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Artificial intelligence (AI) is transforming spinal imaging and patient care through automated analysis and enhanced decision-making. This review presents a clinical task-based evaluation, highlighting the specific impact of AI techniques on different aspects of spinal imaging and patient care. We first discuss how AI can potentially improve image quality through techniques like denoising or artifact reduction. We then explore how AI enables efficient quantification of anatomical measurements, spinal curvature parameters, vertebral segmentation, and disc grading. This facilitates objective, accurate interpretation and diagnosis. AI models now reliably detect key spinal pathologies, achieving expert-level performance in tasks like identifying fractures, stenosis, infections, and tumors. Beyond diagnosis, AI also assists surgical planning via synthetic computed tomography generation, augmented reality systems, and robotic guidance. Furthermore, AI image analysis combined with clinical data enables personalized predictions to guide treatment decisions, such as forecasting spine surgery outcomes. However, challenges still need to be addressed in implementing AI clinically, including model interpretability, generalizability, and data limitations. Multicenter collaboration using large, diverse datasets is critical to advance the field further. While adoption barriers persist, AI presents a transformative opportunity to revolutionize spinal imaging workflows, empowering clinicians to translate data into actionable insights for improved patient care. [ABSTRACT FROM AUTHOR]

Purpose: To develop and validate a deep-learning-based algorithm (DLA) that is designed to segment and classify metallic objects in topograms of abdominal and spinal CT. Methods: DLA training for implant segmentation and classification was based on a U-net-like architecture with 263 annotated hip implant topograms and 2127 annotated spine implant topograms. The trained DLA was validated with internal and external datasets. Two radiologists independently reviewed the external dataset consisting of 2178 abdomen anteroposterior (AP) topograms and 515 spine AP and lateral topograms, all collected in a consecutive manner. Sensitivity and specificity were calculated per pixel row and per patient. Pairwise intersection over union (IoU) was also calculated between the DLA and the two radiologists. Results: The performance parameters of the DLA were consistently >95% in internal validation per pixel row and per patient. DLA can save 27.4% of reconstruction time on average in patients with metallic implants compared to the existing iMAR. The sensitivity and specificity of the DLA during external validation were greater than 90% for the detection of spine implants on three different topograms and for the detection of hip implants on abdominal AP and spinal AP topograms. The IoU was greater than 0.9 between the DLA and the radiologists. However, the DLA training could not be performed for hip implants on spine lateral topograms. Conclusions: A prototype DLA to detect metallic implants of the spine and hip on abdominal and spinal CT topograms improves the scan workflow with good performance for both spine and hip implants. [ABSTRACT FROM AUTHOR]

Background: Determination of preoperative soft tissue sarcoma (STS) margin is crucial for patient prognosis. Purpose: To evaluate diagnostic performance of radiomics model using T2‐weighted Dixon sequence for infiltration degree of STS margin. Study Type: Retrospective. Population: Seventy‐two STS patients consisted of training (n = 58) and test (n = 14) sets. Field Strength/Sequence: A 3.0 T; T2‐weighted Dixon images. Assessment: Pathologic result of marginal infiltration in STS (circumscribed margin; n = 27, group 1, focally infiltrative margin; n = 31, group 2‐A, diffusely infiltrative margin; n = 14, group 2‐B) was the reference standard. Radiomic volume and shape (VS) and other (T2) features were extracted from entire tumor volume and margin, respectively. Twelve radiomics models were generated using four combinations of classifier algorithms (R, SR, LR, LSR) and three different inputs (VS, T2, VS + T2 [VST2] features) to differentiate the three groups. Three radiologists (reader 1, 2, 3) analyzed the marginal infiltration with 6–scale confidence score. Statistical Tests: Area under the receiver operating characteristic curve (AUC) and concordance rate. Results: Averaged AUCs of R, SR, LR, LSR models were 0.438, 0.466, 0.438, 0.466 using VS features, 0.596, 0.584, 0.814, 0.815 using T2 features, and 0.581, 0.587, 0.821, 0.821 using VST2 features, respectively. The LR and LSR models constructed with T2 or VST2 features showed higher AUC and concordance rate compared to radiologists' analysis (AUC; 0.730, 0.675, 0.706, concordance rate; 0.46, 0.43, 0.47 in reader 1, 2, 3). Data Conclusion: Radiomics model constructed with features from tumor margin on T2‐weighted Dixon sequence is a promising method for differentiating infiltration degree of STS margin. Evidence Level: 4 Technical Efficacy: Stage 2 [ABSTRACT FROM AUTHOR]