Pre-reconstruction dual-energy, X-ray computerized tomography (CT): theory, implementation, results, and clinical use

For the task of bone mineral measurement, single-energy quantitative CT has demonstrated its worth in terms of precision for most longitudinal clinical studies. However, for cross-sectional clinical studies, known inaccuracy exists due to less than robust beam-hardening corrections, and negatively biased bone mineral measurement, due to the effect of unknown variable concentration of bone marrow fat within the metabolically active trabecular bone space. A dual-energy measurement technique provides a solution to these deficiencies of single-energy measurements. The fundamental theory of dual-energy measurement techniques is based on a Compton-photoelectric approximation and the mixture rule for the total attenuation coefficient. Resolution of atomic composition and electron density components of attenuation should then be possible. To take full advantage of these principles, the raw dual-energy projection values are operated on before reconstruction. This method beam-hardening and composition-selective imaging. Rapid kilovoltage switching between projection measurements, rather than serial measurements, assures the best measurement quality