Breast ImagingUsefulness of Virtual Monochromatic Dual-Layer Computed Tomographic Imaging for Breast CarcinomaInoue, Taihei MD*; Nakaura, Takeshi MD*; Iyama, Ayumi MD*; Kidoh, Masafumi MD, PhD*; Nagayama, Yasunori MD*; Uetani, Hiroyuki MD, PhD*; Oda, Seitaro MD, PhD*; Utsunomiya, Daisuke MD, PhD†; Yamashita, Yasuyuki MD*Author Information From the *Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University †Department of Radiology, Yokohama City University, Kumamoto, Japan. Received for publication March 18, 2019; accepted September 20, 2019. Correspondence to: Taihei Inoue, MD, Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan (e-mail: firstname.lastname@example.org). The authors declare no conflict of interest. The authors have no financial support to disclose. Journal of Computer Assisted Tomography: January/February 2020 - Volume 44 - Issue 1 - p 78-82 doi: 10.1097/RCT.0000000000000970 Buy Metrics Abstract Objective This study aimed to evaluate virtual monochromatic images (VMIs) obtained using dual-layer dual-energy computed tomography (CT) for breast carcinoma. Methods We retrospectively enrolled 28 patients with breast cancer who were pathologically diagnosed using dual-layer dual-energy CT. Virtual monochromatic images (40–200 keV) were generated. We compared CT number, image noise, contrast, and contrast-to-noise ratio (CNR) between VMIs with the highest CNR and conventional CT images. We performed qualitative image analysis between VMIs at optimized energy and conventional CT images. Results Image noise of VMIs was not significantly different from that of the conventional CT images. As the x-ray energy decreased, CNR increased. The 40-keV VMIs were highest CNR and higher than that of the conventional CT images. In qualitative image analysis, the 40-keV images were significantly higher than conventional CT images. Conclusion Both qualitative and quantitative analyses showed that the image quality of VMIs at 40 keV was significantly higher than that of conventional CT images. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.