Opportunistic assessment of bone mineral density using computed tomography in pediatric liver transplant recipients

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dc.contributor.authorDag, Nurullah
dc.contributor.authorTasolar, Sevgi
dc.contributor.authorUlubaba, Hilal Er
dc.contributor.authorCandur, Mehmet
dc.contributor.authorYilmaz, Sezai
dc.date.accessioned2026-04-04T13:37:31Z
dc.date.available2026-04-04T13:37:31Z
dc.date.issued2026
dc.departmentİnönü Üniversitesi
dc.description.abstractPediatric liver transplant (LT) recipients are at increased risk of impaired bone mineral accrual due to chronic liver disease, growth disturbances, and post-transplant metabolic factors. Although dual-energy X-ray absorptiometry (DXA) remains the reference method for evaluating bone mineral density (BMD), opportunistic assessment using routine abdominal computed tomography (CT) has emerged as a potential adjunct tool. This study aimed to evaluate the potential of using routine abdominal CT scans to assess bone health in pediatric LT recipients by comparing lumbar vertebral Hounsfield unit (HU) values with those obtained using DXA. This retrospective study included 62 pediatric LT recipients who underwent both abdominal CT and lumbar spine DXA within a 3-month period. HU values were measured at vertebral levels L1-L4 in both the sagittal and axial planes. DXA z-scores were classified according to International Society for Clinical Densitometry pediatric guidelines. Correlation and receiver operating characteristic (ROC) analyses were performed to determine the diagnostic performance of HU values. Patients with low bone mineral density had significantly lower sagittal HU values (p < 0.05). Moderate correlation was found between sagittal mean HU and DXA z-scores (r = 0.429, p = 0.003), whereas weaker correlation was observed for axial HU values (r = 0.266, p = 0.037). ROC analysis demonstrated a moderate discriminative ability for sagittal HU (AUC = 0.713, p = 0.016), with an optimal cut-off value of 188 HU yielding 83% sensitivity and 68% specificity.
dc.description.sponsorshipInonu University
dc.description.sponsorshipOpen access funding provided by the Scientific and Technological Research Council of Turkiye (TUB & Idot;TAK).
dc.identifier.doi10.1007/s00431-026-06794-w
dc.identifier.issn0340-6199
dc.identifier.issn1432-1076
dc.identifier.issue3
dc.identifier.orcid0000-0003-2124-4525
dc.identifier.orcid0000-0002-9342-0244
dc.identifier.orcid0000-0002-9836-6814
dc.identifier.orcid0000-0002-8044-0297
dc.identifier.pmid41721876
dc.identifier.scopus2-s2.0-105030577592
dc.identifier.scopusqualityQ1
dc.identifier.urihttps://doi.org/10.1007/s00431-026-06794-w
dc.identifier.urihttps://hdl.handle.net/11616/109888
dc.identifier.volume185
dc.identifier.wosWOS:001697032800001
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherSpringer
dc.relation.ispartofEuropean Journal of Pediatrics
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_WOS_20250329
dc.subjectBone health
dc.subjectPediatric liver transplantation
dc.subjectComputed tomography
dc.subjectDual-energy X-ray absorptiometry
dc.subjectHounsfield unit
dc.titleOpportunistic assessment of bone mineral density using computed tomography in pediatric liver transplant recipients
dc.typeArticle

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