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

• CT-derived sagittal vertebral HU values showed a moderate correlation with DXA lumbar z-scores in pediatric liver transplant recipients, whereas axial measurements were weaker. • A sagittal mean threshold of ~188 HU demonstrated a moderate diagnostic performance for identifying low bone mineral density, supporting opportunistic contrast-enhanced CT as a complementary-not replacement-tool to DXA.