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Dual-energy computed tomography (DECT) is a contemporary development by which the tissue can be characterized beyond conventional computed tomography. It improves tissue differentiation by exploiting the X-ray absorptive property of the tissues. Although still in its early stages, DECT utilization in pulmonary and cardiovascular pathologies is emerging. It includes applications such as pulmonary embolism, pulmonary hypertension, myocardial perfusion, and coronary artery assessment. This article discusses DECT principles and their current and emerging applications in thoracic imaging.

Virtual non-contrast (VNC) imaging is a post-processing technique generated from contrast-enhanced scans using dual-energy computed tomography (DECT). It is generated by removing iodine from imaging acquired at multiple energies. Myriad clinical studies have shown its ability to diagnose the various abdominal and pelvic pathologies discussed in the article. VNC is also a problem-solving tool for characterizing incidentally detected lesions ("incidentalomas"), often decreasing the need for additional follow-up imaging. It also obviates the multiphase image acquisitions to evaluate hematuria, hepatic steatosis, aortic endoleaks, and gastrointestinal bleeding by generating image datasets from different tissue attenuation values. The scope of this article is to provide an overview of various applications of VNC imaging obtained by DECT in the abdomen and pelvis.