SpineReport: Automated 3D Quantification and Reporting of Lumbar Spine Degeneration on MRI
Organizations: 1NeuroPoly, Institute of Biomedical Engineering, Polytechnique Montreal, Montreal, QC, Canada · 2Mila, Quebec AI Institute, Montreal, QC, Canada · Department of Radiology, Balgrist University Hospital, Zurich, Switzerland · Faculty of Medicine, University of Zurich, Zurich, Switzerland · Department of Neurosurgery, Brain & Spine, University of South Florida, Tampa, FL, USA · Center for Neuromusculoskeletal Research, University of South Florida, Tampa, FL, USA · Department of Medical Engineering, University of South Florida, Tampa, FL, USA · 8Stanford School of Medicine, Stanford, CA, USA · 9Functional Neuroimaging Unit, CRIUGM, Université de Montréal, Montreal, QC, Canada · Centre de recherche du CHU Sainte-Justine, Université de Montréal, Montreal, QC, Canada
Abstract
Lumbar spine conditions are a leading cause of disability worldwide, yet reliable quantification of degeneration from MRI remains challenging. In clinical practice, analysis is predominantly performed in two dimensions (2D), as manual three-dimensional (3D) assessment is time-consuming. However, 2D measurements suffer from limited reproducibility, particularly when anatomical structures are not aligned with the imaging plane. Existing automated approaches are often restricted to 2D, rely on discrete grading, or lack robustness and interpretability. We introduce SpineReport, an open-source, fully automated framework for comprehensive 3D morphometric analysis of lumbar spine MRI. Leveraging robust anatomical segmentations, the method extracts quantitative metrics from key structures, including the spinal canal, spinal cord, vertebrae, intervertebral discs, and foramina. These include both morphological and signal-based features, enabling cross-subject and longitudinal assessment. SpineReport further generates subject-specific reports that allow comparison with cohort distributions, improving interpretability and objective characterization of spinal morphology. Clinical relevance was evaluated against radiologist-reported severity grades for central canal, lateral recess, and foraminal stenosis. Metrics showed strong associations with central canal stenosis severity, with T2-weighted CSF signal providing the highest performance (AUC = 0.95). Canal AP diameter and area ratios also demonstrated strong correlations and high discriminative ability (AUC > 0.80). For lateral recess stenosis, associations were moderate, with lateral CSF signal being the most informative (AUC = 0.73). No significant associations were observed for foraminal stenosis despite robust region-of-interest extraction. SpineReport is released as an open-access tool: https://ivadomed.github.io/SpineReport/