ICU sedation, delirium & recovery

Dual-energy and photon-counting computed tomography in critical care

J Crit CarePublished Narrative review

Authors' conclusion

Across these scenarios, DECT offers advantages over conventional CT in critical care, including material differentiation, functional assessment, and potential reductions in contrast dose and radiation exposure.

Study context

Population
Critically ill patients
Comparison
Dual-energy computed tomography (DECT) vs conventional single-energy CT
Outcome
Applications of DECT in critical care

Main finding

As reported in the abstract

  • PE: anatomical and functional assessment via iodine perfusion maps, improving detection of segmental and subsegmental emboli
  • Post-thrombectomy intracerebral hemorrhage: distinguishes true hemorrhage from post-procedural contrast staining
  • Acute abdominal pathology: can improve visualization of ischemia, inflammation, infection and hemorrhage
  • Urolithiasis: can identify uric acid stone composition, informing treatment selection
  • Aortic imaging: may improve diagnostic confidence, enable iodine dose reduction and replace true non-contrast scans with virtual alternatives
  • Musculoskeletal imaging: accurately detects bone marrow edema, potentially reducing need for MRI when access is limited
  • Generally high specificity and variable sensitivity; level of evidence varies by indication, from meta-analyses to small retrospective studies

Original publication

Dual-energy and photon-counting computed tomography in critical care. J Crit Care. Published 9 April 2026. doi:10.1016/j.jcrc.2026.155589

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