Assessing Image Quality Differences Between Single-Energy and Dual-Energy Computed Tomography in Head, Thoracic, and Abdominal Scans: A Systematic Review

Computed tomography (CT) is an essential imaging modality for evaluating head, thoracic, and abdominal conditions. High-quality images are crucial for accurate diagnosis and clinical decision-making. Single-energy CT (SECT) is widely used but is limited by beam-hardening artifacts and suboptimal contrast resolution, particularly in complex anatomical regions. Dual-energy CT (DECT) acquires data at two energy levels, allowing spectral analysis that can improve image quality. This article aims to systematically compare image quality between SECT and DECT in head, thoracic, and abdominal CT, focusing on contrast resolution, image noise, artifact reduction, and diagnostic clarity. A structured literature search was conducted to identify studies directly comparing SECT and DECT. Included studies were analyzed for image quality outcomes across different anatomical regions and clinical tasks, considering the influence of acquisition protocols and reconstruction methods. DECT generally improved contrast-to-noise ratio and reduced beam-hardening artifacts, especially in complex or contrast-enhanced regions. However, benefits varied by anatomical area and technical implementation. Optimized SECT protocols often achieved comparable image quality, emphasizing the importance of protocol refinement. DECT offers potential advantages over SECT in selected applications, but its performance depends on careful optimization of acquisition and reconstruction parameters. Tailored, evidence-based protocol selection is essential to maximize clinical benefits.