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The difference between images and answers with Dual Energy CT

Dual Energy spectral imaging

Dual Energy Heart PBV

COURTESY: Courtesy of Hospital Calmette Lille, Lille, France

Dual Energy can make the difference between images and answers, giving you a greater depth of information compared to a traditional single energy scan.

Our Dual Energy CT (DECT) scanners offer a seamless solution with optimized scanning technologies and automated results. This lets you visualize, characterize, and quantify various materials in a personalized and consistent way for virtually all patients and a wide range of clinical questions.

Dual Energy spectral imaging supports you in making confident diagnostic and treatment decisions based on answers only available with Dual Energy. This helps you to impact clinical outcomes and deliver optimal care for your patients.

Make Dual Energy spectral imaging an integral part of your daily clinical routine.


Features & Benefits of Dual Energy CT

Move from morphological to functional imaging

Dual Energy spectral imaging provides clinical answers that let you move to functional imaging by offering clinical information beyond morphology.

In contrast to standard computed tomography scanners, Dual Energy CT scanners produce image sets with two different X-ray spectra to characterize materials with precision while highlighting abnormalities in the body.

This enables early detection of diseases to enable healthcare providers to initiate treatment.

Dual Energy CT supports all clinical fields with dedicated applications that are fine-tuned for your specific clinical questions.

These include — but are not limited to — quantifying iodine concentrations of oncological lesions, assessing lung perfusion defects, differentiating brain hemorrhages, visualizing bone marrow edemas, and quantifying gout.

Dual Energy CT in clinical practice

A Dual Energy CT scan using the Siemens Healthineers Monoenergetic Plus algorithm, which enhances contrast depending on the energy.

syngo.CT DE Monoenergetic Plus

syngo.CT DE Monoenergetic Plus simulates images that are equivalent to images scanned with a single photon energy beam, depending on the energy (keV). By changing the energy (keV), you can enhance the contrast between different materials. syngo.CT DE Monoergetic Plus provides a range of keV values from 40-190 keV.

COURTESY: Courtesy of Peking Union Medical College, Beijing, China

A Dual Energy CT scan using syngo.CT showing a virtual non-contrast image, created by subtracting iodine from the datasets.

syngo.CT DE Virtual Unenhanced

syngo.CT DE Virtual Unenhanced allows you to visualize the contrast agent concentration in soft body tissue. The application generates virtual non-contrast (VNC) images by subtracting iodine from the Dual Energy data sets. The VNC images can be used for baseline density measurements.

COURTESY: Courtesy of Peking Union Medical College, Beijing, China

A Dual Energy CT scan of the lung using syngo.CT from Siemens Healthineers.

syngo.CT DE Lung Analysis

syngo.CT DE Lung Analysis combines Lung Vessels and Lung PBV. Lung Vessels is designed to visualize the iodine enhancement in pulmonary vessels. Different colors are assigned to differentiate between perfused and non-perfused pulmonary arteries. Lung PBV (Perfused Blood Volume) is designed to visualize and quantify the iodine uptake in the lung parenchyma.

COURTESY: Courtesy of Hospital Calmette Lille, Lille, France

Personalize your Dual Energy acquisition to your patient’s needs

Expanding precision medicine requires us to adapt technology to diverse patients by adjusting to their size and age. This introduces a huge variety of challenging clinical questions.

With powerful Dual Energy CT solutions from Siemens Healthineers, patients benefit from personalized protocols without extra dose, providing reliable clinical answers.

At the same time, you benefit from the automatic selection and the right combination of the scan settings. Multiple kV levels let you adapt to the patient's size,with a large spectral separation means even the most demanding exams, like visualizing bone marrow edemas, are possible. The dose level of a Dual Source CT scanner is comparable to a single-source acquisition, but the built-in tin filter enables even lower doses than a conventional 120 kV CT scan.

Dual Energy spectral imaging is available across the portfolio of Siemens Healthineers CT scanners:

Dual Source Dual Energy

During a Dual Source Dual Energy scan, two CT datasets are acquired simultaneously with different kV and mA levels, allowing you to visualize differences in the energy dependence of the attenuation coefficients of different materials. These images are combined and analyzed to visualize information about anatomical and pathological structures.

Siemens Healthineers Dual Energy CT (DECT) scanners allow you to cover large volumes at high speeds, without increasing dose and offering high spectral separation.

Available for Dual Source CT (SOMATOM Drive and SOMATOM Force).

TwinBeam Dual Energy CT

TwinBeam Dual Energy (TBDE) CT allows simultaneous acquisition of high and low kV datasets in a single spectral CT scan by splitting the X-ray beam with two filters, one made of gold and the second made of tin, before it reaches the patient, enabling high-contrast dynamic applications.

Available for SOMATOM X.cite, SOMATOM go.Top, SOMATOM Edge Plus and SOMATOM Definition Edge.

TwinSpiral & Dual Spiral Dual Energy CT

The TwinSpiral Dual Energy CT scan mode acquires two consecutive spiral data sets at different kV and mA levels in one easy-to-understand UI timeline. The additional tin filter brings improved material separation to the Dual Energy applications. 

CARE kV, a fully automated feature that tailors the tube voltage to the individual patient and clinical task, complements existing dose reduction technologies for dose-neutral Dual Energy acquisitions without compromising image quality. 

The Dual Spiral Dual Energy scan mode consists of two successive spiral scans at different kV and mA levels.

Available for SOMATOM X.cite, SOMATOM Edge Plus, SOMATOM Definition Edge and SOMATOM go.platform

Siemens Healthineers focuses on optimizing relevant quality criteria for spectral imaging

Image quality is crucial for reliable DECT imaging since dual energy data processing is sensitive to small changes of the Hounsfield units. Relevant criteria comprise the spectral separation and temporal coherence of the low and high energy data, as well as the temporal and spatial resolution of the CT images, but of course also the dose efficiency or the workflow aspects play an important role in enabling efficient DECT imaging in daily routine.

Spectral Separation

Spectral separation refers to the amount of overlap between the detected low and high-energy X-ray spectrum. Greater spectral separation results in more reliable and quantitative material decomposition, resulting in better image quality, as illustrated in the figure.

Three images showing spectral separation. The first shows limited differentiation from a single acquisition scan; the second shows some differentiation in a scan with inferior spectral separation; the third image shows clear spectral separation and differentiation from a Dual Energy CT scan.
The tin filter enables dose neutrality by minimizing spectral overlap


Acquisition methods have unique levels of spectral separation. Techniques that can incorporate additional dedicated beam filtration (e.g. Dual Source Dual Energy CT or TwinSpiral Dual Energy CT) have considerably improved spectral separation necessary for challenging spectral imaging tasks such as the differentiation of bone marrow edema. This is also directly related to radiation dose: with better spectral separation, a lesser dose is required to obtain the same image quality.1,2

The single energy gray-scale image (indicated on the left) does not allow for the differentiation of the two materials. Spectral imaging with inferior spectral separation (middle image) allows material differentiation but with limited differentiation (resulting in noise in the green/orange material space). As indicated by the right image, using Dual Source Dual Energy CT or TwinSpiral Dual Energy results in excellent spectral separation with clear differentiation.


CT DE Booklet Graphic

CARE Dose4D

Dose neutrality

Dual Energy spectral imaging can provide additional diagnostic information, but this should not come at the expense of an increased patient dose compared to a conventional single energy examination. Siemens Healthineers Dual Energy CT solutions incorporate all state-of-the-art dose reduction features like tube current modulation or iterative reconstruction to allow dose-neutral spectral imaging acquisitions. 

Spectral separation also plays an important role since systems with dedicated filtration achieve the highest spectral separation without a dose comprise1,2

Get exactly what you need, whenever and wherever you need it

Dual Energy is available across the portfolio of Siemens Healthineers CT scanners, helping you to provide better outcomes for your entire patient population – regardless  of operational, financial, or clinical constraints. Dual Energy spectral imaging offers you automation, control and choice. Your selected combination of spectral series is processed and transferred to your PACS completely automatically, meaning the results are available where you need them, when you need them – even for retrospective analysis.

An illustration showing a Dual Energy CT scanner communicating directly with a PACS system.

Rapid Results Technology for direct to PACS results

Rapid Results enables direct communication between syngo.via and SOMATOM CT scanners, triggering zero-click postprocessing within the selected scan protocol. In that way, syngo.via automatically creates and sends ready-to read results to the PACS. Rapid Results will automatically generate standard visualizations of different anatomies in any required orientation and thickness for all Dual Energy applications.

SPP – Spectral Post Processing data format

By fusing low- and high-kV data into the DICOM conformant spectral imaging data format, Spectral Post-Processing (SPP), data and transfer times to PACS are reduced. In your PACS, the SPP dataset shows a single DICOM dataset either as Mixed or Monoenergetic Plus images while keeping the low and high Dual Energy information intact. SPP also enables Interactive Spectral Imaging and gives the user retrospective access to the encapsulated spectral data at any time.

Courtesy of Peking Union Medical College, Beijing, China

Interactive Spectral Imaging – as easy as windowing

Switch between spectral imaging views on the fly. Use additional diagnostic information at a glance based on spectral image data in MM Reading and CT View&GO. With Interactive Spectral Imaging, toggling between your Iodine maps and VNCs datasets and changing keV levels of Monoenergetic Plus images is as easy as windowing. It’s all enabled by the new Spectral Post Processing (SPP) data format, reducing complexity and storage needs.

myExam Companion for Spectral Imaging

myExam Companion smoothly navigates users through spectral imaging CT examinations by sharing built-in expertise, characterizing real-time patient input, and adjusting key parameters to each patient. It also guides you to Dual Energy reconstructions, such as Iodine Maps or Virtual Non-Contrast, which are PACS-ready. This is valuable for radiologists, giving them additional information to work with.

Recon&Go inline results - A customizable Dual Energy CT workflow that standardizes results in any required orientation

Recon&GO Inline Results

Recon&GO standardizes results by automatically generating the most appropriate DE inline results in any required orientation and thickness. Just define your workflow once and let Recon&GO produce the decision basis.

Available for Mixed, Monoenergetic Plus, VNC, Iodine Maps, Liver VNC, Lung Analysis (incl. Lung PBV), Brain hemorrhage, Direct Angio, Bone Marrow, Gout, Calculi Characterization and Rho/Z.

Parameters and orientations for Dual Energy CT reconstructions calculated directly on the IRS.

Recon&GO Spectral Recon

Benefit from the speed of Dual Energy CT reconstructions calculated directly on the IRS based on the spectral information available in the raw data while reducing data and transfer times to PACS.

Recon&GO offers full freedom of recon parameters (e.g. kernels; recon options, such as different orientations, including oblique), further multiplanar reconstructions, and quantification of DE-related parameters.

Available for Mixed, Monoenergetic Plus, VNC (Virtual Non-Contrast), and Iodine Maps.


The user interface showing spectral results sent from the Dual Energy CT scanner direct to PACS.

FAST DE Results

FAST DE Results directly sends the spectral results from the CT scanner to the PACS. Up to three Dual Energy reconstructions can be sent within one recon job.

Available for Iodine Maps, Monoenergetic Plus, VNC, Lung PBV, Liver VNC and Rho/Z.

A radiologist records insights from scan data using Siemens Healthineers Dual Energy CT.

syngo.CT Dual Energy

syngo.CT Dual Energy allows for retrospective interaction of Dual Energy data and empowers users to customize the Dual Energy analysis to the clinical question by, for example, changing keV levels or the display of Fat Maps.

By enabling customization, syngo.CT Dual Energy allows users to create their own application classes for even more advanced research questions.


Clinical Use of Dual Energy CT

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Oncology

03

Emergency / Trauma

04

Pulmonology

02

Neurology

02

Cardiovascular

03

General Radiology

02
A SOMATOM Force abdominal Dual Energy CT scan showing tissue differentiation.

Abdominal CT with suspicious lesions in the liver

SOMATOM Force

Scan time: 6.85 s
Scan length: 315 mm
80/Sn150 kV
CTDIvol: 4.58 mGy
DLP: 130.23 mGy*cm

Uncompromised, precise Dual Energy with tissue differentiation.


Courtesy of Peking University Medical College, Beijing, PR China
A SOMATOM Force abdominal Dual Energy CT scan showing tissue differentiation.
Several Dual Energy scans of the thorax and pelvis using Siemens Healthineers TwinBeam DE and SOMATOM X.Cite, showing a Monoenergetic 70 keV scan, mixed 120 kVp equivalent, Iodine map, and fused mixed/Iodine with iMAR.
A SOMATOM go.Top Dual Energy CT scan for multiple risk assessment.
A Dual Energy CT scan using SOMATOM Force visualizing perfusion defects to treat a suspicious lesion.
A Dual Energy CT scan of the lung using SOMATOM X.cite, demonstrating perfusion deficiencies caused by a pulmonary embolism.
A SOMATOM X.cite Dual Energy CT scan of the knee, distinguishing blood bruises within bone marrow.
A Dual Energy CT scan of the thorax, abdomen and spine using syngo.CT DE Bone Marrow for post-trauma evaluation.
A SOMATOM Force Dual Energy CT scan visualizing the degree of lung perfusion defects.
A Dual Energy CT scan showing the extension of perfusion deficiencies caused by an embolism in the lung.
A Dual Energy CT scan of the thorax and abdomen, including the spine, with uncompromised spectral imaging and widest spectral separation.
A SOMATOM X.cite and TwinSpiral Dual Energy CT scan showing Iodine uptake and contrast to brain hemorrhage.
A Dual Energy CT scan comprising CTA and myocardium PBV information without a dose penalty.
A Dual Energy CT scan with bone removal shows advanced diagnosed image quality.
A TwinBeam SOMATOM go.Top Dual Energy angiography scan showing the severity of stenosis after a bypass.
A Dual Energy CT scan of the hands using SOMATOM X.cite to evaluate the severity of gout.
An image of a Dual Energy CT scan using SOMATOM X.cite to evaluate kidney stones in the abdomen and pelvis.
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Scientific Corner

Find out about the latest research and clinical trends in Dual Energy CT. Watch the recordings of the scientific sessions from the SOMATOM World Summit 2019:

Role of Dual Energy CT in abdominal imaging

Jeong Min Lee, Seoul National University Hospital

TwinBeam Dual Energy – Benefits in daily clinical routine

Harald Seifarth, Esslingen Hospital

The role of Dual Energy CT in Pulmonary Vascular Diseases

Martine Rémy-Jardin, University Centre of Lille

Value of Dual Energy CT in MSK Imaging

Moritz Albrecht, University Hospital Frankfurt

Role of Dual Energy CT for pancreatic imaging

Lorenz Biggemann, University Medical Center Göttingen

Dual Energy CT response evaluation in GIST - Beyond RECIST and Choi

Mathias Meyer
University Medical Center Mannheim

1

Krauss B, Grand KL, Schmidt BT, Flohr TG. The importance of spectral separation : an assessment of dual energy spectral seperation for quantitative ability and dose efficiency. Invest Radiol. 2015;50(2):114-118.

2

Faby et al. Performance of today's dual energy CT and future multi energy CT in virtual noncontrast imaging and in iodine quantification: A simulation study. Med. Phys. 2015;42(7):4349-4366.

3

Available on syngo.via

* Not all modules maybe available for all systems. Please contact us for further information.
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