E3299. The Role of Dual-Energy CT in Head and Neck Emergency
  1. Serena Pham; Boston University, Boston Medical Center
  2. Vanesa Andreu-Arasa; Boston University, Boston Medical Center
  3. Koji Takumi; Kagoshima University
  4. Inseon Ryoo; Korea University, Guro Hospital
  5. Karen Buch; Harvard Medical School, Massachusetts General Hospital
  6. Osamu Sakai; Boston University, Boston Medical Center
Dual-energy CT (DECT) has been widely used in acute clinical settings to add diagnostic confidence and accuracy. Given the complexity of the head and neck anatomy, there are potential serious consequences from delayed or inaccurate diagnosis of various abnormalities involving this region. It is important for radiologists to understand the utilization and potential pitfalls of DECT in emergency head and neck imaging to maintain interpretative accuracy.

Educational Goals / Teaching Points
The objectives of this educational exhibit are to review basic neck anatomy and common head and neck emergencies, and to discuss the basic principles, the diverse clinical applications, and limitations of DECT in evaluation of head and neck emergency.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
The core concept of DECT is delineating different structures within a patient, particularly those with high atomic numbers, based on their differences in the x-ray absorption behaviors, by using two separate x-ray photon energy spectra. This exhibit will explore that core concept in depth by discussing common postprocessing methods in head and neck imaging, such as virtual monochromatic images, beam hardening correction, and material decomposition images. The exhibit will demonstrate diverse case-based clinical applications of these techniques, in comparison with conventional techniques, to improve lesion detection and characterization, to assess enhancement pattern of inflammatory versus neoplastic conditions, to visualize bone marrow edema in depicting osteomyelitis and occult fractures, and to reduce artifacts from contrasts and metals. We also recognize the potential pitfalls associated with DECT and provide an approach to interpreting DECT images of an unknown material.

The wide range of postprocessing techniques with DECT has the potentials in improving diagnostic accuracy in emergency head and neck imaging. In this exhibit, we present diverse case-based clinical applications and limitations of DECT in evaluation of head and neck emergency, in pursuit of improving diagnostic assessment and, consequently, patient care.