The clinical applications of dual-layer spectral detector CT in digestive system diseases

Abstract Objective Dual-layer spectral detector CT (DLCT) has several advantages in clinical practice, this study aims to reveal the clinical applications of DLCT in digestive system diseases. Materials and methods We searched PubMed and Cochrane Reviews for articles published from January 1, 2010 to May 31, 2024, using the terms “dual-layer spectral detector CT” or “dual-layer CT” combined with “hepatic fat” or “hepatic fibrosis” “hepatocellular carcinoma” or “pancreatic ductal adenocarcinoma” or “pancreatic neuroendocrine tumors” or "gastric cancer" or "colorectal cancer" or "Crohn’s disease" or "bowel ischemia" or "acute abdominal conditions". Results DLCT consists of a top layer sensitive to lower-energy photons and a bottom layer sensitive to higher-energy photons. This configuration enables simultaneous acquisition of two energy spectra from a single X-ray beam ensuring consistent spatial alignment and temporal resolution. Spectral raw images allow image post-processing to improve image quality, reduce radiation doses and contrast media doses, and generate multiple quantitative parameters. It has broad potential for early detection, accurate staging, efficacy assessment, and prognosis prediction of liver, pancreatic, and gastrointestinal diseases, as well as for the assessment of digestive system vasculature. Conclusions DLCT not only provides valuable information for the clinical diagnosis and therapeutic effect evaluation of digestive system diseases but also may play a more important role in the overall management of digestive diseases and in the decision-making of individualized medicine. Key Points Question What are the advantages of DLCT compared to traditional single-energy CT in the early detection, staging, and therapeutic evaluation of digestive system diseases ? Findings DLCT enhances image quality, improves tissue characterization, and allows for multi-parametric analysis, making it superior in detecting and evaluating liver, pancreatic, and gastrointestinal diseases . Clinical relevance DLCT provides high-quality, multi-parametric imaging that improves the accuracy of diagnosing digestive diseases, facilitates more precise treatment planning, and enhances monitoring of treatment response, ultimately contributing to better patient management and prognosis .