Multienergy Cardiovascular CT Imaging: Current State and Future

Multienergy cardiovascular computed tomography (CT) imaging can be defined as data acquisition at two (dual-energy) or multiple x-ray energies. Multienergy cardiovascular CT imaging provides additional qualitative and quantitative information such as material maps or virtual monoenergetic images, which are supposed to further improve the quality and diagnostic yield of CT. Recently introduced photon-counting detector CT scanners further address some of the challenges and limitations of previous, conventional CT machines, hereby enhancing and extending the applications of CT for cardiovascular imaging. This review summarizes the technical principles of multienergy cardiovascular CT imaging and addresses the optimization of image quality and discusses the various dual energy-based applications for coronary, valvular, and myocardial imaging. New developments in regard to k-edge imaging and new contrast media for multienergy cardiovascular CT imaging is being also discussed.