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Fig 1.

Comparison between the standard mixed image and the low-energy VMI+ image.

A 65-year-old man with acute pulmonary embolism. DSDECT images at the level of the right pulmonary artery are shown in the standard mixed image (A) and in the low-energy VMI+ (B). Increased contrast enhancement of the vessels at the same CT window level and width is demonstrated in the low-energy VMI+. Hypodense filling defects of acute pulmonary emboli are also detected in the descending pulmonary arteries in the bilateral lower lobes. DSDECT, dual source dual energy computed tomography; VMI+, virtual monoenergetic plus.

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Fig 1 Expand

Fig 2.

Study workflow for patient recruitment.

PE, pulmonary embolism; DSDECT, dual source dual energy computed tomography.

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Fig 2 Expand

Table 1.

Patient characteristics.

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Table 1 Expand

Table 2.

The interobserver agreement in interpretation of DSDECT image.

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Table 2 Expand

Table 3.

Interpretation of dual source dual energy computed tomography according to the location: Comparison between the 40 keV VMI+ and the standard mixed CT images.

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Table 3 Expand

Fig 3.

Sample of an overlooked case.

A 22-year-old man with acute pulmonary embolism. DSDECT images at the level of the left atrium are displayed. A small right lower lobe segmental embolus (arrow) was unnoticed in the standard mixed image (A) but was identified in the low-energy VMI+ (B). DSDECT, dual source dual energy computed tomography; VMI+, virtual monoenergetic plus.

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Fig 3 Expand

Fig 4.

Sample of an overlooked case.

A 76-year-old woman with acute pulmonary embolism. DSDECT images at the level of the aortic arch are displayed. A subtle left upper lobe segmental embolus (arrow) was unidentified in the standard mixed image (A) but was identified in the low-energy VMI+ (B). DSDECT, dual source dual energy computed tomography; VMI+, virtual monoenergetic plus.

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Fig 4 Expand

Fig 5.

Sample of an overlooked case.

A 22-year-old man with acute pulmonary embolism. DSDECT images at the level of the mid heart are displayed. A small left lower lobe segmental embolus (arrow) was overlooked in the standard mixed image (A) but was detected in the low-energy VMI+ (B). DSDECT, dual source dual energy computed tomography; VMI+, virtual monoenergetic plus.

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Fig 5 Expand

Table 4.

Diagnostic index of the 40 keV VMI+ according to the location.

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Table 4 Expand