Dual-Energy CT Electron Density Detects Anemia on Non-Contrast and Contrast-Enhanced Scans

Electron density from dual-energy CT correlates with hemoglobin levels—AUC up to 0.96 for anemia detection on non-contrast CT. Even on contrast-enhanced CT, ED remained associated (AUC 0.73–0.90) while conventional attenuation did not, suggesting opportunistic screening potentia…

• Retrospective cohort: 2,558 patients with non-contrast CT (NECT) and 2,545 with contrast-enhanced CT (CECT) using dual-layer spectral detector CT.
• After adjusting for age and sex, partial correlation of ED with hemoglobin remained substantial (NECT: rs=0.694; CECT: rs=0.509).
• Single-center, retrospective design; results require external validation on other DECT platforms.

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