Skeletal Radiology最新文献

{"title":"Exact radiological-pathological correlation of chondrosarcomas using a patient-specific 3D mold.","authors":"Maryse Lejoly, Thomas Van Den Berghe, David Creytens, Wouter Huysse, Gwen Sys, Renaat Coopman, Koenraad L Verstraete","doi":"10.1007/s00256-025-04942-1","DOIUrl":"10.1007/s00256-025-04942-1","url":null,"abstract":"<p><strong>Objective: </strong>To identify aggressive regions in high-grade and dedifferentiated chondrosarcomas on MRI by obtaining an exact correlation between radiology and histopathology.</p><p><strong>Materials and methods: </strong>One chondrosarcoma grade II (CSII), chondrosarcoma grade III (CSIII) and dedifferentiated chondrosarcoma (DDCS) were segmented on (DCE-)MRI images. Around the segmentations, a patient specific mold was constructed and 3D-printed with cutting grooves perfectly aligned with selected MRI slices. In this way, resection specimens could be cut at the same locations as the MRI slices. Histopathology slides were stained with hematoxylin-eosin and CD31 (vascularization) and correlated with the (DCE-)MRI. Histopathologically, atypical cartilaginous tumor (ACT), CSII, CSIII and DDCS regions were delineated and vascular hotspots were selected by an experienced pathologist. Exact point-to-point correlation was performed.</p><p><strong>Results: </strong>ACT, CSII, CSIII and DDCS regions all had similar mean signal intensity on T1-weighted images. On fat-saturated T2-weigthed images, CSII and CSIII regions had a higher mean signal intensity. On fat-saturated T1-weighted images after gadolinium contrast injection and on wash-in parametric maps DDCS regions had the highest mean signal intensity and highest wash-in values. There was a higher microvessel density in CSII and CSIII regions. This corresponded with a thick enhancing rim on fat-saturated T1-weighted images after gadolinium contrast injection and with a higher wash-in.</p><p><strong>Conclusion: </strong>This new 3D mold helps to identify high-grade chondrosarcoma regions with myxoid. This may be useful for targeted biopsy and histopathological investigation.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2179-2190"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012622","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":"Magnetic resonance imaging assessment of epiphyseal invasion in paediatric osteosarcoma.","authors":"Jiazhi Zhu, Kunkun Sun, Qianyu Shi, Siyi Huang, Dasen Li, Wei Guo, Xiaodong Tang, Tao Ji","doi":"10.1007/s00256-025-04923-4","DOIUrl":"10.1007/s00256-025-04923-4","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to evaluate the reliability and reproducibility of magnetic resonance imaging (MRI) in the evaluation of epiphyseal invasion (EI).</p><p><strong>Methods: </strong>We included paediatric patients with open epiphyseal plates diagnosed with high-grade osteosarcoma (OS) located in the diaphysis or metaphysis of the long bones. Patients underwent neoadjuvant chemotherapy and MRI, including T1-weighted and short tau inversion recovery (STIR)-/T2-weighted sequences. Significant tumour penetration through the growth plate into the epiphysis, high signal intensity in the epiphysis, oedema-like signals in the epiphysis, and growth plate discontinuity were assessed on MRI. Standardised uptake value (SUV) of the lesions and necrosis rate were included in analysis. Histopathological analysis was performed to confirm EI status.</p><p><strong>Results: </strong>Thirty-three patients (18 males and 15 females; 4-15 years old; mean age 10.7 years) were included. EI was present in 16 cases. Significant tumour penetration through the growth plate (p = 0.002-0.005), high signal intensity in the epiphysis (p < 0.001-0.005), and discontinuous growth plates (p = 0.002-0.010) were associated with EI, but the latter two showed moderate reproducibility. The association between oedema signals and EI status lacked statistical significance (p = 0.175-0.225), with low specificity and reproducibility. Pre-chemotherapy SUV correlated with EI (p = 0.006). Huvos grade III/IV was associated with a lower incidence of EI (p = 0.02).</p><p><strong>Conclusions: </strong>Significant tumour invasion through the growth plate, high signal intensity in the epiphysis, and growth plate discontinuity are reliable indicators of EI on MRI. Oedema-like signals in the epiphysis alone are not associated with tumour invasion.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2077-2085"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781111","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":"Bilateral gonococcal septic tenosynovitis and septic arthritis as a first presentation of HIV in a 53-year-old male.","authors":"Fielding S Fischer, Austin T Gregg, F Joseph Simeone, Arvin B Kheterpal","doi":"10.1007/s00256-025-04940-3","DOIUrl":"10.1007/s00256-025-04940-3","url":null,"abstract":"<p><p>Infection with Neisseria gonorrhoeae is common, primarily affecting the urogenital system. Disseminated gonococcal infection (DGI) through the bloodstream is much less common but has important ramifications on the musculoskeletal system, as it can infect tendon sheaths and joints. We describe a case of bilateral gonococcal septic tenosynovitis and septic arthritis with contiguous osteomyelitis in the ankles/feet of a 53-year-old male whose presentation triggered an immunodeficiency workup revealing HIV. This case highlights challenges associated with the diagnosis of DGI, the need for heightened clinical suspicion in patients presenting with septic tenosynovitis, and the importance of recognizing clinical signs of immunodeficiency.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2199-2203"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032932","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":"Diagnostic value of a coronal STIR sequence in conjoined lumbar nerve root detection: an MRI accuracy study.","authors":"Georg Wilhelm Kajdi, Thomas Marth, Jung-Ah Choi, Mazda Farshad, Reto Sutter","doi":"10.1007/s00256-025-04945-y","DOIUrl":"10.1007/s00256-025-04945-y","url":null,"abstract":"<p><strong>Objectives: </strong>To assess diagnostic accuracy for conjoined lumbosacral nerve root (CLNR) detection on MRI when adding a coronal STIR sequence to the standard lumbar spine protocol.</p><p><strong>Materials and methods: </strong>In this retrospective study, two radiologists assessed the presence of CLNR and lumbosacral transitional vertebrae (LSTV), using a standard lumbar MRI protocol and an expanded protocol with an additional coronal STIR sequence. Prior radiologist consensus using the expanded protocol served as a reference standard for diagnosis.</p><p><strong>Results: </strong>In 751 patients (mean age 61.2 ± 15.7 years, 435 females), CLNR was found in 38 patients (5.1%) in consensus. Without coronal STIR, 13 CLNR patients were correctly identified, CLNR was missed in 25 patients, and 3 patients were falsely detected as having one (sensitivity of 34.2%, specificity of 99.6%, positive predictive value (PPV) of 81.3%, negative predictive value (NPV) of 96.6%, and accuracy of 96.3%). With coronal STIR, 31 CLNR patients were correctly identified, CLNR were missed in 7 patients, and one patient was falsely detected as having one (sensitivity of 81.6%, specificity of 99.9%, PPV of 96.9%, NPV of 99.0%, and accuracy of 98.9%). Inter-reader agreement improved from moderate without coronal STIR (κ = 0.592; 95% CI 0.38, 0.80) to almost perfect with coronal STIR (κ = 0.915; 95% CI 0.84, 0.99). LSTV had a prevalence of 13.3% among patients without and 26.3% among patients with CLNR (p = 0.025).</p><p><strong>Conclusion: </strong>Coronal STIR greatly improved sensitivity and inter-reader agreement for CLNR detection on MRI while slightly improving the specificity and accuracy. A significant association of CLNR and LSTV was found.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2157-2168"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080132","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":"Extra-axial chordoma of the distal femur: a clinical and radiological challenge-case report and literature review.","authors":"Lotje A Hoogervorst, Thomas W Borsje, Danique L M van Broekhoven, Bart Kaptein, Ana Navas Cañete, Shaho Hasan, Robert J P van der Wal","doi":"10.1007/s00256-025-05041-x","DOIUrl":"https://doi.org/10.1007/s00256-025-05041-x","url":null,"abstract":"<p><p>We report a very rare case of an intraossesous extra-axial chordoma (EAC) involving the distal femur. We describe the clinical presentation, radiologic and pathological findings, and the treatment. In addition, a systematic literature search was performed to further expand the knowledge regarding EAC in the lower extremities, including 13 papers describing a total of 21 adult patients.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192569","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":"Tenosynovial giant cell tumour of the nasal dorsum: a novel presentation.","authors":"Sneha Pimpalnerkar, Talisa Ross, Catherine Rennie, Wendy Brown, Sally F Bonar, Mark Wilsher","doi":"10.1007/s00256-025-05039-5","DOIUrl":"https://doi.org/10.1007/s00256-025-05039-5","url":null,"abstract":"<p><p>Tenosynovial giant cell tumour (TSGCT) of the head and neck is exceedingly rare. We report a case of a TSGCT at a novel anatomical site, the nasal dorsum. This case also contributes to the expanding genetic landscape of TSGCT through the identification of a gene fusion that has not previously been described in the literature, to the best of our knowledge. A 20-year-old male presented with progressive changes in the shape of his nasal dorsum, without prior history of trauma or surgery. Clinical examination revealed a firm, mobile, non-tender swelling over the middle third of the nose. Imaging identified a well-defined soft tissue mass, closely related to the nasal cartilage. The mass was completely excised via an external septorhinoplasty approach, enabling removal with reconstruction of the nasal contour. Histopathological analysis demonstrated a giant cell-rich neoplasm with mononuclear cells, foamy histiocytes, and haemosiderin deposition. The unusual location of the mass prompted molecular analysis by next-generation sequencing, RNA analysis of which identified a novel CSF1::AKNAD1 gene fusion. A localised TSGCT was diagnosed. Whilst TSGCT typically arises at sites where synovium is present, its presence at the nasal dorsum introduced uncertainty regarding the tumour's pathogenesis. This case demonstrates the importance of integrating clinical, radiological, histopathological, and molecular findings in diagnosing rare presentations of soft tissue tumours and expands the anatomical locations at which TSGCT may arise.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182274","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":"Quantifying 3D foot and ankle alignment using an AI-driven framework: a pilot study.","authors":"Roel Huysentruyt, Emmanuel Audenaert, Ide Van den Borre, Aleksandra Pižurica, Kate Duquesne","doi":"10.1007/s00256-025-05038-6","DOIUrl":"https://doi.org/10.1007/s00256-025-05038-6","url":null,"abstract":"<p><strong>Objective: </strong>Accurate assessment of foot and ankle alignment through clinical measurements is essential for diagnosing deformities, treatment planning, and monitoring outcomes. The traditional 2D radiographs fail to fully represent the 3D complexity of the foot and ankle. In contrast, weight-bearing CT provides a 3D view of bone alignment under physiological loading. Nevertheless, manual landmark identification on WBCT remains time-intensive and prone to variability. This study presents a novel AI framework automating foot and ankle alignment assessment via deep learning landmark detection.</p><p><strong>Materials and methods: </strong>By training 3D U-Net models to predict 22 anatomical landmarks directly from weight-bearing CT images, using heatmap predictions, our approach eliminates the need for segmentation and iterative mesh registration methods. A small dataset of 74 orthopedic patients, including foot deformity cases such as pes cavus and planovalgus, was used to develop and evaluate the model in a clinically relevant population. The mean absolute error was assessed for each landmark and each angle using a fivefold cross-validation.</p><p><strong>Results: </strong>Mean absolute distance errors ranged from 1.00 mm for the proximal head center of the first phalanx to a maximum of 1.88 mm for the lowest point of the calcaneus. Automated clinical measurements derived from these landmarks achieved mean absolute errors between 0.91° for the hindfoot angle and a maximum of 2.90° for the Böhler angle.</p><p><strong>Conclusion: </strong>The heatmap-based AI approach enables automated foot and ankle alignment assessment from WBCT imaging, achieving accuracies comparable to the manual inter-rater variability reported in previous studies. This novel AI-driven method represents a potentially valuable approach for evaluating foot and ankle morphology. However, this exploratory study requires further evaluation with larger datasets to assess its real clinical applicability.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145178280","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":"An AI-based pipeline for osteoporosis/osteopenia prediction using hip radiographs.","authors":"José Acosta-Batlle, David Coronado-Gutiérrez, Javier Soto, Jaime Moujir, Carlos López, Carlos Suevos Ballesteros, Mónica Vázquez Díaz, María Del Prado Orduña Díez, David Fernández, Javier Blázquez Sánchez","doi":"10.1007/s00256-025-05033-x","DOIUrl":"https://doi.org/10.1007/s00256-025-05033-x","url":null,"abstract":"<p><strong>Objective: </strong>To develop and validate an artificial intelligence-based tool for the diagnosis of osteoporosis/osteopenia using hip radiographs. The tool aims to classify femurs into risk-based categories for osteoporosis/osteopenia, enabling patient prioritization, enhancing preventive medicine through incidental detection, and assisting clinicians' diagnosis in general.</p><p><strong>Materials and methods: </strong>The AI tool was designed to perform three preprocessing tasks before the osteoporosis/osteopenia prediction: (1) splitting images into single femurs, (2) identifying and discarding femurs with prostheses, and (3) cropping images to isolate the proximal femur. A total of 2691 anteroposterior hip radiographs from 1654 patients were included in the study. The osteoporosis/osteopenia prediction model was trained on 3227 single femur images and tested on 826. Additionally, a final evaluation experiment was conducted on 313 new radiographs from 239 patients to assess the tool's applicability.</p><p><strong>Results: </strong>The tool demonstrated high performance in the preprocessing tasks, achieving 99.0% accuracy in classifying single vs. double femur images, 99.3% accuracy in identifying prosthetic femurs, and 99.2% pixel accuracy in delineating the proximal femur before cropping. The final prediction model achieved an area under the curve of 86.6% for detecting osteoporosis/osteopenia in the test set and 81.0% in the final evaluation experiment.</p><p><strong>Conclusions: </strong>The obtained results demonstrate the potential of the proposed AI-based pipeline for prediction of osteoporosis/osteopenia using hip radiographs. This study suggests that a tool based on the proposed methods could support DXA triage, incidental osteoporosis detection, and clinical decision-making in settings with limited access to bone densitometry.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150791","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":"Unstable os subfibulare in the setting of tibiotalar instability.","authors":"Nathan C Beckett, Jeremiah R Long, Phil J Karsen, Karan A Patel, Jonathan A Flug, Nirvikar Dahiya, David M Melville","doi":"10.1007/s00256-025-05040-y","DOIUrl":"https://doi.org/10.1007/s00256-025-05040-y","url":null,"abstract":"<p><p>An os subfibulare is an ossicle that is located distal to the lateral malleolus near the distal fibular tip and typically at the fibular attachment of the anterior talofibular ligament (ATFL). Although there is debate concerning whether these ossicles are unfused accessory ossification centers versus non-united ATFL avulsion fractures, they are seen frequently in the setting of ankle instability. We present a case of an active patient with an unstable os subfibulare contributing to painless \"catching\" of the ankle due to talar subluxation and locking. This report details the clinical presentation, radiological findings, including MRI and dynamic ultrasound in the \"locked\" position, and surgical treatment for this unusual presentation of this unstable ossicle. The case underscores the potential importance of the os subfibulare in a patient with ankle instability and highlights the role of advanced imaging in guiding effective treatment.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150805","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":"Rapid and robust quantitative cartilage assessment for the clinical setting: deep learning-enhanced accelerated T2 mapping.","authors":"Laura Carretero-Gómez, Florian Wiesinger, Maggie Fung, Bruno Nunes, Valentina Pedoia, Sharmila Majumdar, Arjun D Desai, Anthony Gatti, Akshay Chaudhari, Eugenia Sánchez-Lacalle, Norberto Malpica, Mario Padrón","doi":"10.1007/s00256-025-05034-w","DOIUrl":"https://doi.org/10.1007/s00256-025-05034-w","url":null,"abstract":"<p><strong>Objective: </strong>Clinical adoption of T2 mapping is limited by poor reproducibility, lengthy examination times, and cumbersome image analysis. This study aimed to develop an accelerated deep learning (DL)-enhanced cartilage T2 mapping sequence (DL CartiGram), demonstrate its repeatability and reproducibility, and evaluate its accuracy compared to conventional T2 mapping using a semi-automatic pipeline.</p><p><strong>Methods: </strong>DL CartiGram was implemented using a modified 2D Multi-Echo Spin-Echo sequence at 3 T, incorporating parallel imaging and DL-based image reconstruction. Phantom tests were performed at two sites to obtain test-retest T2 maps, using single-echo spin-echo (SE) measurements as reference values. At one site, DL CartiGram and conventional T2 mapping were performed on 43 patients. T2 values were extracted from 52 patellar and femoral compartments using DL knee segmentation and the DOSMA framework. Repeatability and reproducibility were assessed using coefficients of variation (CV), Bland-Altman analysis, and concordance correlation coefficients (CCC). T2 differences were evaluated with Wilcoxon signed-rank tests, paired t tests, and accuracy CV.</p><p><strong>Results: </strong>Phantom tests showed intra-site repeatability with CVs ≤ 2.52% and T2 precision ≤ 1 ms. Inter-site reproducibility showed a CV of 2.74% and a CCC of 99% (CI 92-100%). Bland-Altman analysis showed a bias of 1.56 ms between sites (p = 0.03), likely due to temperature effects. In vivo, DL CartiGram reduced scan time by 40%, yielding accurate cartilage T2 measurements (CV = 0.97%) with no significant differences compared to conventional T2 mapping (p = 0.1).</p><p><strong>Conclusions: </strong>DL CartiGram significantly accelerates T2 mapping, while still assuring excellent repeatability and reproducibility. Combined with the semi-automatic post-processing pipeline, it emerges as a promising tool for quantitative T2 cartilage biomarker assessment in clinical settings.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087360","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}