ARRS 2022 Abstracts

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E1684. Application of Dual-Energy CT in Gynecological Imaging
Authors
  1. Roberta Catania; Northwestern University Feinberg School of Medicine
  2. Camila Lopes Vendrami; Northwestern University Feinberg School of Medicine
  3. Frank Miller; Northwestern University Feinberg School of Medicine
  4. Amir Borhani; Northwestern University Feinberg School of Medicine
  5. Linda Kelahan; Northwestern University Feinberg School of Medicine
  6. Jeanne Horowitz; Northwestern University Feinberg School of Medicine
Background
Dual-energy CT is an evolving diagnostic tool used to improve reader confidence and optimize patient management. Although its role in different abdominal conditions is already well established, the usage of DECT applications in gynecological imaging is not widely known. The purpose of this exhibit is to review the applications of DECT in gynecological imaging and provide radiologists with clues to increase diagnostic accuracy of a variety of conditions commonly encountered which often remain indeterminate on conventional CT.

Educational Goals / Teaching Points
The goals of this exhibit are to review DECT imaging principles and techniques; discuss the role of DECT in gynecological imaging; and describe imaging interpretation of DECT in a wide range of gynecologic conditions.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
DECT acquires data from two different energy levels and allows differentiation of multiple materials by calculating energy-dependent changes in attenuation. Different source-based and detector-based DECT technologies are currently available, and various post-processed images may be reconstructed. Virtual unenhanced images (VUE), iodine-selective maps, and low-kev virtual monoenergetic images provide additional information to conventional CT images that help in different gynecological scenarios such as detecting and characterizing lesions and distinguishing blood from iodine and calcium. Practical examples will be presented with particular emphasis to the following indications: emergency conditions and differential diagnosis of acute pelvic pain, bleeding, and infections; postoperative complications including from cesarean sections and hysterectomy; leak from adjacent organs including bladder and bowel; and primary gynecologic cancers and metastatic diseases.

Conclusion
DECT is an evolving diagnostic tool used to improve reader confidence and optimize patient management. DECT can add value in diagnosis of a wide spectrum of gynecological conditions encountered daily on CT, reducing requests for additional imaging and optimizing patient management.