Automated Thoracolumbar Stump Rib Detection and Analysis in a Large CT Cohort

Thoracolumbar stump ribs are one of the essential indicators of thoracolumbar transitional vertebrae or enumeration anomalies. While some studies manually assess these anomalies and describe the ribs qualitatively, this study aims to automate thoracolumbar stump rib detection and analyze their morphology quantitatively. To this end, we train a high-resolution deep learning model for rib segmentation using nnUNet and achieve significant improvements over existing models (Dice score 0.997 vs. 0.779, p-value < 0.01). In addition, we employ a novel iterative algorithm and piecewise linear interpolation to estimate rib length, achieving a success rate of 98.2%. When analyzing morphological features, we show that stump ribs articulate more posteriorly at the vertebrae (−19.2±3.8 vs. −13.8±2.5 mm, p-value < 0.01), are thinner (260.6±103.4 vs. 563.6±127.1mm2, p-value < 0.01), and are oriented more downwards and sideways within the first centimeters in contrast to full-length ribs. We show that with partially visible ribs, these features can achieve an F1-score of 0.84 and an AUC of 0.98 in differentiating stump ribs from regular ones. We publish the model weights and masks for public use.