Journal Article DKFZ-2025-01407

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AI-based CT assessment of 3117 vertebrae reveals significant sex-specific vertebral height differences.

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2025
Springer Nature [London]

Scientific reports 15(1), 20756 () [10.1038/s41598-025-05091-0]
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Abstract: Predicting vertebral height is complex due to individual factors. AI-based medical imaging analysis offers new opportunities for vertebral assessment. Thereby, these novel methods may contribute to sex-adapted nomograms and vertebral height prediction models, aiding in diagnosing spinal conditions like compression fractures and supporting individualized, sex-specific medicine. In this study an AI-based CT-imaging spine analysis of 262 subjects (mean age 32.36 years, range 20-54 years) was conducted, including a total of 3117 vertebrae, to assess sex-associated anatomical variations. Automated segmentations provided anterior, central, and posterior vertebral heights. Regression analysis with a cubic spline linear mixed-effects model was adapted to age, sex, and spinal segments. Measurement reliability was confirmed by two readers with an intraclass correlation coefficient (ICC) of 0.94-0.98. Female vertebral heights were consistently smaller than males (p < 0.05). The largest differences were found in the upper thoracic spine (T1-T6), with mean differences of 7.9-9.0%. Specifically, T1 and T2 showed differences of 8.6% and 9.0%, respectively. The strongest height increase between consecutive vertebrae was observed from T9 to L1 (mean slope of 1.46; 6.63% for females and 1.53; 6.48% for males). This study highlights significant sex-based differences in vertebral heights, resulting in sex-adapted nomograms that can enhance diagnostic accuracy and support individualized patient assessments.

Keyword(s): Humans (MeSH) ; Adult (MeSH) ; Male (MeSH) ; Female (MeSH) ; Middle Aged (MeSH) ; Tomography, X-Ray Computed: methods (MeSH) ; Young Adult (MeSH) ; Sex Characteristics (MeSH) ; Thoracic Vertebrae: diagnostic imaging (MeSH) ; Thoracic Vertebrae: anatomy & histology (MeSH) ; Sex Factors (MeSH) ; Spine: diagnostic imaging (MeSH) ; Spine: anatomy & histology (MeSH) ; Nomograms (MeSH) ; Reproducibility of Results (MeSH) ; Anthropometry ; Artificial intelligence ; Image interpretation, computer-assisted ; Image processing, computer-assisted ; Sex characteristics ; Spine

Classification:

Contributing Institute(s):
  1. E230 Medizinische Bildverarbeitung (E230)
Research Program(s):
  1. 315 - Bildgebung und Radioonkologie (POF4-315) (POF4-315)

Appears in the scientific report 2025
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 Record created 2025-07-17, last modified 2025-07-18


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