Dual Energy Computed Tomography in Musculoskeletal Imaging, with Focus on Fragility Fractures of the Pelvis

Dual energy computed tomography (DECT) is a constantly evolving technology, which opens up new diagnostic possibilities. It is particularly valuable for musculoskeletal (MSK) imaging. Due to the lack of recognition and availability of dual energy scanners, routine use is only established in a few centres. The intention of this review is to show the possibilities and fields of applications of the DECT in MSK imaging, as well as to describe technical principles and typical indications. We mainly focus on the use of DECT in the context of fragility fractures of the pelvis. The use of the DECT in pelvic fractures of the elderly could combine the advantages of CT diagnostics - fast and continuous availability, lower costs by dispensing with a supplementary MRI examination - and the high sensitivity of MRI to oedema in fragility fractures. Furthermore, the latest DECT scanners are dose neutral, so that these examinations can also be carried out without increased radiation exposure.