2
|
Gruenewald LD, Koch V, Martin SS, Yel I, Mahmoudi S, Bernatz S, Eichler K, Gruber-Rouh T, Pinto Dos Santos D, D'Angelo T, Wesarg S, Herrmann E, Golbach R, Handon M, Vogl TJ, Booz C. Dual-Energy CT-based Opportunistic Volumetric Bone Mineral Density Assessment of the Distal Radius. Radiology 2023; 308:e223150. [PMID: 37552067 DOI: 10.1148/radiol.223150] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
Background In patients with distal radius fractures (DRFs), low bone mineral density (BMD) is associated with bone substitute use during surgery and bone nonunion, but BMD information is not regularly available. Purpose To evaluate the feasibility of dual-energy CT (DECT)-based BMD assessment from routine examinations in the distal radius and the relationship between the obtained BMD values, the occurrence of DRFs, bone nonunion, and use of surgical bone substitute. Materials and Methods Scans in patients who underwent routine dual-source DECT in the distal radius between January 2016 and December 2021 were retrospectively acquired. Phantomless BMD assessment was performed using the delineated trabecular bone of a nonfractured segment of the distal radius and both DECT image series. CT images and health records were examined to determine fracture severity, surgical management, and the occurrence of bone nonunion. Associations of BMD with the occurrence of DRFs, bone nonunion, and bone substitute use at surgical treatment were examined with generalized additive models and receiver operating characteristic analysis. Results This study included 263 patients (median age, 52 years; IQR, 36-64 years; 132 female patients), of whom 192 were diagnosed with fractures. Mean volumetric BMD was lower in patients who sustained a DRF (93.9 mg/cm3 vs 135.4 mg/cm3; P < .001), required bone substitutes (79.6 mg/cm3 vs 95.5 mg/cm3; P < .001), and developed bone nonunion (71.1 mg/cm3 vs 96.5 mg/cm3; P < .001). Receiver operating characteristic curve analysis identified these patients with an area under the curve of 0.71-0.91 (P < .001). Lower BMD increased the risk to sustain DRFs, develop bone nonunion, and receive bone substitutes at surgery (P < .001). Conclusion DECT-based BMD assessment at routine examinations is feasible and could help predict surgical bone substitute use and the occurrence of bone nonunion in patients with DRFs. © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Carrino in this issue.
Collapse
Affiliation(s)
- Leon D Gruenewald
- From the Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology (L.D.G., V.K., S.S.M., I.Y., C.B.), Department of Diagnostic and Interventional Radiology (S.M., S.B., K.E., T.G.R., D.P.D.S., M.H., T.J.V.), and Department of Biostatistics and Mathematical Modeling (E.H., R.G.), University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany; Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy (T.D.); Department of Radiology and Nuclear Medicine, Erasmus Medical College, Rotterdam, the Netherlands (T.D.); and Fraunhofer IGD, Darmstadt, Germany (S.W.)
| | - Vitali Koch
- From the Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology (L.D.G., V.K., S.S.M., I.Y., C.B.), Department of Diagnostic and Interventional Radiology (S.M., S.B., K.E., T.G.R., D.P.D.S., M.H., T.J.V.), and Department of Biostatistics and Mathematical Modeling (E.H., R.G.), University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany; Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy (T.D.); Department of Radiology and Nuclear Medicine, Erasmus Medical College, Rotterdam, the Netherlands (T.D.); and Fraunhofer IGD, Darmstadt, Germany (S.W.)
| | - Simon S Martin
- From the Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology (L.D.G., V.K., S.S.M., I.Y., C.B.), Department of Diagnostic and Interventional Radiology (S.M., S.B., K.E., T.G.R., D.P.D.S., M.H., T.J.V.), and Department of Biostatistics and Mathematical Modeling (E.H., R.G.), University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany; Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy (T.D.); Department of Radiology and Nuclear Medicine, Erasmus Medical College, Rotterdam, the Netherlands (T.D.); and Fraunhofer IGD, Darmstadt, Germany (S.W.)
| | - Ibrahim Yel
- From the Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology (L.D.G., V.K., S.S.M., I.Y., C.B.), Department of Diagnostic and Interventional Radiology (S.M., S.B., K.E., T.G.R., D.P.D.S., M.H., T.J.V.), and Department of Biostatistics and Mathematical Modeling (E.H., R.G.), University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany; Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy (T.D.); Department of Radiology and Nuclear Medicine, Erasmus Medical College, Rotterdam, the Netherlands (T.D.); and Fraunhofer IGD, Darmstadt, Germany (S.W.)
| | - Scherwin Mahmoudi
- From the Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology (L.D.G., V.K., S.S.M., I.Y., C.B.), Department of Diagnostic and Interventional Radiology (S.M., S.B., K.E., T.G.R., D.P.D.S., M.H., T.J.V.), and Department of Biostatistics and Mathematical Modeling (E.H., R.G.), University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany; Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy (T.D.); Department of Radiology and Nuclear Medicine, Erasmus Medical College, Rotterdam, the Netherlands (T.D.); and Fraunhofer IGD, Darmstadt, Germany (S.W.)
| | - Simon Bernatz
- From the Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology (L.D.G., V.K., S.S.M., I.Y., C.B.), Department of Diagnostic and Interventional Radiology (S.M., S.B., K.E., T.G.R., D.P.D.S., M.H., T.J.V.), and Department of Biostatistics and Mathematical Modeling (E.H., R.G.), University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany; Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy (T.D.); Department of Radiology and Nuclear Medicine, Erasmus Medical College, Rotterdam, the Netherlands (T.D.); and Fraunhofer IGD, Darmstadt, Germany (S.W.)
| | - Katrin Eichler
- From the Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology (L.D.G., V.K., S.S.M., I.Y., C.B.), Department of Diagnostic and Interventional Radiology (S.M., S.B., K.E., T.G.R., D.P.D.S., M.H., T.J.V.), and Department of Biostatistics and Mathematical Modeling (E.H., R.G.), University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany; Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy (T.D.); Department of Radiology and Nuclear Medicine, Erasmus Medical College, Rotterdam, the Netherlands (T.D.); and Fraunhofer IGD, Darmstadt, Germany (S.W.)
| | - Tatjana Gruber-Rouh
- From the Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology (L.D.G., V.K., S.S.M., I.Y., C.B.), Department of Diagnostic and Interventional Radiology (S.M., S.B., K.E., T.G.R., D.P.D.S., M.H., T.J.V.), and Department of Biostatistics and Mathematical Modeling (E.H., R.G.), University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany; Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy (T.D.); Department of Radiology and Nuclear Medicine, Erasmus Medical College, Rotterdam, the Netherlands (T.D.); and Fraunhofer IGD, Darmstadt, Germany (S.W.)
| | - Daniel Pinto Dos Santos
- From the Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology (L.D.G., V.K., S.S.M., I.Y., C.B.), Department of Diagnostic and Interventional Radiology (S.M., S.B., K.E., T.G.R., D.P.D.S., M.H., T.J.V.), and Department of Biostatistics and Mathematical Modeling (E.H., R.G.), University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany; Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy (T.D.); Department of Radiology and Nuclear Medicine, Erasmus Medical College, Rotterdam, the Netherlands (T.D.); and Fraunhofer IGD, Darmstadt, Germany (S.W.)
| | - Tommaso D'Angelo
- From the Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology (L.D.G., V.K., S.S.M., I.Y., C.B.), Department of Diagnostic and Interventional Radiology (S.M., S.B., K.E., T.G.R., D.P.D.S., M.H., T.J.V.), and Department of Biostatistics and Mathematical Modeling (E.H., R.G.), University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany; Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy (T.D.); Department of Radiology and Nuclear Medicine, Erasmus Medical College, Rotterdam, the Netherlands (T.D.); and Fraunhofer IGD, Darmstadt, Germany (S.W.)
| | - Stefan Wesarg
- From the Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology (L.D.G., V.K., S.S.M., I.Y., C.B.), Department of Diagnostic and Interventional Radiology (S.M., S.B., K.E., T.G.R., D.P.D.S., M.H., T.J.V.), and Department of Biostatistics and Mathematical Modeling (E.H., R.G.), University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany; Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy (T.D.); Department of Radiology and Nuclear Medicine, Erasmus Medical College, Rotterdam, the Netherlands (T.D.); and Fraunhofer IGD, Darmstadt, Germany (S.W.)
| | - Eva Herrmann
- From the Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology (L.D.G., V.K., S.S.M., I.Y., C.B.), Department of Diagnostic and Interventional Radiology (S.M., S.B., K.E., T.G.R., D.P.D.S., M.H., T.J.V.), and Department of Biostatistics and Mathematical Modeling (E.H., R.G.), University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany; Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy (T.D.); Department of Radiology and Nuclear Medicine, Erasmus Medical College, Rotterdam, the Netherlands (T.D.); and Fraunhofer IGD, Darmstadt, Germany (S.W.)
| | - Rejane Golbach
- From the Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology (L.D.G., V.K., S.S.M., I.Y., C.B.), Department of Diagnostic and Interventional Radiology (S.M., S.B., K.E., T.G.R., D.P.D.S., M.H., T.J.V.), and Department of Biostatistics and Mathematical Modeling (E.H., R.G.), University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany; Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy (T.D.); Department of Radiology and Nuclear Medicine, Erasmus Medical College, Rotterdam, the Netherlands (T.D.); and Fraunhofer IGD, Darmstadt, Germany (S.W.)
| | - Marlin Handon
- From the Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology (L.D.G., V.K., S.S.M., I.Y., C.B.), Department of Diagnostic and Interventional Radiology (S.M., S.B., K.E., T.G.R., D.P.D.S., M.H., T.J.V.), and Department of Biostatistics and Mathematical Modeling (E.H., R.G.), University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany; Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy (T.D.); Department of Radiology and Nuclear Medicine, Erasmus Medical College, Rotterdam, the Netherlands (T.D.); and Fraunhofer IGD, Darmstadt, Germany (S.W.)
| | - Thomas J Vogl
- From the Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology (L.D.G., V.K., S.S.M., I.Y., C.B.), Department of Diagnostic and Interventional Radiology (S.M., S.B., K.E., T.G.R., D.P.D.S., M.H., T.J.V.), and Department of Biostatistics and Mathematical Modeling (E.H., R.G.), University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany; Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy (T.D.); Department of Radiology and Nuclear Medicine, Erasmus Medical College, Rotterdam, the Netherlands (T.D.); and Fraunhofer IGD, Darmstadt, Germany (S.W.)
| | - Christian Booz
- From the Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology (L.D.G., V.K., S.S.M., I.Y., C.B.), Department of Diagnostic and Interventional Radiology (S.M., S.B., K.E., T.G.R., D.P.D.S., M.H., T.J.V.), and Department of Biostatistics and Mathematical Modeling (E.H., R.G.), University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany; Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy (T.D.); Department of Radiology and Nuclear Medicine, Erasmus Medical College, Rotterdam, the Netherlands (T.D.); and Fraunhofer IGD, Darmstadt, Germany (S.W.)
| |
Collapse
|