Evidence for Spectral Imaging CT is mounting... Incredible breadth of research on GSI Journal publications 2010-2017 Professional society consensus statements on DECT clinical utility for3: Avg. yearly growth in # of publications 2011-2017 Quantitative assessment of fatty liver and contrast uptake in focal hepatic lesions Renal masses and urothelial tumors Improved iodine sensitivity from DECT angiography Reduced artifacts in patients with orthopedic metallic implants Known or suspected pancreas neoplasms Liver damage/Fat 4% Vascular/ Perfusion 18% Routine clinical use for carotid/cerebral and extremity CTA Abdo-pelvic 38% Routine pulmonary CTA Renal stones to discriminate uric acid stones Radiation doses are reliably comparable to SECT GSI: DELIVERING VALUE BASED CARE Example findings from peer reviewed GSI publications* ANGIOGRAPHY Low keV images can reduce iodine load by at least 50% Pulmonary Angiography Imaging, Total Iodine, g4 ABDOMEN – ONCOLOGY benefitting patients with compromised renal function3,4,5 CT Aortography (no difference in CNR or SNR), Total Iodine, g5 Improves liver lesion detection 17% and kidney lesion characterization 12% 77.8% Kidney Lesion Characterization, Specificity enhancing evaluation of metal implants and adjacent bone or tissue6,7 Periprosthetic Imaging, Rate of Non-Diagnostic Studies6 6x reduction in non-diagnostic scans with GSI MAR Liver Lesion Detection after transarterial chemoembolization (TACE), Specificity2 ORTHOPEDICS – REDUCED METAL ARTIFACT HEAD AND NECK TUMOR VISIBILITY 2.3x higher average tumor attenuation for increased tumor conspicuity and improve tumor evaluation12 RENAL STONE CHARACTERIZATION 100% Sensitivity and 99.7% Specificity for uric acid stones,9 and atomic number for stone composition for faster and simplified diagnosis workflow GOUT 100% detection by uric acid (calcium) mapping *The example findings cited are limited to the referenced studies only and may not be broadly applicable to your clinical practice

# OF PATIENTS ARTICLE CONCLUSION The results of our study demonstrate that analysis of contrast-enhanced dual-energy material attenuation significantly improves the specificity for characterization of small (1–4 cm) renal lesions compared with that of conventional attenuation measurements. This improvement in specificity may decrease the frequency of unnecessary work-up for small indeterminate renal lesions. Compared with conventional CT, GSI could significantly improve the detection of small and multiple lesions without increasing the radiation dose. Based on spectrum features, GSI could assess...