Imaging of the Gallbladder with Multi-energy CT

Purpose of Review: The goal of this review article is to provide an overview of applications of multi-energy CT as they pertain to gallbladder imaging. We discuss benefits and shortcomings of MECT of various gallbladder pathology, with an emphasis on the imaging of gallstones and cholecystitis. It also touches on promising areas that warrant further investigation. Recent Findings: MECT has demonstrated improved sensitivity for cholelithiasis compared to conventional single-energy CT, with added value of MECT reconstructions, particularly virtual monoenergetic reconstructions, to detect isoattenuating gallstones. MECT iodine maps and virtual monoenergetic images potentially add value in evaluating other gallbladder pathologies, including detecting complications of acute cholecystitis, characterization of xanthogranulomatous cholecystitis and adenomyomatosis, and identifying and evaluating the extent of gallbladder carcinoma. Summary: MECT is emerging as a useful exam to evaluate the gallbladder, particularly in the setting of acute abdominal pain, and has the potential to eliminate the need for other imaging exams such as ultrasound.