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Incident fractures of the distal radius: dual-energy CT-derived metrics for opportunistic risk stratification

Background - Dual-energy CT (DECT)-derived bone mineral density (BMD) of the distal radius and other CT-derived metrics related to bone health have been suggested for opportunistic osteoporosis screening and risk evaluation for sustaining distal radius fractures (DRFs). - Methods - The distal radius...

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Main Authors: Grünewald, Leon David (Author) , Booz, Christian (Author) , Gotta, Jennifer (Author) , Reschke, Philipp (Author) , Martin, Simon (Author) , Mahmoudi, Scherwin (Author) , Bernatz, Simon (Author) , Eichler, Katrin (Author) , D'Angelo, Tommaso (Author) , Chernyak, Victoria (Author) , Sommer, Christof-Matthias (Author) , Vogl, Thomas J. (Author) , Koch, Vitali (Author)
Format: Article (Journal)
Language:English
Published: February 2024
In: European journal of radiology
Year: 2024, Volume: 171, Pages: 1-7
ISSN:1872-7727
DOI:10.1016/j.ejrad.2023.111283
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.ejrad.2023.111283
Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S0720048X23005971
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Author Notes:Leon D. Gruenewald, Christian Booz, Jennifer Gotta, Philipp Reschke, Simon S. Martin, Scherwin Mahmoudi, Simon Bernatz, Katrin Eichler, Tommaso D'Angelo, Victoria Chernyak, Christof M. Sommer, Thomas J. Vogl, Vitali Koch
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Summary:Background - Dual-energy CT (DECT)-derived bone mineral density (BMD) of the distal radius and other CT-derived metrics related to bone health have been suggested for opportunistic osteoporosis screening and risk evaluation for sustaining distal radius fractures (DRFs). - Methods - The distal radius of patients who underwent DECT between 01/2016 and 08/2021 was retrospectively analyzed. Cortical Hounsfield Unit (HU), trabecular HU, cortical thickness, and DECT-based BMD were acquired from a non-fractured, metaphyseal area in all examinations. Receiver-operating characteristic (ROC) analysis was conducted to determine the area under the curve (AUC) values for predicting DRFs based on DECT-derived BMD, HU values, and cortical thickness. Logistic regression models were then employed to assess the associations of these parameters with the occurrence of DRFs. - Results - In this study, 263 patients (median age: 52 years; interquartile range: 36-64; 132 women; 192 fractures) were included. ROC curve analysis revealed a higher area under the curve (AUC) value for DECT-derived BMD compared to cortical HU, trabecular HU, and cortical thickness (0.91 vs. 0.61, 0.64, and 0.69, respectively; p <.001). Logistic regression models confirmed the association between lower DECT-derived BMD and the occurrence of DRFs (Odds Ratio, 0.83; p <.001); however, no influence was observed for cortical HU, trabecular HU, or cortical thickness. - Conclusions - DECT can be used to assess the BMD of the distal radius without dedicated equipment such as calibration phantoms to increase the detection rates of osteoporosis and stratify the individual risk to sustain DRFs. In contrast, assessing HU-based values and cortical thickness does not provide clinical benefit.
Item Description:Online verfügbar: 3. Januar 2024, Artikelversion: 6. Januar 2024
Gesehen am 12.06.2024
Physical Description:Online Resource
ISSN:1872-7727
DOI:10.1016/j.ejrad.2023.111283

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