40-keV Virtual Monoenergetic Images with Deep Learning Reconstruction Maximize Hypovascular Liver Lesion Detection on Dual-Energy CT: Phantom Study Suggests 31.3% Iodine Dose Reduction Potential

40-keV virtual monoenergetic images with deep learning reconstruction (DLIR-H) maximized hypovascular liver lesion detectability in a phantom study, suggesting a 31.3% potential for iodinated contrast media dose reduction. Larger body habitus limited this margin.

• Phantom abdominal model with three body habitus sizes; model observer assessed hypovascular liver lesion detection (5-10 mm) on dual-energy CT.
• 40 keV with DLIR-H provided highest detectability; theoretical iodine dose reduction potential was at least 31.3% compared to standard iterative reconstruction.
• Main limitation: phantom study with model observer; clinical validation in patients is needed, and larger body habitus reduced detection margins.

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