Bone & Joint Research最新文献

{"title":"Bone mineral density measurement in the Gruen zones using dual-energy x-ray absorptiometry : insights from quantitative CT analysis.","authors":"Keisuke Uemura, Yoshito Otake, Kazunori Tamura, Ryo Higuchi, Sotaro Kono, Hirokazu Mae, Kazuma Takashima, Seiji Okada, Nobuhiko Sugano, Hidetoshi Hamada","doi":"10.1302/2046-3758.1410.BJR-2025-0036.R1","DOIUrl":"https://doi.org/10.1302/2046-3758.1410.BJR-2025-0036.R1","url":null,"abstract":"<p><strong>Aims: </strong>After total hip arthroplasty (THA), dual-energy x-ray absorptiometry (DXA) is used as necessary to assess the bone mineral density (BMD) in the Gruen zones around the femoral stem implants. Although periprosthetic BMD may serve as a potential indicator for evaluating stress adaptive remodelling and stem fixation, several factors can introduce measurement errors. Therefore, an automated method was applied using quantitative CT, verified for the total hip with correlation coefficient > 0.9, for BMD assessment in the Gruen zones.</p><p><strong>Methods: </strong>This was a retrospective analysis of 71 hips from 58 participants (9 male and 49 female) who underwent THA using the same taper-wedge type stem. Preoperative and postoperative CT scans were acquired alongside DXA measurements of the Gruen zones. A deep-learning method was used to measure BMD in the Gruen zones from preoperative CT images by embedding the stem position information acquired from postoperative CT images through iterative closest point registration. CT images were rotated to the neutral position and were projected anteroposteriorly to generate a digitally reconstructed radiograph to measure the BMD at each zone (CT-aBMD). Correlations between CT-aBMD and DXA measurements were assessed for each zone.</p><p><strong>Results: </strong>The correlations between CT-aBMD and DXA measurements for zones 1 to 7 were 0.924, 0.783, 0.817, 0.921, 0.731, 0.847, and 0.677, respectively (p < 0.001 for all).</p><p><strong>Conclusion: </strong>Our results based on CT analysis suggest that DXA is generally reliable for assessing BMD in the Gruen zones. However, caution may be advised for zones 5 and 7 because of limited correlations. As zone 7 plays a crucial role in stem fixation, during longitudinal evaluation of post-THA stress adaptive remodelling, we recommend ensuring cautious interpretation and consistent BMD measurements using the image attached to the DXA report. It is imperative to calculate the least significant change for accurate BMD evaluation.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"14 10","pages":"850-859"},"PeriodicalIF":5.1,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discogenic pain in lumbar vertebra : is quantitative assessment of the osteochondral endplates by simultaneous 18F-NaF PET/MRI helpful?","authors":"Yu-Pang Lin, Chih-Chien Wang, Han-Bin Huang, Guo-Shu Huang, Shih-Wei Chiang, Yi-Chih Hsu","doi":"10.1302/2046-3758.1410.BJR-2025-0064.R1","DOIUrl":"10.1302/2046-3758.1410.BJR-2025-0064.R1","url":null,"abstract":"<p><strong>Aims: </strong>Discogenic pain due to intervertebral disc (IVD) degeneration contributes substantially towards low back pain (LBP). This study aims to develop novel and non-invasive diagnostic tools by directly comparing the quantitative results of the normal and degenerated osteochondral endplates obtained using simultaneous ¹⁸F-NaF PET/MRI.</p><p><strong>Methods: </strong>We prospectively enrolled 22 participants with chronic lower back pain from August 2022 to November 2023. We classified all 110 lumbar IVDs (L1/2-L5/S1 in 22 people) into 75 normal IVDs and 35 degenerative IVDs. The T2 relaxation times in the cartilaginous endplate on MRI (<i>T</i>2<i>rt</i>-CEP-MR) and normalized subchondral bone on positron emission tomography (PET) images (SUVmax-SB-PET) of all 110 lumbar IVDs were recorded. To analyze the relationship between the cartilaginous endplate and neighbouring subchondral bone, we employed Pearson correlation coefficient and generalized estimating equation (GEE) models to examine the <i>T</i>2<i>rt</i>-CEP-MR and SUVmax-SB-PET results in normal and degenerative IVDs.</p><p><strong>Results: </strong>We observed lower <i>T</i>2<i>rt</i>-CEP-MR in the middle location of the disc (p = 0.003) and higher SUVmax-SB-PET in the anterior, middle, and posterior locations of the disc (p = 0.030, p = 0.006, and p < 0.001, respectively) in degenerative IVDs. Regarding the association between the <i>T</i>2<i>rt</i>-CEP-MR of discs and the SUVmax-SB-PET of the neighbouring subchondral bone, we observed a significant correlation (<i>r</i> = 0.211 to 0.328, p < 0.001) in all locations of normal IVDs. Additionally, a significant correlation was observed in the anterior and middle locations of the degenerative IVDs, and a marginally significant correlation was observed in the posterior region of the degenerative IVDs (<i>r</i> = 0.159, p = 0.060).</p><p><strong>Conclusion: </strong>Simultaneous ¹⁸F-NaF PET/MRI is a novel and reliable technique for evaluating the osteochondral endplate. The differences in quantitative results could help clinicians to establish an impression of discogenic pain. A spatial relationship exists between the biochemical changes within discs and subchondral bone metabolism.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"14 10","pages":"839-849"},"PeriodicalIF":5.1,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12498161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiomics in FAI: current status and perspectives.","authors":"Hariharan Subbiah Ponniah, Eros Montin, Srikar Namireddy, Riccardo Lattanzi, Kartik Logishetty","doi":"10.1302/2046-3758.1410.BJR-2024-0353.R2","DOIUrl":"10.1302/2046-3758.1410.BJR-2024-0353.R2","url":null,"abstract":"<p><p>Femoroacetabular impingement (FAI) is caused by abnormal contact between the femur and acetabulum, resulting in pain, limited motion, and early osteoarthritis. Existing imaging techniques for diagnosing FAI face considerable challenges. Radiomics involves the quantitative extraction and analysis of imaging features using advanced algorithms, often combined with machine learning (ML), to enhance diagnostic and prognostic precision. When integrated with ML, radiomics can identify patterns beyond conventional imaging measurements, potentially enabling automated, precise, and reproducible assessment of hip morphology and pathology. Early studies demonstrate its potential to differentiate between normal, symptomatic, and asymptomatic cam-type hips. However, challenges persist, including the standardization of imaging protocols, feature selection, access to large datasets, and the explainability of models. This review summarizes the state of the art in radiomics for FAI and highlights its future applications.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"14 10","pages":"832-838"},"PeriodicalIF":5.1,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12492042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cystic lesions in osteoarthritis and osteonecrosis of the femoral head : a comparative analysis of 3D distribution, microstructure, and histology.","authors":"Yiwei Chen, Jiapeng Li, Jiali Lin, Yu Miao, Junhui Yin, Guangyi Li, Changqing Zhang","doi":"10.1302/2046-3758.1410.BJR-2024-0478.R2","DOIUrl":"10.1302/2046-3758.1410.BJR-2024-0478.R2","url":null,"abstract":"<p><strong>Aims: </strong>Cystic lesions are strongly associated with the pathogenesis and selection of treatment strategies in osteoarthritis (OA) and osteonecrosis of the femoral head (ONFH). However, the differences in cystic lesions arising from these two diseases are not fully understood. This study aimed to delineate the variations in cyst characteristics in the femoral heads of patients with OA and ONFH.</p><p><strong>Methods: </strong>A total of 45 patients with OA and 105 patients with ONFH who underwent total hip arthroplasty (THA) between September 2014 and December 2021 were recruited in the study. The 3D distribution, microstructure, and histological characteristics of cystic lesions were comprehensively analyzed. Comparative assessments of the microstructural, histomorphometric, and histopathological properties of cystic lesions between OA and ONFH were performed, using micro-CT, decalcified and undecalcified bone histomorphology, and scanning electron microscopy (SEM).</p><p><strong>Results: </strong>In comparison to ONFH, cystic lesions in OA exhibited a smaller volume and a denser distribution. Despite a common prevalence in the anterior hemisphere in both conditions, ONFH cysts were predominantly located laterally, whereas OA cysts were found mainly medially. In OA, the trabecular bone surrounding the cystic lesions exhibited a more sclerotic microarchitecture, with an increase in bone formation and a decrease in bone resorption at the remodelling level. Histologically, cystic lesions in ONFH demonstrated a higher degree of angiogenesis compared to those in OA.</p><p><strong>Conclusion: </strong>While cystic lesions in both OA and ONFH were predominantly located in the anterior hemisphere, they exhibited different distribution and involvement characteristics, microstructure and bone remodelling properties, as well as histopathological features.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"14 10","pages":"820-831"},"PeriodicalIF":5.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of human adipose stem cell-derived mitochondrial transplantation on the activity of chronically injured anterior cruciate ligament cells.","authors":"Hon Lok Lo, Yao-Hui Huang, Yu-Chuan Lin, Wen-Wei Li, Shun Cheng Wu, Pei-Hsi Chou, Cheng-Chang Lu","doi":"10.1302/2046-3758.149.BJR-2025-0186","DOIUrl":"10.1302/2046-3758.149.BJR-2025-0186","url":null,"abstract":"<p><strong>Aims: </strong>Mitochondrial transplantation has been proposed as a potential treatment for injured ligament tissue. This study aimed to investigate the relationship between the time from injury to surgery and the activity of injured anterior cruciate ligament (ACL) cells. Additionally, we evaluated the effectiveness of mitochondrial transplantation in chronically injured ACL cells and in an in vivo ACL partial tear animal model.</p><p><strong>Methods: </strong>First, ACL injured tissue from rabbits (n = 6 for each timepoint) was harvested at two (acute), four (subacute), and eight (chronic) weeks following ACL transection. We investigated cell proliferation, migration capability, and the expression of collagen synthesis, vascular endothelial growth factor (<i>VEGF</i>), and transforming growth factor-β (<i>TGF-β</i>) genes in injured ACL cells at different injury timepoints. Second, we isolated mitochondria from human adipose-derived stem cells (hADSCs) and transplanted them into the ACL cells. Lastly, we evaluated the in vivo effects of hADSCs-mitochondrial transplantation in a rabbit knee model with partial ACL tear.</p><p><strong>Results: </strong>After injury, the highest cell activity was observed at four weeks. Immunohistochemical staining showed that hADSCs-mitochondria were taken up by the eight-week injured ACL cells, leading to subsequent improvements in cell viability, migration capability, and collagen synthesis, and <i>VEGF</i> gene expression which were superior to those of untreated cells. At eight weeks, treated injured ACL cells achieved cell proliferation and collagen type I, type III, and <i>VEGF</i> expression levels comparable to those of four-week injured cells. In the in vivo study, enhanced collagen synthesis was observed in the histological analysis following hADSCs-mitochondrial transplantation.</p><p><strong>Conclusion: </strong>The optimal timing of ACL reconstruction is four to six weeks after injury due to peak cell activity. Mitochondrial transplantation improves the activity of chronically injured ACL cells and enhances collagen synthesis in ACL partial tears, highlighting its potential as a treatment for improving their regenerative capability.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"14 9","pages":"805-819"},"PeriodicalIF":5.1,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An analysis of the medial femoral condyle flap anatomy and the involvement of different tissue components for the reconstruction of complex defects.","authors":"Michael Kohlhauser, Anna Vasilyeva, Heinz Bürger, Friedrich Anderhuber, Lars-Peter Kamolz, Michael Schintler","doi":"10.1302/2046-3758.149.BJR-2024-0536.R2","DOIUrl":"10.1302/2046-3758.149.BJR-2024-0536.R2","url":null,"abstract":"<p><strong>Aims: </strong>The reconstruction of complex defects involving various tissues still presents a challenge for reconstructive surgery and makes a combined flap indispensable. The mediodistal femur region (MDFR), which is supplied by the descending genicular artery (DGA), represents a unique donor site for harvesting combined flaps. This study analyzes the vascular anatomy of this region and the possible types of combined flaps.</p><p><strong>Methods: </strong>Within this analysis, the vascular supply of the DGA in a total of 35 lower limbs was investigated, having been embalmed with the Walter Thiel technique in order to enable lifelike conditions.</p><p><strong>Results: </strong>The DGA was detectable in 100% (n = 35) of all instances. The artery divided into three branches in 48.57% (n = 17) of cases and two branches in the remaining cases. In 40% (n = 14) of cases we found a saphenous artery (SA) and a musculoarticular branch (MAB), in 8.57% (n = 3) an articular branch (AB) and a muscular branch (MB), and in 2.86% (n = 1) a SA and a MB. Usage of DGA branches enabled corticoperiosteal, corticocancellous, osteochondral, or osteocutaneous flaps in 100% (n = 35) of our cases, and myocorticoperiostal, osteomyotendinous, osteomyotendocutanous, or osteotendofasciocutaneous flaps in 97.14% (n = 34). Vascular supply of skin flaps was feasible via the SA in 100% (n = 35) of cases or via dermal branches of the AB in 37.14% (n = 13).</p><p><strong>Conclusion: </strong>The multitissue, distal-mediofemoral region, supplied by the DGA and its branches, offers an optimal donor site with reliable vascularization, enabling the harvesting of combined flaps.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"14 9","pages":"795-804"},"PeriodicalIF":5.1,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overcoming barriers to interdisciplinary research in engineering and orthopaedic surgery.","authors":"Irene Yang, Shao-Ting Jerry Tsang, Simon G F Abram, Chloe E H Scott, A Hamish R W Simpson","doi":"10.1302/2046-3758.149.BJR-2024-0444.R1","DOIUrl":"10.1302/2046-3758.149.BJR-2024-0444.R1","url":null,"abstract":"","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"14 9","pages":"791-794"},"PeriodicalIF":5.1,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sagittal-oriented articular processes and intervertebral disc degeneration phenotypes can concurrently lead to an increased presence of annulus tears in the cranial adjacent motion segment : a clinical review and biomechanical simulation.","authors":"Zhipeng Xi, Yimin Xie, Shenglu Sun, Fei Hu, Jingchi Li","doi":"10.1302/2046-3758.149.BJR-2024-0461.R2","DOIUrl":"10.1302/2046-3758.149.BJR-2024-0461.R2","url":null,"abstract":"<p><strong>Aims: </strong>Intervertebral disc degeneration (IDD) and sagittal-oriented articular processes can restrict motility and increase stiffness of the motion segment, potentially causing compensatory stress and higher motility in adjacent segments. It is unclear if these factors trigger IDD progression in adjacent segments. This study aimed to elucidate this using functional MRI, and identify biomechanical mechanisms with a validated numerical model.</p><p><strong>Methods: </strong>Clinical data from 95 patients were retrospectively collected from January 2022 to April 2023. Disc collapse and fibrosis were assessed by disc height ratio and fractional anisotropy (FA) values in the L4-L5 segment. The orientation of articular facet processes in L4-L5 was examined. Annulus fibrosus integrity was investigated using diffusion tensor fibre tractography in cranial (L3-L4) and caudal (L5-S1) segments. Statistical analyses determined differences between patients with and without annulus tears, and regression analyses identified predictors of annulus tears. Numerical models of L3-S1 motion segment were developed, incorporating variations in disc collapse, fibrosis, and facet orientation angles in L4-L5. Stress distribution on cranial and caudal discs was calculated under various loading conditions.</p><p><strong>Results: </strong>Compared to patients with intact annulus at the cranial segment (L3-L4), those with annulus tears show reduced facet orientation angles and disc height ratios, and elevated FA values. These parameters are independent risk factors for cranial annulus tears, not observed on the caudal side. Models with sagittal-oriented articular processes (facet orientation = 35°), disc collapse, and fibrosis show higher stress on the cranial disc, particularly within the annulus, compared to models with coronal-oriented processes (facet orientation = 65°) and healthy discs.</p><p><strong>Conclusion: </strong>Sagittal orientation of articular processes and IDD phenotypes may increase the risk of annulus tears in the cranial adjacent segment by compromising the biomechanical environment. This offers a novel perspective for understanding biomechanical interactions in adjacent segments during IDD progression.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"14 9","pages":"777-790"},"PeriodicalIF":5.1,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12409390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomy and pattern of tibial periosteal circulation: implications for tibial plating : a cadaveric study.","authors":"Morteza Kalhor, Omid Elahifar, Arvin Eslami, Jaber Gharehdaghi","doi":"10.1302/2046-3758.149.BJR-2024-0547.R2","DOIUrl":"10.1302/2046-3758.149.BJR-2024-0547.R2","url":null,"abstract":"<p><strong>Aims: </strong>The significance of periosteal vessels in the healing of tibial shaft fractures is well-established. However, the gross anatomical patterns and differential distribution of these vessels on the medial versus lateral surface of the tibial shaft have not been thoroughly described. This study aimed to illustrate the comparative anatomy of periosteal circulation on the medial versus lateral surface of the tibial shaft, where tibial plates are commonly applied.</p><p><strong>Methods: </strong>Ten adult fresh cadavers underwent aortic injection with coloured silicone to investigate the vascular system of the lower limbs, including the tibial extraosseous circulation. Following material fixation, the medial and lateral tibial surfaces were dissected extraperiosteally from the knee to the ankle joint to visualize the gross anatomy of periosteal vessels running along the medial and lateral surfaces of the tibial shaft.</p><p><strong>Results: </strong>In all specimens, periosteal vessels on the lateral tibial consisted of six to eight main trunks in 17 out of 20 specimens. These vessels were evenly distributed, horizontally oriented, and exhibited variable side branching. Most of these vessels crossed the anterior tibial crest, terminating on the medial side. The extensor muscles on the lateral tibial surface made negligible contributions to the periosteal circulation. The medial tibial surface received its periosteal blood supply partly from the terminal branches of the traversing vessels from the lateral surface and partly from branches of the posterior tibial artery. These vessels were shorter, smaller, sparsely scattered, randomly distributed, and exhibited greater variability in number and size compared to their lateral counterparts.</p><p><strong>Conclusion: </strong>Periosteal circulation to the anterior two-thirds of the tibial shaft is mainly delivered through the lateral tibial surface. When periosteal circulation is a concern, lateral plating may be more disruptive compared to medial plating.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"14 9","pages":"769-776"},"PeriodicalIF":5.1,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and evaluation of deep learning models for detecting and classifying various bone tumours in full-field limb radiographs using automated object detection models.","authors":"Masashi Yamana, Ryoma Bise, Makoto Endo, Tomoya Matsunobu, Nokitaka Setsu, Nobuhiko Yokoyama, Yasuharu Nakashima, Seiichi Uchida","doi":"10.1302/2046-3758.149.BJR-2024-0505.R1","DOIUrl":"10.1302/2046-3758.149.BJR-2024-0505.R1","url":null,"abstract":"<p><strong>Aims: </strong>We aim to develop a fully automated deep-learning model to detect and classify benign/malignant bone tumours in full-field limb radiographs using an object detection model. The secondary aim is to identify differences in classification characteristics between the developed automated model, three orthopaedic oncologists, and three general orthopaedic surgeons.</p><p><strong>Methods: </strong>This retrospective analysis included 642 limb bone tumours with 40 diagnoses confirmed pathologically from three institutions (378 benign, 264 malignant including intermediate types). We employed end-to-end object Detection with transformers with Improved deNoising anchOr boxes (DINO) and You Only Look Once (YOLO) models. We performed five-fold cross validation on the collected radiographs, using the training data to train the models, validation data to optimize the models' parameters, and independent test data for final performance evaluation. Firstly, we confirmed DINO achieves a higher detection rate than YOLO. Secondly, we compared the classification performance of DINO with those of doctors, using various metrics such as accuracy, sensitivity, specificity, precision, and F-measure.</p><p><strong>Results: </strong>The DINO model achieved a higher mean tumour detection rate (85.7% (95% CI 81.5 to 89.8)) than the YOLO model (80.1% (95% CI 77.2 to 82.9)). For the evaluation of classification performance, we used 113 cases that DINO detected out of 128 randomly selected cases as the evaluation test set. The accuracy and sensitivity of the DINO model, as a superior model, were significantly higher than those of general orthopaedic surgeons. The DINO model correctly classified 78.6% (22 out of 28 cases) of the challenging cases that two or more doctors misclassified. However, DINO's diagnostic errors primarily occurred with tumours that were diagnostically challenging for orthopaedic oncologists or present in unusual sites.</p><p><strong>Conclusion: </strong>The DINO model automatically detects bone tumours better than the YOLO model, and may assist doctors in detecting tumours and classifying malignant/benign bone tumours in clinical practice.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"14 9","pages":"760-768"},"PeriodicalIF":5.1,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}