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Opportunistic Bone Health Assessment Using Contrast-Enhanced Abdominal CT: A DXA-Referenced Analysis in Liver
Nurullah Dag1, Hilal Er Ulubaba1, Sevgi Tasolar1
1Department of Radiology, Faculty of Medicine, Inonu University, Malatya 44280, Türkiye.
Diagnostics (Basel, Switzerland)
|January 10, 2026
Summary
Computed tomography (CT) Hounsfield Unit (HU) measurements correlate with bone density assessed by dual-energy X-ray absorptiometry (DXA). Contrast-enhanced CT can complement DXA for opportunistic bone health screening in liver transplant recipients.
Area of Science:
- Radiology and Imaging
- Bone Metabolism and Osteoporosis
- Transplantation Medicine
Background:
- Liver transplant recipients are at increased risk for osteoporosis and fractures.
- Dual-energy X-ray absorptiometry (DXA) is the gold standard for bone mineral density (BMD) assessment.
- Opportunistic screening for bone health in this population is desirable.
Purpose of the Study:
- To investigate the relationship between computed tomography (CT)-derived Hounsfield Unit (HU) measurements and DXA.
- To evaluate the feasibility of using contrast-enhanced abdominal CT for bone health assessment in liver transplant recipients.
Main Methods:
- Retrospective study of adult liver transplant recipients with concurrent contrast-enhanced abdominal CT and DXA.
- Hounsfield Unit (HU) measurements obtained from lumbar spine (L1-L4) and femoral neck.
- Correlation analysis and ROC curves used to assess HU-DXA association and diagnostic performance.
Main Results:
- CT-derived HU values were significantly lower in patients with reduced BMD (osteopenia/osteoporosis).
- HU values showed a graded decline with worsening DXA categories and positive correlation with T-scores.
- Fair diagnostic performance for osteoporosis detection with AUCs ranging from 0.70 to 0.75.
Conclusions:
- Contrast-enhanced abdominal CT offers valuable ancillary data for opportunistic bone health assessment.
- CT-derived HU values provide a rapid, cost-effective complementary tool for bone density evaluation.
- CT-derived HU should not replace DXA for the definitive diagnosis of osteoporosis.
Keywords:
Hounsfield unitbone healthcomputed tomographydual-energy X-ray absorptiometryliver transplantationMore Related Videos
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