Evidence mapPaperPMID 39864034Full record

ArticleLa Radiologia medica2025

Automated spinopelvic measurements on radiographs with artificial intelligence: a multi-reader study.

Boj Friedrich Hoppe, Johannes Rueckel, Jan Rudolph, Nicola Fink, Simon Weidert, Wolf Hohlbein, Adrian Cavalcanti-Kußmaul, Lena Trappmann, Basel Munawwar, Jens Ricke and 1 more

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Article in La Radiologia medica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Review
  3. AI model for automatic spinopelvic and spinal alignment parameters measurement from EOS.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Boj Friedrich HoppeDepartment of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany. boj.hoppe@med.lmu.de.ORCID http://orcid.org/0000-0001-6248-5128
Johannes RueckelDepartment of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
Jan RudolphDepartment of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
Nicola FinkDepartment of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
Simon WeidertDepartment of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Munich, Germany.
Wolf HohlbeinDepartment of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Munich, Germany.
Adrian Cavalcanti-KußmaulDepartment of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Munich, Germany.
Lena TrappmannDepartment of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
Basel MunawwarDepartment of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
Jens RickeDepartment of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
Bastian Oliver SabelDepartment of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo develop an artificial intelligence (AI) algorithm for automated measurements of spinopelvic parameters on lateral radiographs and compare its performance to multiple experienced radiologists and surgeons.

methodsOn lateral full-spine radiographs of 295 consecutive patients, a two-staged region-based convolutional neural network (R-CNN) was trained to detect anatomical landmarks and calculate thoracic kyphosis (TK), lumbar lordosis (LL), sacral slope (SS), and sagittal vertical axis (SVA). Performance was evaluated on 65 radiographs not used for training, which were measured independently by 6 readers (3 radiologists, 3 surgeons), and the median per measurement was set as the reference standard. Intraclass correlation coefficient (ICC), mean absolute error (MAE), and standard deviation (SD) were used for statistical analysis; while, ANOVA was used to search for significant differences between the AI and human readers.

resultsAutomatic measurements (AI) showed excellent correlation with the reference standard, with all ICCs within the range of the readers (TK: 0.92 [AI] vs. 0.85-0.96 [readers]; LL: 0.95 vs. 0.87-0.98; SS: 0.93 vs. 0.89-0.98; SVA: 1.00 vs. 0.99-1.00; all p < 0.001). Analysis of the MAE (± SD) revealed comparable results to the six readers (TK: 3.71° (± 4.24) [AI] v.s 1.86-5.88° (± 3.48-6.17) [readers]; LL: 4.53° ± 4.68 vs. 2.21-5.34° (± 2.60-7.38); SS: 4.56° (± 6.10) vs. 2.20-4.76° (± 3.15-7.37); SVA: 2.44 mm (± 3.93) vs. 1.22-2.79 mm (± 2.42-7.11)); while, ANOVA confirmed no significant difference between the errors of the AI and any human reader (all p > 0.05). Human reading time was on average 139 s per case (range: 86-231 s).

conclusionOur AI algorithm provides spinopelvic measurements accurate within the variability of experienced readers, but with the potential to save time and increase reproducibility.

Indexed as

Artificial IntelligenceRadiographic Image Interpretation, Computer-AssistedRadiographySpineAdultAgedAlgorithmsFemaleHumansMaleMiddle AgedNeural Networks, ComputerObserver VariationRetrospective StudiesArtificial IntelligenceDeep LearningRadiographsSpinopelvic Measurements

Identifiers

PMID39864034
PMCPMC11903605

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.