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AI Automatically Detects Vertebral Fractures on CT Images

By MedImaging International staff writers
Posted on 02 May 2023

$Image: 2D sectional image of CT scan showing two fractures correctly classified by AI (Photo courtesy of Kiel University)$

Image: 2D sectional image of CT scan showing two fractures correctly classified by AI (Photo courtesy of Kiel University)

As people age, many experience a decrease in bone density, a process known as osteoporosis. Often, this condition goes unnoticed even when there are fractures in the vertebral bodies. While X-rays or computed tomography (CT) scans can detect these fractures, they may be overlooked, especially if the CT scan is performed for a different purpose or due to the hectic nature of clinical environments. Now, a new software program employs artificial intelligence (AI) to improve osteoporosis diagnostics by automatically identifying signs of the condition and detecting prognostically unfavorable vertebral fractures on CT scans conducted for various other reasons.

Chest CT images are frequently taken to examine the lungs, for instance. Although the spine is visible in these images, it may not be examined if the focus is on another issue. The innovative software program developed by researchers at Kiel University (Kiel, Germany) operates in the background during such examinations, automatically assessing the spine and alerting clinicians to any vertebral fractures that might have otherwise gone undetected. Identifying these fractures is crucial, as their presence significantly raises the risk of subsequent fractures.

The software relies on neural networks, which are algorithms designed to mimic the human brain's functioning and are commonly employed for pattern recognition. The AI was evaluated on 159 spinal CT images from seven different hospitals. Prior to the test, experienced radiologists examined the images and identified 170 fractures. The neural network accurately classified 90% of the cases with fractures and 87% of the vertebrae without fractures. Moreover, the program is capable of not only detecting fractures but also differentiating between mild fractures (grade 1) and more severe ones (grade 2 or higher).

"This diagnosis is crucial for estimating future fracture risks," said Eren Yilmaz, a doctoral candidate. "It is particularly applicable to hip fractures, which are associated with a high reduction in quality of life and increased mortality, especially in old age. We are thus developing an early warning system to prevent serious consequences of osteoporosis."

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67 (41.961669921875): select jos_twitters.link from jos_twitters where cat=10

68 (31.948089599609): select jos_facebook.link from jos_facebook where cat=10

69 (30.040740966797): select jos_google_plus.link from jos_google_plus where cat=10

70 (30.040740966797): select jos_linkedin.link from jos_linkedin where cat=10

71 (32.186508178711): SELECT fid FROM jos_deeppockets WHERE id=294797035 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294797035 AND published='1' LIMIT 1

72 (30.994415283203): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=215 ORDER BY `ordering`

73 (468.01567077637): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294797035 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

74 (312.08992004395): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294797035 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

75 (56.982040405273): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

76 (78.201293945312): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (49.829483032227): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (67.949295043945): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (34.809112548828): SELECT show_live FROM jos_com_show_setting LIMIT 1

90 (70.810317993164): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294797035 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

91 (44.107437133789): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294797035 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

92 (42.915344238281): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

93 (57.93571472168): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

106 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

107 (75.101852416992): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797035 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797035 AND published='1' LIMIT 1

108 (56.028366088867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797035 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797035 AND published='1' LIMIT 1

109 (58.174133300781): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294797035 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

110 (46.968460083008): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294797035 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (93.936920166016): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797035 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797035 AND published='1' LIMIT 1

112 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797035 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797035 AND published='1' LIMIT 1

113 (84.161758422852): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294797035 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

114 (581.02607727051): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294797035 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

115 (690.93704223633): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

116 (344.99168395996): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

117 (109.91096496582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797035 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797035 AND published='1' LIMIT 1

118 (56.028366088867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797035 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797035 AND published='1' LIMIT 1

119 (61.988830566406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797035 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797035 AND published='1' LIMIT 1

120 (41.961669921875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797035 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797035 AND published='1' LIMIT 1

121 (50.067901611328): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797035 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797035 AND published='1' LIMIT 1

122 (38.862228393555): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797035 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797035 AND published='1' LIMIT 1

123 (45.061111450195): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797035 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797035 AND published='1' LIMIT 1

124 (39.815902709961): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797035 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797035 AND published='1' LIMIT 1

125 (329.01763916016): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

126 (!!!!! 51687.955856323): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

127 (!!!!! 1644.1345214844): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294797035 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294797035 AND type='deeppockets_item' AND published='1' LIMIT 1

128 (!!!!! 22036.075592041): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

129 (72.956085205078): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

130 (39.100646972656): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

131 (33.855438232422): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

132 (102.99682617188): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

133 (49.829483032227): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

134 (465.15464782715): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

135 (52.928924560547): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

136 (49.114227294922): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

137 (39.100646972656): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

138 (669.00253295898): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797035 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

139 (527.14347839355): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797035 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

140 (76.055526733398): SELECT name FROM jos_deeppockets WHERE id=215

141 (37.908554077148): SELECT name FROM jos_deeppockets WHERE id=215

142 (684.97657775879): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

143 (536.91864013672): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

144 (70.095062255859): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797035 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797035 AND published='1' LIMIT 1

145 (51.975250244141): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797035 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797035 AND published='1' LIMIT 1

146 (!!!!! 12239.933013916): TRUNCATE TABLE jos_trademed_module

147 (98.943710327148): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294797035 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

148 (56.982040405273): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294797035 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

149 (931.0245513916): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797035 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

150 (77.962875366211): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797035 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

151 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797035 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797035 AND published='1' LIMIT 1

152 (88.930130004883): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797035 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797035 AND published='1' LIMIT 1

153 (!!!!! 1271.9631195068): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

154 (119.92454528809): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797035 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797035 AND published='1' LIMIT 1

155 (56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797035 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797035 AND published='1' LIMIT 1

156 (51.975250244141): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294797035 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294797035 AND type='deeppockets_item' AND published='1' LIMIT 1

157 (35.04753112793): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

158 (30.994415283203): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

159 (88.930130004883): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

160 (76.055526733398): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797035 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797035 AND published='1' LIMIT 1

161 (46.014785766602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797035 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797035 AND published='1' LIMIT 1

162 (51.021575927734): select jos_twitters.link from jos_twitters where cat=10

163 (36.001205444336): select jos_facebook.link from jos_facebook where cat=10

164 (30.994415283203): select jos_google_plus.link from jos_google_plus where cat=10

165 (30.994415283203): select jos_linkedin.link from jos_linkedin where cat=10

166 (296.83113098145): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14202,14203)

167 (!!!!! 1166.1052703857): insert into jos_banners_delta values (14202,'2025-07-30 00:06:59','216.73.216.8','view'),(14203,'2025-07-30 00:06:59','216.73.216.8','view')

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