{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T15:21:14Z","timestamp":1783437674245,"version":"3.54.6"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T00:00:00Z","timestamp":1738368000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T00:00:00Z","timestamp":1738368000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100009379","name":"Interdisziplin\u00e4res Zentrum f\u00fcr Klinische Forschung, Universit\u00e4tsklinikum W\u00fcrzburg","doi-asserted-by":"publisher","award":["Z-3BC\/02"],"award-info":[{"award-number":["Z-3BC\/02"]}],"id":[{"id":"10.13039\/501100009379","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Radiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>Combining fluoroscopy and high-resolution cone-beam CT (CBCT) in a multipurpose scanner without a conventional gantry holds the potential for time-saving in musculoskeletal interventions. This study investigated the performance of gantry-free CBCT arthrography in patients with suspected scapholunate ligament (SLL) tears.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Materials and methods<\/jats:title>\n            <jats:p>Fifty-five patients (29 men, 46.0\u2009\u00b1\u200915.3 years) who underwent preoperative gantry-free CBCT arthrography between June 2021 and March 2024 were analyzed retrospectively. Three radiologists assessed CBCT arthrograms for tears of the palmar and dorsal SLL segments. Surgical reports served as the reference standard for calculating indicators of diagnostic accuracy. Interreader agreement was tested by computing Krippendorff <jats:italic>\u03b1<\/jats:italic>. Radiation dose and examination time were recorded.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Tears of the palmar and dorsal SLL segment were recorded in 25 (45%) and 6 patients (11%), respectively. CBCT arthrography facilitated good sensitivity (range for all readers: 84\u201392%) and excellent specificity (93\u201397%) in the assessment of the palmar SLL. For the dorsal SLL, sensitivity (83\u2013100%) and specificity (96\u201398%) were even higher. Substantial agreement was determined for both the palmar (<jats:italic>\u03b1<\/jats:italic>\u2009=\u20090.83, 95% CI: 0.74\u20130.90) and dorsal SLL (0.84, 0.70\u20130.95). The mean volume CT dose index for CBCT arthrography was 3.2\u2009\u00b1\u20091.4\u2009mGy. Not requiring patient repositioning, the median time between fluoroscopy-guided contrast injection and CBCT was 3:05\u2009min (2:31\u20133:50\u2009min).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Gantry-free CBCT arthrography allows for excellent accuracy in the preoperative diagnosis of SLL tears with low radiation dose. The ability to alternate between fluoroscopy and CBCT without repositioning facilitates a \u201cone-stop-shop\u201d approach with short examination time.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Key Points<\/jats:title>\n            <jats:p>\n              <jats:bold>\n                <jats:italic>Question<\/jats:italic>\n              <\/jats:bold>\n              <jats:italic>Performing fluoroscopy-guided arthrography and high-resolution cone-beam CT without patient repositioning appears advantageous for the preoperative work-up of distal radius fractures with concomitant scapholunate ligament injuries<\/jats:italic>.<\/jats:p>\n            <jats:p>\n              <jats:bold>\n                <jats:italic>Findings<\/jats:italic>\n              <\/jats:bold>\n              <jats:italic>Gantry-free cone-beam CT arthrography allowed for short examination times and high diagnostic accuracy for either segment of the scapholunate ligament (89\u201398% versus surgery)<\/jats:italic>.<\/jats:p>\n            <jats:p>\n              <jats:bold>\n                <jats:italic>Clinical relevance<\/jats:italic>\n              <\/jats:bold>\n              <jats:italic>Preoperative assessment of scapholunate instability influences treatment since surgeons can reduce radius fractures and perform osteosynthesis via a dorsal portal to simultaneously stabilize the scapholunate compartment or use an additional dorsal access route for ligament suture and transfixation<\/jats:italic>.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00330-025-11405-7","type":"journal-article","created":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T15:05:51Z","timestamp":1738422351000},"page":"4562-4570","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Gantry-free cone-beam CT arthrography for diagnosis of scapholunate ligament injuries: accelerating the preoperative work-up in acute wrist trauma"],"prefix":"10.1007","volume":"35","author":[{"given":"Karsten Sebastian","family":"Luetkens","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas Steven","family":"Kunz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mila Marie","family":"Paul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie","family":"H\u00f6lscher-Doht","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henner","family":"Huflage","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julius Frederik","family":"Heidenreich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"M\u00fcller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thorsten Alexander","family":"Bley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rainer","family":"Schmitt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4524-1620","authenticated-orcid":false,"given":"Jan-Peter","family":"Grunz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,2,1]]},"reference":[{"key":"11405_CR1","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1016\/j.hcl.2012.02.001","volume":"28","author":"KW Nellans","year":"2012","unstructured":"Nellans KW, Kowalski E, Chung KC (2012) The epidemiology of distal radius fractures. 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The Department of Diagnostic and Interventional Radiology of the University Hospital W\u00fcrzburg receives ongoing research funding from Siemens Healthineers. The remaining authors declare no conflicts of interest.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"One of the authors (Jan-Peter Grunz) has significant statistical expertise. Of note, no complex statistical methods were necessary for this paper.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statistics and biometry"}},{"value":"Written informed consent was waived by the institutional review board of the University of W\u00fcrzburg, Germany (IRB number 20210615 01).","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Ethical approval was obtained from the institutional review board of the University of W\u00fcrzburg, Germany (IRB number 20210615 01).","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"No study subjects or cohorts have been previously reported.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Study subjects or cohorts overlap"}},{"order":8,"name":"Ethics","group":{"name":"EthicsHeading","label":"Methodology"}}]}}