Does dual-energy CT differentiate benign and malignant ovarian tumours?

•Malignant OTs had significantly higher Zeff and IC compared with benign OTs.•IC≥9.74 g/cm3 predicted malignancy with 81% sensitivity, 73% specificity, and 0.77 AUC.•Zeff ≥8.16 predicted malignancy with 85% sensitivity, 73% specificity, and 0.78 AUC.•High-grade malignant OTs had significantly higher WC compared with low-grade malignant OTs.•DECT may be a tool to help distinguish malignant and benign OTs and predict tumor grade.