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Schenzle JC, Sommer WH, Neumaier K, et al. Dual energy CT of the chest: how about the dose? Invest Radiol. 2010;45:347–53. 11. Bauer RW, Kramer S, Renker M, et al. Dose and image quality at CT pulmonary angiography: comparison of first and second generation dual energy CT and 64-slice CT. Eur Radiol. 2011;21:2139–47. 12. Henzler T, Fink C, Schoenberg SO, Schoepf UJ. Dual energy CT: radiation dose aspects. AJR. 2012;199:S16. 13. Petersilka M, Stierstorfer K, Bruder H, Flohr T. Strategies for scatter correction in dual source CT.

11. 2 Technical Aspects of Dual Energy CT with Dual Source CT Systems 23 Fig. 25 s. Left: combined low-kV/high-kV axial image and curved MPR of the LAD, corresponding to a standard 120 kV acquisition. Right: Mono+ images at 45 keV (same window setting). Note the significantly increased iodine CNR (Courtesy of University Hospital Mannheim, Germany) Fig. 25 s. Pseudo mono-energetic images of the RCA using Mono+ at 50 keV, 70 keV, 90 keV and 110 keV (from left to right, same window setting). Note the visually perceived reduction of Ca blooming at higher keV, when the window level is left unchanged (Courtesy of University Hospital Mannheim, Germany) Automated Removal of Bone and Calcifications in CT Angiographic Studies The polychromatic low-kV and high-kV images can be used for a binary distinction between two materials.

In combined DE images (weighted addition of the low-kV and high-kV images) for coronary CT angiography evaluation, however, a temporal resolution of a quarter of the gantry rotation time (83 ms for first generation DSCT, 75 ms for second generation DSCT, 66 ms for third generation DSCT) can be restored by means of a hybrid image reconstruction technique. This way, obtaining information on the myocardial blood supply by DE evaluation does not come at the cost of reduced diagnostic performance of coronary CT angiography for stenosis detection.

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