The diagnosis of spinal diseases is often assisted by 3D imaging techniques in clinical practice. However, precise 3D spinal assessment is limited by the high costs of 3D imaging hardware and the challenges posed by the physical differences between imaging modalities, which hinder the generalizability of models. To address these issues, we propose UniSpine-GS, an efficient, physics-aware Gaussian framework designed for novel-view projection rendering in multi-view spine imaging via a 3D-aware representation. Instead of performing explicit 3D reconstruction, our approach learns a geometry-aware Gaussian representation that ensures anatomical consistency across different views. We introduce SPWM, a structure-guided loss reweighting strategy to improve boundary fidelity and local details. We evaluate our method on the CTSpine3D dataset and a newly constructed 3D fetal ultrasound dataset, FeSpine3D. Our results demonstrate that UniSpine-GS significantly outperforms existing methods across all metrics, offering a practical and cost-effective solution for unified multi-view medical imaging. Our code is publicly available at https://github.com/orangeisland66/UniSpine-GS.
Nathan Molinier, Adrian A. Marth, Reto Sutter +6cs.CV
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/