SA-Profile: Automated Sulcus Angle Profiling from Super-Resolution MRI

Computed tomography (CT) remains the reference for 3D osseous morphometry in femoroacetabular impingement (FAI) but requires ionizing radiation and manual measurement. Zero echo time (ZTE) MRI visualizes cortical bone and yields FAI angles that agree with CT, but automated angle extraction remains limited. We developed and validated automated FAI angle computation from ZTE MRI and assessed agreement with expert manual measurements in a cross-sectional study (level of evidence, 3). Pelvic ZTE MRI was acquired in 73 participants (mean age 36.8 +/- 18.5 years; 51 women, 22 men), yielding 135 hips. nnU-Net was trained on 100 manually curated hips to segment the femur, pelvis, and three osseous landmarks. Custom geometric algorithms computed alpha, femoral neck-shaft, Tonnis, coronal and sagittal center-edge, and acetabular version angles from inferred segmentations. Measurements on 35 test hips were compared with the mean of two radiologists' manual measures using intraclass correlation (ICC) and Bland-Altman analysis. Dice exceeded 0.96 for bone and ranged from 0.65 to 0.83 for landmarks. Median landmark error was 0.38 mm (femoral head), 0.82 mm (lateral acetabulum), and <2.5 mm (medial acetabulum, greater trochanter). Interrater ICC was excellent for acetabular version, coronal center-edge, and Tonnis (>=0.82) but poor for alpha and femoral neck-shaft. Model versus rater-mean agreement was excellent for acetabular version, coronal center-edge, and Tonnis (0.92-0.96), good for mid-acetabular sagittal center-edge (0.74), and fair for alpha (0.45) and femoral neck-shaft (0.55). Model Bland-Altman limits of agreement were narrower than interrater limits for most angles. Fully automated morphometric assessment from ZTE MRI is feasible and performs comparably to expert readers for most coverage and version angles.

Radiographic assessment of lower-limb alignment (LLA) is important for predicting joint health and surgical outcomes in total knee arthroplasty. Traditional measurement methods are manual and time-consuming, while recent machine learning approaches typically rely on locating a fixed set of anatomical landmarks. This dependence limits flexibility and may require re-annotation when clinical definitions change. To address this, we propose an automated workflow using Implicit Neural Shape Functions (INSF). Rather than relying on explicit landmark coordinates, we encode the anatomy into a compact latent space and regress clinical alignment measurements directly from these latent codes. This architecture allows for rapid extendability to new tasks without altering the backbone representation. We trained our method on an internal dataset of 566 knee radiographs, each annotated with the outline of the femur and tibia. We evaluated it on both an internal test dataset of 50 patients and a separate external set of 402 preoperative cases from the MRKR dataset. Manual clinical measurements are available for these data, and the MRKR measurements will be made publicly accessible. Performance was comparable to state-of-the-art landmark-based methods and manual agreement, while offering a flexible shape representation that can be extended to additional measurement tasks.

Accelerated magnetic resonance imaging reduces acquisition time, but reconstruction from undersampled k-space can blur diagnostically relevant structures or introduce failures that are not captured by global image metrics. We propose SA-RDM-DC, a Self-Auditing Residual generative Drifting Model with Data Consistency for accelerated knee MRI. The method adapts the newly proposed generative drifting paradigm to accelerated MRI by training a physics-conditioned drift field from the zero-filled reconstruction toward the fully sampled residual correction. It predicts image- and missing-k-space residual corrections, enforces data consistency with acquired k-space, uses frequency-aware and residual drifting supervision to recover fine detail, and produces dense error maps and slice-level risk scores in the same inference pass. We evaluate SA-RDM-DC on multi-coil fastMRI knee data at acceleration factors of 4, 8, and 12, with fastMRI+ pathology annotations for region-level and classifier-based task preservation, and on SKM-TEA for zero-shot and fine-tuned protocol-shift evaluation. Compared with zero-filled reconstruction, UNet-image-SENSE, DC-UNet, Score-Diffusion, ELF-Diff, SENSE-VarNet, and MoDL baselines, SA-RDM-DC achieves the highest SSIM across fastMRI acceleration factors while retaining subsecond per-slice inference and avoiding the long sampling time of iterative diffusion baselines. In pathology-aware analysis, SA-RDM-DC preserves lesion-region structural fidelity and reduces meniscus prediction instability. Its self-auditing scores strongly identify high-error reconstructions on fastMRI and partially transfer as a selective-review signal under SKM-TEA protocol shift. These results support reconstruction evaluation that jointly considers image fidelity, pathology preservation, runtime, and case-specific reliability.