Daily Papers

Osteoporotic vertebral compression fractures (VCFs) are prevalent in the elderly population, typically assessed on computed tomography (CT) scans by evaluating vertebral height loss. This assessment helps determine the fracture's impact on spinal stability and the need for surgical intervention. However, clinical data indicate that many VCFs exhibit irregular compression, complicating accurate diagnosis. While deep learning methods have shown promise in aiding VCFs screening, they often lack interpretability and sufficient sensitivity, limiting their clinical applicability. To address these challenges, we introduce a novel vertebra synthesis-height loss quantification-VCFs grading framework. Our proposed model, HealthiVert-GAN, utilizes a coarse-to-fine synthesis network designed to generate pseudo-healthy vertebral images that simulate the pre-fracture state of fractured vertebrae. This model integrates three auxiliary modules that leverage the morphology and height information of adjacent healthy vertebrae to ensure anatomical consistency. Additionally, we introduce the Relative Height Loss of Vertebrae (RHLV) as a quantification metric, which divides each vertebra into three sections to measure height loss between pre-fracture and post-fracture states, followed by fracture severity classification using a Support Vector Machine (SVM). Our approach achieves state-of-the-art classification performance on both the Verse2019 dataset and our private dataset, and it provides cross-sectional distribution maps of vertebral height loss. This practical tool enhances diagnostic sensitivity in clinical settings and assisting in surgical decision-making. Our code is available: https://github.com/zhibaishouheilab/HealthiVert-GAN.

Spine disorders affect 619 million people globally and are a leading cause of disability, yet AI-assisted diagnosis remains limited by the lack of level-aware, multimodal datasets. Clinical decision-making for spine disorders requires sophisticated reasoning across X-ray, CT, and MRI at specific vertebral levels. However, progress has been constrained by the absence of traceable, clinically-grounded instruction data and standardized, spine-specific benchmarks. To address this, we introduce SpineMed, an ecosystem co-designed with practicing spine surgeons. It features SpineMed-450k, the first large-scale dataset explicitly designed for vertebral-level reasoning across imaging modalities with over 450,000 instruction instances, and SpineBench, a clinically-grounded evaluation framework. SpineMed-450k is curated from diverse sources, including textbooks, guidelines, open datasets, and ~1,000 de-identified hospital cases, using a clinician-in-the-loop pipeline with a two-stage LLM generation method (draft and revision) to ensure high-quality, traceable data for question-answering, multi-turn consultations, and report generation. SpineBench evaluates models on clinically salient axes, including level identification, pathology assessment, and surgical planning. Our comprehensive evaluation of several recently advanced large vision-language models (LVLMs) on SpineBench reveals systematic weaknesses in fine-grained, level-specific reasoning. In contrast, our model fine-tuned on SpineMed-450k demonstrates consistent and significant improvements across all tasks. Clinician assessments confirm the diagnostic clarity and practical utility of our model's outputs.

Spine-related diseases have high morbidity and cause a huge burden of social cost. Spine imaging is an essential tool for noninvasively visualizing and assessing spinal pathology. Segmenting vertebrae in computed tomography (CT) images is the basis of quantitative medical image analysis for clinical diagnosis and surgery planning of spine diseases. Current publicly available annotated datasets on spinal vertebrae are small in size. Due to the lack of a large-scale annotated spine image dataset, the mainstream deep learning-based segmentation methods, which are data-driven, are heavily restricted. In this paper, we introduce a large-scale spine CT dataset, called CTSpine1K, curated from multiple sources for vertebra segmentation, which contains 1,005 CT volumes with over 11,100 labeled vertebrae belonging to different spinal conditions. Based on this dataset, we conduct several spinal vertebrae segmentation experiments to set the first benchmark. We believe that this large-scale dataset will facilitate further research in many spine-related image analysis tasks, including but not limited to vertebrae segmentation, labeling, 3D spine reconstruction from biplanar radiographs, image super-resolution, and enhancement.

Bone density prediction via CT scans to estimate T-scores is crucial, providing a more precise assessment of bone health compared to traditional methods like X-ray bone density tests, which lack spatial resolution and the ability to detect localized changes. However, CT-based prediction faces two major challenges: the high computational complexity of transformer-based architectures, which limits their deployment in portable and clinical settings, and the imbalanced, long-tailed distribution of real-world hospital data that skews predictions. To address these issues, we introduce MedConv, a convolutional model for bone density prediction that outperforms transformer models with lower computational demands. We also adapt Bal-CE loss and post-hoc logit adjustment to improve class balance. Extensive experiments on our AustinSpine dataset shows that our approach achieves up to 21% improvement in accuracy and 20% in ROC AUC over previous state-of-the-art methods.

Vertebral labelling and segmentation are two fundamental tasks in an automated spine processing pipeline. Reliable and accurate processing of spine images is expected to benefit clinical decision-support systems for diagnosis, surgery planning, and population-based analysis on spine and bone health. However, designing automated algorithms for spine processing is challenging predominantly due to considerable variations in anatomy and acquisition protocols and due to a severe shortage of publicly available data. Addressing these limitations, the Large Scale Vertebrae Segmentation Challenge (VerSe) was organised in conjunction with the International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI) in 2019 and 2020, with a call for algorithms towards labelling and segmentation of vertebrae. Two datasets containing a total of 374 multi-detector CT scans from 355 patients were prepared and 4505 vertebrae have individually been annotated at voxel-level by a human-machine hybrid algorithm (https://osf.io/nqjyw/, https://osf.io/t98fz/). A total of 25 algorithms were benchmarked on these datasets. In this work, we present the the results of this evaluation and further investigate the performance-variation at vertebra-level, scan-level, and at different fields-of-view. We also evaluate the generalisability of the approaches to an implicit domain shift in data by evaluating the top performing algorithms of one challenge iteration on data from the other iteration. The principal takeaway from VerSe: the performance of an algorithm in labelling and segmenting a spine scan hinges on its ability to correctly identify vertebrae in cases of rare anatomical variations. The content and code concerning VerSe can be accessed at: https://github.com/anjany/verse.

Modeling spinal motion is fundamental to understanding human biomechanics, yet remains underexplored in computer vision due to the spine's complex multi-joint kinematics and the lack of large-scale 3D annotations. We present a biomechanics-aware keypoint simulation framework that augments existing human pose datasets with anatomically consistent 3D spinal keypoints derived from musculoskeletal modeling. Using this framework, we create the first open dataset, named SIMSPINE, which provides sparse vertebra-level 3D spinal annotations for natural full-body motions in indoor multi-camera capture without external restraints. With 2.14 million frames, this enables data-driven learning of vertebral kinematics from subtle posture variations and bridges the gap between musculoskeletal simulation and computer vision. In addition, we release pretrained baselines covering fine-tuned 2D detectors, monocular 3D pose lifting models, and multi-view reconstruction pipelines, establishing a unified benchmark for biomechanically valid spine motion estimation. Specifically, our 2D spine baselines improve the state-of-the-art from 0.63 to 0.80 AUC in controlled environments, and from 0.91 to 0.93 AP for in-the-wild spine tracking. Together, the simulation framework and SIMSPINE dataset advance research in vision-based biomechanics, motion analysis, and digital human modeling by enabling reproducible, anatomically grounded 3D spine estimation under natural conditions.

The increasing prevalence of lumbar spinal canal stenosis has resulted in a surge of MRI (Magnetic Resonance Imaging), leading to labor-intensive interpretation and significant inter-reader variability, even among expert radiologists. This paper introduces a novel and efficient deep-learning framework that fully automates the grading of lumbar spinal canal stenosis. We demonstrate state-of-the-art performance in grading spinal canal stenosis on a dataset of 1,975 unique studies, each containing three distinct types of 3D cross-sectional spine images: Axial T2, Sagittal T1, and Sagittal T2/STIR. Employing a distinctive training strategy, our proposed multistage approach effectively integrates sagittal and axial images. This strategy employs a multi-view model with a sequence-based architecture, optimizing feature extraction and cross-view alignment to achieve an AUROC (Area Under the Receiver Operating Characteristic Curve) of 0.971 in spinal canal stenosis grading surpassing other state-of-the-art methods.

Radiographs are used as the most important imaging tool for identifying spine anomalies in clinical practice. The evaluation of spinal bone lesions, however, is a challenging task for radiologists. This work aims at developing and evaluating a deep learning-based framework, named VinDr-SpineXR, for the classification and localization of abnormalities from spine X-rays. First, we build a large dataset, comprising 10,468 spine X-ray images from 5,000 studies, each of which is manually annotated by an experienced radiologist with bounding boxes around abnormal findings in 13 categories. Using this dataset, we then train a deep learning classifier to determine whether a spine scan is abnormal and a detector to localize 7 crucial findings amongst the total 13. The VinDr-SpineXR is evaluated on a test set of 2,078 images from 1,000 studies, which is kept separate from the training set. It demonstrates an area under the receiver operating characteristic curve (AUROC) of 88.61% (95% CI 87.19%, 90.02%) for the image-level classification task and a mean average precision (mAP@0.5) of 33.56% for the lesion-level localization task. These results serve as a proof of concept and set a baseline for future research in this direction. To encourage advances, the dataset, codes, and trained deep learning models are made publicly available.

Adolescent idiopathic scoliosis (AIS) is a lifetime disease that arises in children. Accurate estimation of Cobb angles of the scoliosis is essential for clinicians to make diagnosis and treatment decisions. The Cobb angles are measured according to the vertebrae landmarks. Existing regression-based methods for the vertebra landmark detection typically suffer from large dense mapping parameters and inaccurate landmark localization. The segmentation-based methods tend to predict connected or corrupted vertebra masks. In this paper, we propose a novel vertebra-focused landmark detection method. Our model first localizes the vertebra centers, based on which it then traces the four corner landmarks of the vertebra through the learned corner offset. In this way, our method is able to keep the order of the landmarks. The comparison results demonstrate the merits of our method in both Cobb angle measurement and landmark detection on low-contrast and ambiguous X-ray images. Code is available at: https://github.com/yijingru/Vertebra-Landmark-Detection.

This paper presents a large publicly available multi-center lumbar spine magnetic resonance imaging (MRI) dataset with reference segmentations of vertebrae, intervertebral discs (IVDs), and spinal canal. The dataset includes 447 sagittal T1 and T2 MRI series from 218 patients with a history of low back pain. It was collected from four different hospitals and was divided into a training (179 patients) and validation (39 patients) set. An iterative data annotation approach was used by training a segmentation algorithm on a small part of the dataset, enabling semi-automatic segmentation of the remaining images. The algorithm provided an initial segmentation, which was subsequently reviewed, manually corrected, and added to the training data. We provide reference performance values for this baseline algorithm and nnU-Net, which performed comparably. We set up a continuous segmentation challenge to allow for a fair comparison of different segmentation algorithms. This study may encourage wider collaboration in the field of spine segmentation, and improve the diagnostic value of lumbar spine MRI.

This study presents an automated lameness detection system that uses deep-learning image processing techniques to extract multiple locomotion traits associated with lameness. Using the T-LEAP pose estimation model, the motion of nine keypoints was extracted from videos of walking cows. The videos were recorded outdoors, with varying illumination conditions, and T-LEAP extracted 99.6% of correct keypoints. The trajectories of the keypoints were then used to compute six locomotion traits: back posture measurement, head bobbing, tracking distance, stride length, stance duration, and swing duration. The three most important traits were back posture measurement, head bobbing, and tracking distance. For the ground truth, we showed that a thoughtful merging of the scores of the observers could improve intra-observer reliability and agreement. We showed that including multiple locomotion traits improves the classification accuracy from 76.6% with only one trait to 79.9% with the three most important traits and to 80.1% with all six locomotion traits.

Poor sitting posture can lead to various work-related musculoskeletal disorders (WMSDs). Office employees spend approximately 81.8% of their working time seated, and sedentary behavior can result in chronic diseases such as cervical spondylosis and cardiovascular diseases. To address these health concerns, we present SitPose, a sitting posture and sedentary detection system utilizing the latest Kinect depth camera. The system tracks 3D coordinates of bone joint points in real-time and calculates the angle values of related joints. We established a dataset containing six different sitting postures and one standing posture, totaling 33,409 data points, by recruiting 36 participants. We applied several state-of-the-art machine learning algorithms to the dataset and compared their performance in recognizing the sitting poses. Our results show that the ensemble learning model based on the soft voting mechanism achieves the highest F1 score of 98.1%. Finally, we deployed the SitPose system based on this ensemble model to encourage better sitting posture and to reduce sedentary habits.

Bone degradation, especially for astronauts in microgravity conditions, is crucial for space exploration missions since the lower applied external forces accelerate the diminution in bone stiffness and strength substantially. Although existing computational models help us understand this phenomenon and possibly restrict its effect in the future, they are time-consuming to simulate the changes in the bones, not just the bone microstructures, of each individual in detail. In this study, a robust yet fast computational method to predict and visualize bone degradation has been developed. Our deep-learning method, TransVNet, can take in different 3D voxelized images and predict their evolution throughout months utilizing a hybrid 3D-CNN-VisionTransformer autoencoder architecture. Because of limited available experimental data and challenges of obtaining new samples, a digital twin dataset of diverse and initial bone-like microstructures was generated to train our TransVNet on the evolution of the 3D images through a previously developed degradation model for microgravity.