by email to all the members of the Society of Thoracic Radiology (STR). Survey questions focused on the practice type, case volume, DECT scanner availability, common indications, image types, and perceived utility of DECT. Study data were collected and managed using SurveyMonkey tools and analyzed with χ tests. The survey response rate was 11% (104/962). DECT was available in 75% of respondents' institutions, with 90% of these having 1 to 5 DECT scanners (P<0.001). Seventy percent performed 1 to 500 DECT chest CTs per month (P<0.001). Dual-source was the most common DECT scanner (81%) (P=0.239). DECT was opted depending on the clinical indication in 89% (P=0.433). The technologist reconstructs the additional DECT images in 75% of instances (P<0.001). Acute pulmonary embolism (PE) was the most common indication of DECT (53%) (P=0.006), while chronic PE was considered the most valuable use of DECT (33%) (P<0.001). Iodine map was the most commonly used DECT image (53%) (P<0.001) followed by low-energy virtual monoenergetic image (VMI) (29%). For VMI, 50 keV was the most commonly used energy level for improving vascular contrast (43%) (P=0.048), whereas 120 keV was the most commonly used energy in VMI for decreasing artifacts (25%) (P=0.027). There is wide variability on the utilization of DECT in thoracic imaging. PE is perceived to be the most valuable utility of DECT, and iodine map is considered the most valuable DECT image.