Skeletal Radiology最新文献

{"title":"Hierarchical classification of acute and chronic osteoporotic vertebral compression fractures of the lumbar spine using X-ray images.","authors":"Joohyun Kim, Keewon Shin, Sungjae An, Subum Lee, Woo-Keun Kwon, Younggyu Oh, Kyu-Chong Lee, Sungjin Park, Kyung-Sik Ahn, Junseok W Hur","doi":"10.1007/s00256-026-05328-7","DOIUrl":"10.1007/s00256-026-05328-7","url":null,"abstract":"<p><strong>Objective: </strong>To develop and validate a hierarchical deep learning model for differentiating acute and chronic lumbar osteoporotic vertebral compression fractures (OVCFs) using X-ray images.</p><p><strong>Materials and methods: </strong>We retrospectively reviewed approximately 2600 lateral lumbar radiographs obtained from patients clinically suspected of having OVCFs between 2007 and 2022. After excluding poor-quality images and surgically instrumented vertebrae, 1299 radiographs (6495 vertebral patches, L1-L5) were included. Labeling was performed by neurosurgeons and radiologists using X-ray images, with CT and/or MRI findings serving as the reference standard. A two-step hierarchical classification was implemented: first classifying vertebrae into Normal-Chronic, Acute, and Indeterminate (cement-augmented vertebrae without instrumentation) groups, followed by subdivision of the Normal-Chronic group into Normal and Chronic categories.</p><p><strong>Results: </strong>A total of 1299 radiographs were evaluated. The hierarchical model achieved an accuracy of 91% in the initial three-class step. For the detection of acute fractures in the final classification step, the model demonstrated a sensitivity of 91.0% (95% CI 84.8-95.0%), a specificity of 82.1% (95% CI 79.8-84.5%), and a high negative predictive value (NPV) of 98.8% (95% CI 97.9-99.3%). The Normal-aligned hierarchical approach outperformed the Acute-aligned and end-to-end models, particularly for acute and chronic cases.</p><p><strong>Conclusion: </strong>The proposed hierarchical approach enhances the diagnostic utility of standard X-ray images by enabling more accurate classification of lumbar fracture types. This study is limited by its single-institution retrospective design. This model may reduce reliance on advanced imaging and support faster and more informed clinical decision-making.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"3181-3193"},"PeriodicalIF":2.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148712980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging features of soft tissue hibernoma: a review of 73 cases.","authors":"Jeremiah R Long, Brandon T Larsen, Mark D Murphey, Mark J Kransdorf","doi":"10.1007/s00256-026-05351-8","DOIUrl":"10.1007/s00256-026-05351-8","url":null,"abstract":"<p><strong>Objective: </strong>To review the spectrum of clinical presentations and imaging features of soft tissue hibernoma, emphasizing those which are most characteristic of this diagnosis.</p><p><strong>Material and methods: </strong>A retrospective review of our institutional pathology and imaging databases from 2004 to 2025 identified 73 soft tissue lesions having a confirmed pathology diagnosis of hibernoma and imaging evaluation. Imaging included MRI (54 cases), CT (29 cases), ultrasound (20 cases), radiography (20 cases), and PET (8 cases).</p><p><strong>Results: </strong>The 73 soft tissue lesions occurred in 39 males (53.4%) and 34 females (46.6%) from 5 to 75 years of age, with an overall average age and median age of 46 years. Soft tissue lesions measured from 5 to 288 mm in greatest dimension, with a median of 101 mm and a mean of 111.5 mm. Soft-tissue lesions demonstrated characteristic features of T1 shading that was best identified on non-fat-suppressed T1-weighted imaging, which should allow an accurate diagnosis in the majority of soft tissue hibernomatous lesions. The hibernomatous lesions were also delineated on CT, ultrasound, and radiography; however, these modalities did not adequately characterize brown fat to allow a definitive imaging diagnosis. Intestinally, PET imaging, available in 8 patients, demonstrated standardized-uptake-values (SUVmax) averaging 10.4 (range: 3.5-28.1), greater than the conventional PET/CT 2.5 value used as a marker for suggesting malignancy.</p><p><strong>Conclusion: </strong>Although hibernoma is a relatively uncommon tumor, there are specific imaging features that will allow a confident diagnosis in the majority of cases which arise in soft tissue.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"3073-3082"},"PeriodicalIF":2.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A semimembranosus-related band directed toward the posterior horn of the lateral meniscus: MRI prevalence and relationship to posterior knee stabilizing structures.","authors":"Ozgur Tosun, Bilgenur Aksoy, Su Ozgur, Cemal Kazimoglu, Aliye Tosun, Asli Irmak Akdogan","doi":"10.1007/s00256-026-05341-w","DOIUrl":"10.1007/s00256-026-05341-w","url":null,"abstract":"<p><strong>Objective: </strong>To determine the MRI prevalence of the semimembranosus-lateral meniscus (SM-LM) attachment and the imaging plane on which it is most conspicuous, and to evaluate its relationships with the meniscofemoral ligaments and the oblique popliteal ligament (OPL).</p><p><strong>Materials and methods: </strong>In this retrospective single-center study, 205 1.5-T knee MRI examinations in patients ≥ 18 years (134 women, 71 men; median age, 38 years) were evaluated by a musculoskeletal radiologist, with a random subset of 100 independently evaluated by a second reader; those with prior ipsilateral knee trauma or surgery or Kellgren-Lawrence grade 3-4 osteoarthritis were excluded. Interobserver agreement was evaluated with Cohen κ; logistic regression and chi-square analyses were performed.</p><p><strong>Results: </strong>The SM-LM attachment was identified in 32 of 205 knees (15.6%), exclusively thin and most conspicuous on axial images. The ligament of Wrisberg was present in 139 knees (67.8%), the OPL in 129 (62.9%), and the ligament of Humphrey in 113 (55.1%); the meniscofemoral ligaments co-occurred inversely (χ2 = 46.2, p < 0.001). The OPL was inversely associated with the SM-LM attachment on univariable analysis, and this inverse association persisted on multivariable analysis (adjusted OR, 0.42; 95% CI, 0.19-0.91; p = 0.029). Interobserver agreement was substantial to almost perfect (κ range, 0.69-0.94).</p><p><strong>Conclusion: </strong>The SM-LM attachment is an identifiable, thin semimembranosus-related band on knee MRI whose definitive anatomical nature requires cadaveric or surgical correlation. Its inverse association with the OPL suggests that these semimembranosus-related structures may represent alternative patterns within the posterior stabilizing network.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"3195-3205"},"PeriodicalIF":2.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A higher threshold of lumbar spine QCT trabecular BMD of < 95 or < 100 mg/mL for fragility fracture risk screening among Caucasian men than that of < 80 mg/mL for Caucasian women.","authors":"Yì Xiáng J Wáng, Maria Pilar Aparisi Gómez, Jason C S Leung, Ali Guermazi, Alberto Bazzocchi","doi":"10.1007/s00256-026-05345-6","DOIUrl":"10.1007/s00256-026-05345-6","url":null,"abstract":"","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"3137-3146"},"PeriodicalIF":2.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"De novo osteosarcoma following prolonged denosumab treatment for giant cell tumor of bone at an anatomically distant site: a case report.","authors":"Katherine Elon Burbank, Robert Mikael Henshaw, James Stephen Jelinek, Mark D Murphey","doi":"10.1007/s00256-026-05347-4","DOIUrl":"10.1007/s00256-026-05347-4","url":null,"abstract":"<p><p>Denosumab is a monoclonal antibody targeting RANKL, FDA-approved for the treatment of giant cell tumor of bone (GCTB). While it has shown efficacy in tumor regression and bone preservation, rare cases of malignant transformation to osteosarcoma have been associated with denosumab treatments. Previous literature has attributed such cases to either initial misdiagnosis of a malignant giant cell tumor at baseline presentation or, more rarely, transformation of previously histologically benign GCTB to a secondary malignant GCTB. To our knowledge, these cases involved or arose from an existing giant cell tumor neoplasm. We present a unique case of a patient who developed de novo osteosarcoma at a distant location from their original GCTB tumor following prolonged denosumab therapy, highlighting the clinical course, diagnostic challenges, and therapeutic considerations.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"3389-3396"},"PeriodicalIF":2.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Test yourself: question: a 44-year-old woman with chronic left medial clavicular pain.","authors":"Pranav Rajaram, Kyle D Perry, William R Aibinder, Jon A Jacobson, Steven B Soliman","doi":"10.1007/s00256-026-05248-6","DOIUrl":"10.1007/s00256-026-05248-6","url":null,"abstract":"","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"3371-3373"},"PeriodicalIF":2.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148144523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteoarthritis and fibroblast activation: an imaging study assessing feasibility and reliability of whole-body ⁶⁸ Ga-FAPI PET-CT for structural osteoarthritis evaluation.","authors":"Anna Katharina Roemer, Rafael Heiss, Christian Schmidkonz, Jamie E Collins, Maria Gabriella Raimondo, Michael Beck, Ali Guermazi, Tobias Bäuerle, Georg Schett, Michael Uder, Torsten Kuwert, Andreas Ramming, Frank W Roemer, Alina Mihaela Ramming, Armin Atzinger","doi":"10.1007/s00256-026-05354-5","DOIUrl":"10.1007/s00256-026-05354-5","url":null,"abstract":"<p><strong>Objective: </strong>Primary aim was to evaluate whether presence of osteoarthritis (OA), as assessed by ordinal grading on whole-body computed tomography (CT), is associated with ⁶⁸ Ga fibroblast activation protein inhibitor (FAPI) positron emission tomography (PET) tracer uptake as a measure of fibroblastic activation. Secondary aim was to evaluate whether OA disease severity is positively correlated with increased tracer uptake and to evaluate reliability.</p><p><strong>Material and methods: </strong>In a retrospective study design, patients who had undergone ⁶⁸ Ga-FAPI PET-CT for a spectrum of clinical reasons were included. Whole-body CT was assessed for OA using the OsteoArthritis Computed Tomography-Score in multiple joints and the spine. Maximum standard uptake value (SUV_max) was determined correspondingly. Logistic regression and correlation analyses were used to describe associations between structural OA and ⁶⁸ Ga-FAPI PET activity.</p><p><strong>Results: </strong>Fifty-four patients were included. Presence of OA in the acromioclavicular joints (ACJ) was associated with odds of SUV_max being in the highest tertile. Increased odds were seen for one location of the cervical spine (OR 5.7, 95% confidence interval [1.6, 20.4]) and both locations of the lumbar spine (OR 8.3, 95% confidence interval [1.5, 46.6]; 5.0, 95% confidence interval [1.3, 18.7]). Moderate correlations were observed for OA severity and ⁶⁸ Ga-FAPI PET uptake for most joints and spine. Reliability for OA scoring (overall percent agreement) ranged from 40 to 100% (intra-reader) and from 66.3 to 100% (inter-reader). Mean intraclass correlation coefficients for SUV_max were 0.76 and 0.82, respectively.</p><p><strong>Conclusion: </strong>Presence of OA was associated with increased SUV_max uptake for the ACJ and the cervical and lumbar spine. In this feasibility study, CT-based OA scoring and ⁶⁸ Ga-FAPI PET SUV_max determinations could be achieved with good reliability.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"3297-3313"},"PeriodicalIF":2.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13669032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical management and postoperative imaging assessment of hallux valgus.","authors":"Hicham Bouredoucen","doi":"10.1007/s00256-026-05327-8","DOIUrl":"10.1007/s00256-026-05327-8","url":null,"abstract":"<p><p>Hallux valgus (HV) is a common and complex three-dimensional deformity of the first ray, resulting from multifactorial interactions involving anatomical, biomechanical, ligamentous, muscular, and extrinsic factors. The absence of a single etiological mechanism explains the wide variety of proposed surgical techniques and highlights the need for individualized management. The therapeutic strategy is based on a structured radioclinical weight-bearing assessment integrating angular parameters, first-ray stability, sesamoid alignment, and joint status. Depending on the severity of the deformity and the presence of associated instability, surgical options include distal, diaphyseal, or proximal osteotomies, Lapidus tarsometatarsal arthrodesis, and metatarsophalangeal arthrodesis. Certain complex situations, particularly those associated with metatarsus adductus or juvenile HV, require specific morphological analysis because of an increased risk of recurrence and particular biomechanical constraints. Postoperative imaging plays a central role in the assessment of surgical outcomes. It allows evaluation of deformity correction, osteotomy healing, fixation stability, sesamoid repositioning, and restoration of first-ray alignment. Weight-bearing radiographs remain the reference examination, whereas WBCT enables a more precise three-dimensional analysis of rotational correction, first metatarsal pronation, and the sesamoid complex. Imaging is also essential for the detection of postoperative complications, including recurrence, malunion, nonunion, avascular necrosis, transfer metatarsalgia, infection, osteoarthritis, and nerve injury. WBCT currently represents a major complementary tool for the analysis of multiplanar corrections and their biomechanical consequences. Thorough knowledge of normal and pathological postoperative findings is essential to optimize the management of HV.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"3031-3059"},"PeriodicalIF":2.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13669031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Zero-shot segmentation and tumor diameter measurement of soft tissue sarcomas on MRI using a multimodal large language model.","authors":"Haruto Sugawara, Shimpei Kato, Akiyo Takada","doi":"10.1007/s00256-026-05335-8","DOIUrl":"10.1007/s00256-026-05335-8","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the zero-shot capabilities of a multimodal deep learning model (Gemini 3.0) in segmenting Soft Tissue Sarcomas (STS) on MRI and to compare the accuracy of tumor diameter measurements derived from automated segmentation versus direct model estimation.</p><p><strong>Methods: </strong>This retrospective study utilized a public dataset (The Cancer Imaging Archive) consisting of 51 patients (mean age, 54.8 ± 17.0 years; 24 men, 27 women) with histologically confirmed STS. Gemini 3.0 performed zero-shot lesion segmentation and direct diameter estimation on a fat-suppressed T2-weighted or STIR image. Segmentation accuracy was evaluated using the Dice similarity coefficient (DSC) against manual segmentation by a board-certified radiologist. Tumor diameters derived from Gemini segmentation masks and direct estimates were compared with manual measurements using intraclass correlation coefficients (ICC) and Bland-Altman analysis. Bootstrap analysis was performed to compare the performance of the two automated measurement methods.</p><p><strong>Results: </strong>Gemini generated segmentation masks with a mean DSC of 0.935 ± 0.082, comparable to inter-radiologist agreement (0.949 ± 0.037) and showing high reproducibility (DSC, 0.981 ± 0.038). For tumor size assessment, the segmentation-derived measurement yielded an ICC of 0.976, significantly higher than the direct estimation ICC of 0.922 (p = 0.027). Bland-Altman analysis revealed a smaller mean bias for the segmentation-based approach (-0.5 mm) compared with direct estimation (-5.0 mm).</p><p><strong>Conclusions: </strong>Gemini 3.0 achieved high accuracy in zero-shot segmentation of STS on MRI. Deriving quantitative measurements from automated segmentation proved significantly more reliable than direct size estimation by the large language model.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"3157-3165"},"PeriodicalIF":2.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bibliometric analysis of 50 years of publications in Skeletal Radiology (1976-2025): trends, impact, and global collaboration patterns.","authors":"Raju Vaishya, Alok Singh, Brij Mohan Gupta, Abhishek Vaish, Rajesh Botchu","doi":"10.1007/s00256-026-05359-0","DOIUrl":"10.1007/s00256-026-05359-0","url":null,"abstract":"<p><strong>Objective: </strong>To conduct a comprehensive bibliometric analysis of 50 years of publications in Skeletal Radiology to evaluate publication trends, citation impact, authorship patterns, institutional contributions, international collaboration, and research themes.</p><p><strong>Methods: </strong>Data were retrieved from the Scopus database on 1 May 2026, covering all publications indexed in Skeletal Radiology from 1976 to 2025. A total of 8258 documents were analyzed using VOSviewer for network visualization (co-authorship and keyword co-occurrence) and Microsoft Excel for descriptive and statistical analyses. Key metrics included total publications (TP), total citations (TC), citations per paper (CPP), relative citation index (RCI), and total link strength (TLS).</p><p><strong>Results: </strong>The journal demonstrated steady growth with an average of 168.5 papers per year and a 6.5% annual growth rate, peaking at 261.2 papers/year during 2016-2025. Scientific articles comprised 81.86% and reviews 10.01% of publications. The US led in productivity (4120 papers, 49.9%), followed by the UK (831) and Japan (464). However, Austria and the Netherlands recorded the highest citation impact. Prominent authors included D. Resnick (108 papers) and A. Saifuddin (175 papers). MRI, CT, osteoarthritis, and bone tumors emerged as dominant keywords. Highly cited papers focused on osteoarthritis imaging, meniscal pathology, and artificial intelligence (AI) applications in fracture detection.</p><p><strong>Conclusion: </strong>Over five decades, Skeletal Radiology has established itself as a leading platform in musculoskeletal imaging, with increasing international collaboration and a clear shift toward advanced imaging technologies and AI. This analysis highlights key contributors, evolving research themes, and provides strategic insights for future directions in the field.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"3315-3324"},"PeriodicalIF":2.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}