Forghani R, Kelly HR, eds. Mukherji SK, consulting ed. Neuroimaging Clinics of North America: Dual Energy CT: Applications in Head and Neck and Neurologic Imaging. Elsevier; 2017;27(3):371–546; $365.00

Dual energy CT (DECT) is probably the single most exciting innovation in CT in the last decade. I have been passionate about this topic since 2006 when DECT was first introduced into clinical practice. There are many excellent publications covering this topic; however, this long-awaited issue of Neuroimaging Clinics is an excellent place to start.

The entire issue is dedicated to DECT and provides a rather comprehensive review of this topic. It is comprised of 13 articles contributed by 32 authors, many of whom are well-recognized neuroradiologists. In order to simplify this review, I chose to categorize the articles into 4 sections:

DECT Physics: Two articles cover the fundamental principles of DECT. The authors make a genuine effort to simplify a very complicated topic. The articles are comprehensive and cover physical principles, CT scanner systems, and practical considerations for implementing DECT acquisition in clinical practice.

DECT Applications: Nine articles deal with the practical clinical applications of DECT. One article discusses the evaluation of intracranial pathology, another the evaluation of spine pathology, and 6 articles thoroughly review the DECT evaluation of head and neck anatomy and pathology with specific emphasis on head and neck tumor imaging, including squamous cell carcinoma and cervical lymphadenopathy. Overall, the articles are well written, and each topic is methodically discussed. The authors include scenarios where DECT provides superfluous information and others where DECT is key in making a correct diagnosis. Generally, the image quality is excellent and most images and diagrams are of high resolution and vibrant in color.

A separate article in this “section” highlights the advantages of DECT in reducing artifacts and improving image quality in neuroimaging. This is an invaluable article validating the utility of DECT in many common clinical scenarios where conventional scanning can be degraded by metal artifacts.

My only criticism of this “section” is that it does not cover DECT application after cochlear implantation. This is a very exciting topic where DECT can provide invaluable information that is not possible with conventional scanning. This information, namely the exact electrode position, can have significant implications for management.

DECT in Clinical Practice: This is a very important article for any radiologist or group considering incorporating DECT in their practice. The article objectively goes over advantages and hurdles for implementing this technique and suggests a practical workflow.

DECT Tissue Characterization and Emerging Applications: The final article of this issue deals with advanced applications of DECT in tissue characterization and discusses exciting potential future applications of this scanning technique.

Overall, I really enjoyed reading this well-organized, well-illustrated book. In my opinion, it provides essential information that each and every neuroradiologist should be familiar with. It is a must read for neuroradiology fellows and faculty alike.