Assessment of hepatic fatty infiltration using dual-energy computed tomography: a phantom study

The purpose of this study was to examine the performance of dual-energy computed tomography (DECT) for the quantification of liver fat content (LFC). We prepared two phantoms: homogenized mixtures of porcine liver and fat and homogeneous mixtures of liver- and fat-equivalent solutions. Tubes containing mixtures with known fat concentrations were scanned on a dual-source CT scanner using two DE scanning protocols (80 kV/Sn140 kV and 100 kV/Sn140 kV). Attenuation curves obtained from DECT were used to describe attenuations of various degrees of LFC at different energies. LFC was calculated from DECT data and compared with the known LFC. The phantom made of liver/fat mixtures was not used for liver fat quantification because the increase of fat content did not show a decline of CT numbers. This may be due to inhomogeneity as observed in CT images. Attenuation curves obtained from two DE scanning protocols had the ability to discriminate small differences in fat concentrations. Our results also showed a strong correlation between DECT measurements and known LFC (R(2) > 0.99, P < 0.005). DECT will be a reliable tool for liver fat quantification. Furthermore, attenuation curves obtained from DECT data can be used for discriminating various degrees of LFC.