We are happy to announce a new DEI publication in Radiology. Gruenwald et al showed dual energy CT-based bone mineral density assessment in the distal radius at routine examinations is feasible and could help predict surgical bone substitute use and the occurrence of bone nonunion in patients with distal radius fractures.

In their study, Gruenwald et al evaluated the feasibility of dual-energy CT-based BMD assessment from routine examinations in the distal radius and the relationship between the obtained BMD values, the occurrence of distal radius fractures, bone nonunion, and use of surgical bone substitute. In this context, 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. Finally, the 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). Thus, the authors concluded dual energy CT-based bone mineral density assessment in the distal radius at routine examinations is feasible and could help predict surgical bone substitute use and the occurrence of bone nonunion in patients with distal radius fractures.