Replacing true non-contrast imaging with DECT in GI bleeding demonstrates non-inferior diagnostic performance, reading time and confidence

Question Eliminating true non-contrast scans from CT protocols for gastrointestinal bleeding could reduce radiation dose, but its impact on diagnostic performance remains unclear. Findings Dual-energy CT with virtual non-contrast images and iodine maps achieved non-inferior sensitivity, specificity, reading time, and diagnostic confidence compared to conventional triphasic CT. Clinical relevance Dual-energy CT with virtual non-contrast images and iodine maps can reliably replace true non-contrast scans in GI bleeding protocols, maintaining diagnostic performance while reducing radiation exposure-offering a safer and more efficient diagnostic alternative for patients.