Advances in Pancreatic Imaging: The Expanding Role of Dual-Energy CT in Clinical Diagnosis: A Comprehensive Review

Dual-energy computed tomography has become a pivotal tool in abdominal imaging, particularly for pancreatic pathologies such as pancreatic ductal adenocarcinoma, trauma assessment, and acute pancreatitis. Its ability to provide enhanced contrast resolution, reduce artifacts, and optimize radiation dose makes it invaluable in both acute and non-acute clinical settings. This narrative review summarizes the technological advancements and clinical applications of dual-energy computed tomography in pancreatic imaging. A comprehensive review of 21 peer-reviewed studies published between 2013 and 2024 was conducted to evaluate the role of dual-energy computed tomography in all pancreatic imaging indications, including tumor detection, pancreatitis assessment, trauma evaluation, and radiation dose optimization. The analysis included retrospective and prospective studies retrieved from multiple databases, including PubMed, Scopus, and Google Scholar. The findings highlight the technology's capacity to improve diagnostic accuracy, reduce image artifacts, and lower radiation exposure through techniques such as virtual monoenergetic imaging and iodine quantification. Comparisons with conventional computed tomography focused on diagnostic performance metrics such as contrast-to-noise ratio, and signal-to-noise ratio. Additionally, this narrative review underscores the clinical relevance of dual-energy computed tomography in evaluating non-traumatic acute abdominal conditions, especially among elderly patients.