Representative DECT images of contrast-enhanced venous phase in four breast lesion patients. Patient 1: pathological diagnosis of a 34-year-old woman with right breast mucinous carcinoma (arrows). According to the multiple parameters of DECT, benign breast lesions were diagnosed (false negatives). Patient 2: a 52-year-old woman was diagnosed with left breast invasive ductal carcinoma (arrows) on both histopathology and multiple parameters of DECT (true positive). Patient 3: pathological diagnosis of a 45-year-old woman with left breast adenosis (arrows). According to the multiple parameters of DECT, malignant breast lesions were diagnosed (false positive). Patient 4: a 45-year-old woman was diagnosed with right breast fibroadenoma (arrows) on both histopathology and multiple parameters of DECT (true negative). DECT, dual-energy computed tomography; NIC, normalized iodine concentration; λHu, slope of the spectral Hounsfield unit curve, nZeff, normalized effective atomic number, HU, Hounsfield unit.