Spectral CT
Truth in beauty and beauty in layers...

Cases

Adrenal "incidentaloma"

1.5 cm incidental adrenal nodule, with attenuation of 26 HU on routine CT is indeterminate. Per ACR white paper, a 12 month follow-up CT/MR should be considered, given that the nodule is homogeneous and low-density.

Virtual non-contrast shows attenuation of -7 HU, confirming benign adenoma.

A true non-contrast exam was performed 6 months later, which shows nodule is stable with an attenuation of -10 HU. A virtual non-contrast scan can, in most situations, substitute for a true non-contrast scan.

Conventional CT with indeterminate nodule in left adrenal gland (yellow arrow)

Conventional CT with indeterminate nodule in left adrenal gland (yellow arrow)

Virtual non-contrast with attenuation of -7 HU, diagnostic of a benign adenoma

Virtual non-contrast with attenuation of -7 HU, diagnostic of a benign adenoma

Follow-up true non-contrast CT shows nearly identical attenuation

Follow-up true non-contrast CT shows nearly identical attenuation

Gopal PunjabiComment