Advancements in Dual-Energy CT Applications for Musculoskeletal Imaging

Purpose of Review Dual-energy computed tomography (DECT) has become a unique highly useful imaging modality in musculoskeletal (MSK) radiology practice. In this article, we provide a concise overview of the four main applications for DECT in (MSK) imaging: monosodium urate (Gout) detection, metal artifact reduction, bone marrow edema detection, and collagen imaging. We also highlight the recent studies published in radiology and rheumatology literature. Recent Findings Virtual monoenergetic images performed by utilizing DECT, particularly with the use of metal artifact reduction algorithm software, deliver superior image quality and have an impact on the assessment of the bone–metal interface. Regarding gout detection, DECT is a reliable, non-invasive diagnostic method to establish the diagnosis of gout that has been validated in the recent years. DECT has been incorporated into ACR/EULAR 2015 Gout Classification Criteria. Summary DECT continues to play an important role in musculoskeletal radiology practice. Further research is required to validate some of the more recent and novel applications, for example, the collagen imaging application to compare its sensitivity and specificity in detecting tears and other tendon- and ligament-related pathologies as compared to MRI.