Osteoporosis (OP) is characterised by loss of bone mineral density (BMD) and deterioration of trabecular microarchitecture, yet routine clinical imaging techniques remain limited in their ability to fully characterise bone microarchitecture. As new imaging technologies are developed, the potential for point of care bone assessment with both density and microarchitectural parameters of bone becomes a reality. Although advanced imaging modalities such as high-resolution peripheral quantitative computed tomography (HR-pQCT) offers improved sensitivity to bone structure, this is primarily focused on research settings. The development of higher resolution digital tomosynthesis (DT), required rethinking of phantoms, otherwise development and pre-clinical validation are constrained by the lack of reproducible, structure-controlled reference standards. In this study, we present a novel anthropomorphic bone phantom designed as a preclinical platform for calibration, benchmarking, and validation of bone imaging systems and quantitative analysis methods. The phantom integrates digital-twin trabecular models derived from micro-computed tomography (μ-CT), enabling parametric control of trabecular thickness and bone volume fraction to represent healthy and osteoporotic conditions. BMD is independently controlled using calibrated contrast agent (PVP-BaSO4), while moulded lean and adipose soft-tissue equivalents are incorporated to provide realistic X-ray attenuation for projection-based imaging. The phantoms were evaluated using multiple imaging modalities, including X-ray, DXA, pQCT, DT, and μCT, to verify their fidelity in reproducing both BMD and trabecular microstructural features. Imaging-derived parameters showed strong correlations with controlled variations in trabecular architecture and BMD, demonstrating the utility of the phantom as a source of controlled ground truth for cross-modality comparison. This reproducible platform enables systematic evaluation of imaging systems and facilitates early osteoporosis detection by bridging structure-density relationships. Our phantom serves as a valuable tool for preclinical diagnostic validation, imaging quality assurance, and the development of bone health biomarkers, thereby reducing reliance on animal or cadaveric studies.

Magnetic resonance imaging (MRI) has limited capacity to visualise cortical bone due to its low proton density and short decay time. Recently developed ultrashort (UTE) and zero-echo time (ZTE) sequences enable bone imaging without ionising radiation. This study aims to identify the key technical parameters, advantages, and limitations of UTE and ZTE for musculoskeletal (MSK) imaging. JBI methodology was applied, and three databases (MEDLINE, EMBASE and CINAHL) were selected to identify articles published after 2005 (French-English). Keywordsand MeSH terms related to UTE, ZTE, MRI and MSK were used. Two independent reviewers screened titles, abstracts, and full texts. Disagreements were solved through consensus. From 671 articles, 18 met all criteria. UTE and ZTE were applied for spine (6/18), lower limb (4/18), head and neck (4/18), general bone (3/18) and shoulder (1/18) investigations. Eight articles suggest a very short repetition time (TR) (0.425-8 ms), three longer TR (100-1075 ms), six did not mention TR. All articles mentioned very short echo time (TE) (0.00-0.34 ms). Acquisition time ranged from 3 to 12 min. UTE and ZTE are based on radial acquisition, allowing to acquire the cortical bone signal and increasing fracture contrast, comparable to CT-scan. Acquisition time was the main disadvantage. UTE and ZTE sequences are promising for the MSK applications, offering good contrast for cortical bone evaluation. Further studies are necessary to assess the possibilities of AI tools as approaches to improve image quality and reduce acquisition time. UTE and ZTE sequences can be added to MSK MRI exams to improve fracture and cortical bone evaluation, allowing radiation-free imaging. ZTE's lower acoustic noise benefits anxious, paediatric, or dementia patients' MRI experience.

Deep learning can automate chicken tibia-breaking strength quantification to improve animal welfare.

An aberrant tympanic segment of the internal carotid artery is a rare vascular anomaly. Clinical manifestations are variable and nonspecific, including hearing loss, tinnitus, vertigo, headache, and aural fullness. In military settings, it may remain undiagnosed, particularly when candidates are asymptomatic or do not report minor symptoms. This condition can render a candidate unfit for enlistment because of the risk of ear trauma during training or procedures. The French Armed Forces require comprehensive medical evaluations before enlistment, including audiometric testing and otoscopic examination. Detecting rare anomalies such as an aberrant carotid artery is critical to ensure candidates' safety. We present the case of a 23-year-old female candidate who attended a military medical selection center for army enlistment. Audiometric testing revealed unilateral conductive hearing loss, otoscopic examination demonstrated a pale red pulsatile mass in the middle ear anterior to the umbo, and computed tomography (CT) and magnetic resonance imaging (MRI) of the temporal bone confirmed an aberrant internal carotid artery. The medical team recommended conservative management with regular follow-up. Because military duty increases the risk of ear trauma, the candidate was classified as unfit for service. This case illustrates a rare vascular cause of military unfitness and underscores the importance of systematic otoscopic examination and audiometric testing during initial medical screening. Beyond military qualification considerations, early recognition of an aberrant internal carotid artery is critical to prevent catastrophic iatrogenic complications, including massive hemorrhage during otologic procedures or head trauma. Raising awareness of this entity among military clinicians enhances patient safety and helps prevent future complications.

Osteosarcopenia Is Associated With Mild Cognitive Impairment in Chinese Community-Dwelling Older Adults.

Traditionally, CT has been the go-to method for visualizing bone structures, while MRI has been preferred for assessing soft tissues, because structures containing tightly bound water molecules - such as bones, tendons, cartilage, and ligaments - produce a rapidly decaying T2* signal, which conventional MRI sequences fail to capture. To address this limitation, spoiled gradient echo sequences were refined, and short-TE sequences were introduced, enabling radiation-free bone imaging. This advance is particularly crucial for pediatric patients and in scenarios where an MRI-only approach is preferred, such as in radiation-sensitive cases and surgical planning.A comprehensive literature review was conducted by searching the PubMed and Google Scholar databases, using specific keywords: "black bone MRI" or "sCT bone" (Synthetic CT), "ZTE" (zero echo time), "UTE" (ultrashort echo time), "VIBE" (Volumetric Interpolated Breath-hold Examination), "FRACTURE" (FFE resembling a CT using restricted echo-spacing) and for title and abstract queries. The selection criteria included scientific articles published in English and German. The research was focused on the advances of the past five years in the application of the sequences in the area of the skull and spine. To support the technical understanding, earlier publications were also examined to offer readers essential background on the fundamental principles of the sequences, helping them better comprehend recent advances. For the investigation of the recent applications of the sequences, a narrow five-year time frame was applied, resulting in approximately 250 findings. From these, publications focused on the skull and spine regions were selected, with an emphasis on covering various pathologies and a preference for studies that compare different gradient echo sequences. To explore the technical aspects of the sequences, a broader time frame of ten years was selected, yielding approximately 868 results. From these, studies with more general explanations - avoiding in-depth physical and computer science details - were chosen. Using these selection parameters, 69 studies were highlighted.The gradient echo technique enables rapid and adaptable imaging, which can be customized to highlight specific tissue types. Spoiled GRE sequences such as VIBE, STAR/VIBE, and FRACTURE provide enhanced bone-to-soft tissue contrast, particularly when used with Dixon reconstruction. Short-TE sequences like UTE and ZTE utilize fast gradient switching, low flip angles, and non-Cartesian acquisition to improve bone visualization while suppressing soft tissue signals. These methods can effectively detect traumatic, neoplastic, and degenerative changes, offering CT-like imaging capabilities when patient-specific factors and the region or pathology of interest are properly considered. Additionally, integrating bone-selective sequences with deep learning could further enhance diagnostic accuracy and potentially replace CT. · Short TE-sequences achieve better bone/soft tissue contrast, but are more computationally demanding.. · ZTE is the sequence of choice for skull vault pathology, preoperative spine and skull imaging and is a preferable base for neural networks in sCT generation.. · Modified UTE sequences excel in viscerocranium and spine imaging DURANDE for bone/air-interface, 3D-stack of stars UTE with Dixon reconstruction for spine pathologies, replacing the conventional MRI sequences.. · VIBE/STAR-VIBE for facial preoperative and traumatic imaging, where motion artifacts are problematic.. · Bone and ligament matrix quantification with Dual echo and IR-UTE-Cones sequence, emitting porosity index, suppression ratio, and mapping values.. · Kavrakova IG, Haage P, Stueckle CA. Current State-of-the-Art 3D MRI Sequences for Assessing Bone Morphology with Emphasis on Cranial and Spinal Imaging: A Narrative Review. Rofo 2025; DOI 10.1055/a-2673-4339.

99mTc-sulfur colloid (99mTc-SC) single-photon computed emission tomography/computed tomography (SPECT/CT) bone marrow (BM) scintigraphy is a key diagnostic tool for distinguishing active red BM from inactive yellow BM. Although previous research has documented that it could reduce the volume of ABM irradiated at higher doses, the role of SPECT/CT parameters in assessing BM function in different pelvic regions and in predicting hematologic toxicity (HT) remains underexplored. This study aimed to investigate the value of 99mTc-SC SPECT/CT imaging for assessing BM function and its predictive role for HT in patients with cervical cancer undergoing concurrent chemoradiotherapy (CRT). In this retrospective study, 40 patients with stage IB2-IVA cervical cancer underwent 99mTc-SC SPECT/CT before and within 2 weeks after CRT. Patients were stratified into BM suppression (BMS) and non-BMS groups based on grade ≥ 3 HT. Semi-quantitative uptake ratios (R, liver-normalized) and their changes (ΔR) across 5 pelvic sites (L4, L5, sacrum, ilium, pubis) were compared. Analyses incorporated False Discovery Rate correction for multiple comparisons, non-parametric sensitivity tests, and effect size reporting. Predictive performance for HT was assessed using receiver operating characteristic curves and internally validated via leave-one-out cross-validation. CRT induces a spatially heterogeneous suppression of BM function, predominantly affecting the lumbosacral region. Elevated semi-quantitative uptake on pretreatment 99mTc-SC SPECT/CT, particularly in the lumbosacral region, exhibits potential as a biomarker for predicting severe HT. These findings underscore the promise of functional imaging for personalized risk stratification, pending validation in larger, prospective, multi-institutional cohorts. Post-CRT reduction in BM uptake (ΔR) was significantly more substantial within the lumbosacral spine (L4, L5, Sacrum) compared to the pelvic bones (Ilium, Pubis), with a moderate overall effect (partial η2 = 0.156). Patients who developed grade ≥ 3 HT (BMS group) exhibited significantly higher pretreatment R values and greater ΔR declines in the lumbosacral spine compared to the non-BMS group, with large effect sizes (e.g., Cohen d up to -1.05). Pretreatment R values at L4 (area under the curve [AUC] = 0.769), L5 (AUC = 0.767), and sacrum (AUC = 0.793) were significant predictors of grade ≥ 3 HT, a finding affirmed by leave-one-out cross-validation (cross-validated AUCs: 0.724, 0.737, and 0.752, respectively).

Bone metastasis is among the most common complications of advanced malignant tumors and severely affects prognosis in patients. Nuclear medicine, particularly bone-targeted radiopharmaceuticals, plays a unique and pivotal role in the diagnosis and treatment of bone metastases. This review systematically outlines the evolutionary trajectory of bone-targeted radiopharmaceuticals. It revisits functional bone imaging agents based on Single Photon Emission Computed Tomography (SPECT) and Positron Emission Tomography (PET), as well as recently developed therapeutic radiopharmaceuticals for bone metastases. Building on this foundation, this article focuses on the advanced paradigm of "theranostics" in nuclear medicine, encompassing strategies for theranostic radionuclide pairing and the development of single-radionuclide theranostic agents, aiming to achieve individualized and precise dosimetry. Moreover, this review emphasizes bone-targeting molecular scaffolds, such as bisphosphonates, and highlights their potential and direction for optimization through rational drug design, with the goal of developing a new generation of highly effective and low-toxicity theranostic platforms. This work aims to provide systematic insights for enhancing the precise management of bone metastases.

Abstract: Bone fractures are among the most common medical conditions requiring immediate and accurate diagnosis. Conventional manual interpretation of radiographs is time-consuming and subject to variability among radiologists, often leading to diagnostic delays or inconsistencies. To overcome these limitations, this project develops an automated bone-fracture detection system that integrates deep-learning models with an intuitive web interface. The system employs a customized InceptionV3 architecture enhanced with a Bottleneck Attention Module (BAM), enabling the model to focus on clinically relevant features such as subtle discontinuities and fine structural patterns in bone images. Images are preprocessed by resizing to 224×224 pixels and normalized to match the training distribution, ensuring consistency between training and inference. The model is trained on acurated dataset of fractured and non- fractured X-ray images, with augmentation techniques applied to improve generalization and reduce over fitting. Performance evaluation is carried out using validation accuracy, loss curves, and a confusion matrix, with additional metrics such as ROC-AUC and PR-AUC for binary classification robustness. The web application, built using Flask, provides a user-friendly interface that allows clinicians and researchers to upload X-ray images, receive predictions with confidence scores, and view supporting analytics such as class distribution and prediction history. Authentication mechanisms, secure file handling, and integrated visualization charts enhance usability and reliability. The proposed system demonstrates the potential of combining attention-based deep learning with interactive web deployment for clinical decision support. This project lays the groundwork for scalable, real-time diagnostic tools that can complement radiological expertise in resource-constrained healthcare environments. Keywords Artificial Intelligence, Bone Fracture Detection, Medical Imaging, Deep Learning, X-ray Analysis, Computer-Aided Diagnosis, Convolutional Neural Networks (CNN), Image Classification.,

Contemporary prostate cancer prognostic models do not include imaging and generally are based on pretreatment parameters. We sought to develop an externally validated model that used novel quantification of soft-tissue and bone disease, integrated with standard clinical and serum biomarkers, at baseline and up to 6 months of treatment. Two randomized phase 3 trials, Cougar COU-AA-302 (NCT00887198; for derivation) and Alliance A031201 (NCT01949337; for validation), were used to evaluate the added value of early on-treatment bone imaging and more than 1,000 radiomics features on CT, used in conjunction with clinical and serum biomarkers in first-line metastatic castration-resistant prostate cancer. Predictive accuracy measures were computed to determine whether these early on-treatment biomarkers could reliably sort patients into risk groups that inform overall survival (OS) and whether the patient-specific biomarker risk score could precisely predict their OS time. Imaging improved patient risk stratification but did not improve individual survival predictions. The strongest risk prediction model was developed for patients with bone-only metastases. This model was also the least complex, relying on just 16 risk factors, whereas all other models were high-dimensional, incorporating approximately 1,100 intercept and 1,100 slope features from the early on-treatment biomarker trajectories. Pretreatment and early on-treatment serum and automated quantitative imaging markers can well discriminate risk of death. Imaging improves this risk categorization relative to serum biomarkers alone. Such models can give early outcome predictions and can be used in future trials that involve imaging, even using traditional techniques such as bone scintigraphy.

Multiplanar reformatted imaging is a useful technique in cross-sectional imaging. Multiplanar reformatted imaging allows for the creation of images in planes that are oblique to the original volumetric data. Use of this tool is particularly important in the temporal bone, an anatomically complex structure that is composed of minute osseous landmarks, foramina, clefts, and aqueducts. For example, multiplanar reformatted imaging can be used to assess the integrity and alignment of the ossicles, highlight various pathologic entities, and evaluate the morphology of the inner ear structures. This video article discusses the use of multiplanar reformatted imaging in temporal bone imaging, focusing on its use in the assessment of normal anatomy and postoperative changes.

Characterization of middle ear ossicular ligaments using photon counting detector CT.

Immunohistochemical studies show PSMA may be a potential target for molecular imaging and treatment in bone and soft tissue sarcomas. We describe 68 Ga-PSMA-11 PET/CT findings in a case with metastatic undifferentiated sarcoma. The sarcoma lesions showed a high variability of 68 Ga-PSMA-11 uptake measured by SUV max , ranging from 3.2 to 21.5. This case indicates that undifferentiated sarcoma can show increased PSMA uptake, 68 Ga-PSMA-11 PET may noninvasively evaluate the inter-tumor heterogeneity of PSMA expression, and PSMA-targeted radioligand therapy may be a promising therapeutic option for this aggressive sarcoma.

To compare the diagnostic accuracy of a 15-channel dental coil with that of a standard 20-channel coil in the evaluation of head and neck tumours with suspected bone invasion. A total of 40 patients (18 females, mean age 67.0±15.1years) with head and neck cancer and clinical suspicion of bone invasion underwent MRI using both coils. Two radiologists retrospectively evaluated the images for signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR), subjectively for bone infiltration, image quality, metal artefacts and tumour delineation using a 5-point grading scale. The sensitivity and specificity of both coils in detecting bone invasion were calculated in histopathological correlation. Interobserver agreement was assessed using Cohen's kappa. SNR and CNR values of tumours were significantly higher with the 15-channel coil (SNR: 12.1 vs. 9.9; CNR: 3.6 vs. 1.5). The 15-channel coil was superior in image quality, metal artifacts, lesion delineation, and assessment of bone infiltration. Interobserver agreement was very good for bone infiltration assessment, overall image quality and artefact reduction, and substantial for lesion delineation. The 15-channel coil was found to be more sensitive (100% vs. 76%) and more specific (97% vs. 82%) in detecting bone invasion. Twenty-three histopathologically confirmed tumours with bone invasion were correctly detected with the 15-channel coil, whereas sixteen were detected with the standard coil. MRI with the 15-channel coil provides significantly better image quality and accuracy in the assessment of head and neck cancer, particularly in cases of bone invasion, compared with the standard coil. The use of a 15-channel coil enhances diagnostic accuracy in the detection and characterization of head and neck cancer especially regarding bone infiltration and contributes to more individualized cancer treatment.

This feasibility study evaluated quantitative ultrasound imaging of bone (QUSIB) for non-ionizing assessment of rib quality in the context of breast cancer treatment. In silico, microcomputed tomography-based rib models simulated five-year of the effects of radiation and bisphosphonate therapy. Broadband ultrasound propagation (6-MHz center frequency, 128-element array) yielded backscatter and attenuation coefficients, which were related to structural and material parameters via univariate and partial least squares (PLS) regression analyses with 5-fold cross-validation. The strongest univariate correlations were observed for trabecular total bone volume fraction (BV/TVtb) and cortical porosity with attenuation at 7-8MHz. PLS models significantly predicted trabecular BV/TVtb (R2=0.50; p<0.001) and cortical porosity (R2=0.58; p<0.001). Treatment-dependent spectral shifts in backscatter and attenuation coefficients confirmed sensitivity to pathological changes. In-vivo QUSIB measurements at the antero-lateral 4th-6th ribs and at the tibia midshaft in n=10 healthy volunteers produced apparent integrated backscatter and attenuation values that closely matched in-silico distributions (p>0.01) and did not differ significantly from tibia measurements. These results demonstrate that QUSIB backscatter biomarkers robustly reflect rib microstructure and treatment-induced alterations, supporting their potential for fracture-risk assessment in breast cancer patients.

Photon-counting detector CT (PCD-CT) offers superior spatial resolution and noise characteristics compared to conventional CT. However, optimal reconstruction parameters for temporal bone imaging, especially kernel selection, remain unclear. This study aimed to identify the optimal reconstruction kernel using both objective physical image quality metrics and subjective expert assessments. In phantom experiments, the system performance function (SPF) based on the task-based transfer function (TTF) and noise power spectrum (NPS) was calculated across 11 reconstruction kernels (Hr60-Hr98). Based on the results of the physical evaluation and clinical considerations from clinical practice, a subset of kernels was selected for visual assessment. For clinical images, two diagnostic radiologists evaluated three fine anatomical structures (i.e., stapes footplate, incudomalleolar joint, and cochlea) and overall image quality using both a ranking method and a 5-point Likert scale. TTF analysis indicated that Hr96 had the highest spatial resolution, while Hr60 showed the lowest noise in the NPS. SPF analysis identified Hr72 as providing the optimal balance between resolution and noise. Visual assessment using four reconstruction kernels (Hr60, Hr72, Hr76, and Hr84) showed that Hr76 consistently received the highest preference for overall image quality and visualization of fine structures. Statistically significant differences were observed among the kernels, with Hr60 consistently rated the lowest (p < 0.05). The kernel Hr76 was found suitable for middle and inner ear diagnoses using PCD-CT, providing a good balance between spatial resolution and image noise. This finding provides a foundation for standardized reconstruction protocols in high-resolution temporal bone imaging. These findings support the use of Hr76 as a standard kernel for high-resolution temporal bone imaging and may contribute to protocol optimization in clinical PCD-CT practice.

High-resolution Computed Tomography (CT) is the gold standard medical imaging technique for bone assessment. However, its clinical use is limited by high radiation dose (8.8 mSv; biplanar X-rays 1.4 mSv), cost, and reduced accessibility. These barriers are particularly significant for patients requiring frequent imaging. This study introduces a novel hybrid framework combining statistical intensity modeling with Deep Learning to reconstruct 3D tibial CT volumes including internal density distributions from biplanar radiographs. The method employs principal component analysis (PCA) to capture intensity variations in a compact latent space and trains a convolutional neural network (CNN) to regress PCA coefficients directly from radiographs. The framework was developed and validated using 60 subjects from the publicly available Korea Institute of Science and Technology Information (KISTI) database. Compared to ground truth CT, it achieved a mean absolute error of 127.17 ± 12.08 Hounsfield Units (HU), a structural similarity index of 0.8558 ± 0.0215, and a peak signal-to-noise ratio of 21.40 ± 0.78 dB. The method has the potential to achieve substantial radiation dose reduction compared to conventional CT while preserving sufficient anatomical detail for potential clinical tasks such as patient-specific implant planning and bone quality triage. However, the actual dose reduction depends on clinical imaging protocols and requires validation through protocol-matched dosimetry on actual radiographs. Moreover, it produces interpretable outputs that reflect anatomical intensity variations (e.g., cortical vs. trabecular regions), demonstrating feasibility for hybrid statistical-Deep Learning bone reconstruction. The proposed pipeline establishes a foundation for reduced-dose 3D bone imaging and offers a pathway toward clinical translation pending validation on real-world radiographic data.

Sex estimation is a critical component of human identification in forensic investigations, particularly when dealing with recovered skeletal remains. In South Africa, where crime rates remain high, the largest population group, Black South Africans, is disproportionately affected. Existing pelvic-based sex estimation standards were developed from cadaveric measurements and may not be fully applicable to contemporary populations. This study, therefore, evaluated the reliability of these previously established standards by applying them to three-dimensional computed tomography (3DCT)-derived pelvic measurements from a contemporary Black South African sample. Five of the six previously published standards yielded low overall accuracies (55–78%), highlighting the need to develop new population-specific equations. The newly developed discriminant function analyses produced overall sex-classification accuracies ranging from 86.4% to 91.4%, while the logistic regression models achieved accuracies between 89.3% and 92.2%. 3DCT-derived pelvic measurements provide reliable sex estimation in the contemporaneous Black South African population group. The formulated equations demonstrate high overall accuracy and are therefore valuable tools for correct sex estimation.

Osteoarthritis (OA) is a degenerative skeletal condition marked by the loss of articular cartilage and changes to subchondral bone homeostasis. Treatments for OA beyond full joint replacement are lacking primarily due to gaps in molecular knowledge of the biological drivers of disease. Mass Spectrometry Imaging (MSI) enables molecular spatial mapping of the proteomic landscape of tissues. Histologic sections of human tibial plateaus from knees of human OA patients and cadaveric controls were treated with collagenase III to target extracellular matrix (ECM) proteins prior to MS Imaging of bone and cartilage proteins. Spatial MS imaging of the knee identified distinct areas of joint damage to the subchondral bone underneath areas of lost cartilage. This damaged bone signature extended underneath remaining cartilage in OA joints, indicating subchondral bone remodeling could occur before full thickness cartilage loss in OA. Specific ECM peptide markers from OA-affected medial tibial plateaus were compared to their healthier lateral halves from the same patient, as well as to healthy, age-matched cadaveric knees. Overall, 31 peptide candidates from ECM proteins, including Collagen alpha-1(I), Collagen alpha-1(III), and surprisingly, Collagen alpha-1(VI) and Collagen alpha-3(VI), exhibited significantly elevated abundance in diseased tissues. Additionally, highly specific hydroxyproline-containing collagen peptides, mainly from collagen type I, dominated OA subchondral bone directly under regions of lost cartilage but not areas where cartilage remained intact. A separate analysis of synovial fluid from a second cohort of OA patients found similar regulation of collagens and ECM proteins via LC-MS/MS demonstrating that markers of subchondral bone remodeling discovered by MALDI-MS may be detectable as biomarkers in biofluid samples. The identification of specific protein markers for subchondral bone remodeling in OA advances our molecular understanding of disease progression in OA and provides potential new biomarkers for OA detection and disease grading.

Multi-task interactive feature transfer network for dual-energy-like chest radiography image synthesis using CT data.