The Role of Dual-Energy CT in the Study of Urinary Tract Tumors: Review of Recent Literature

Urothelial cancers are often detected incidentally because of an exponential growth in med-ical cross-sectional imaging. Nowadays there is the need for improved lesion characteriza-tion to distinguish clinically significant tumors from benign conditions. The gold standard for diagnosis of bladder cancer is cystoscopy, while for upper tract urothelial cancer com-puted tomographic urography and flexible ureteroscopy are more appropriate modalities. Computed tomography (CT) is the cornerstone in the assessment of locoregional and dis -tant disease, using a protocol with precontrastographic and postcontrastographic phases. In particular, renal pelvis, ureter and bladder lesions can be assessed during the urography phase in the acquisition protocol of the urothelial tumors. Multiphasic CT is associated with overexposure to ionising radiation and repeated infusion of iodinated contrast media, which can be problematic especially in certain types of patients (allergic, nephropathic, pregnant women and in paediatric age). Dual-energy CT can overcome these difficulties with a num-ber of methods, for example, by reconstructing virtual noncontrast images from a single-phase examination with contrast medium. In this review of the recent literature, we would like to highlight the role of Dual-energy CT in the diagnosis of urothelial cancer, its potential in this setting and possible advantages related to it.Semin Ultrasound CT MRI 44:136-144 & COPY; 2023 Elsevier Inc. All rights reserved.