A chest or abdominal CT acquired for oncology staging or respiratory workup puts the radiologist’s focus elsewhere. A vertebral compression fracture visible in the thoracic or lumbar spine can go unreported, leading to unmanaged pain, progressive kyphosis, and missed eligibility for vertebroplasty or kyphoplasty.
Avicenna.AI offers two dedicated tools to close this gap: CINA-VCF for triage and notification, and CINA-VCF Quantix for severity grading, vertebral labeling, and bone density estimation.
Approximately 1.4 million new vertebral compression fractures occur annually worldwide, with around 750,000 in the United States alone. Globally, an estimated 66% go undetected or unreported. The scan was ordered for something else. The radiologist is focused on something else. The fracture is present, visible in the field of view, and in most cases, not in the report.
Oncology patients undergo repeated CT scans for staging and surveillance. Metastasis, treatment, and age all contribute to bone fragility. Vertebral compression fractures are common in this population and frequently appear on thoraco-abdominal CT as secondary findings. They are not the focus of the report. They are often not reported at all.
Older adults undergo chest and abdominal CT for a wide range of indications. Vertebral compression fractures are prevalent in patients 50 and over, and many go undetected until the patient presents with a second fracture, or until pain prompts a dedicated bone workup weeks or months later.
An unreported VCF is not a neutral outcome. It is the entry point to a documented clinical cascade. Women with severe vertebral fractures carry a 12.6-times greater risk of a new vertebral fracture. A prior vertebral fracture increases hip fracture risk 2.3-fold. Hip fractures carry a 20 to 24% first-year mortality rate. In the IGR oncology study (3,055 patients), 36% of patients with a grade 3 fracture eligible for vertebroplasty or kyphoplasty had fractures that were not in the clinical radiological report. The scan had been acquired. The finding was in the image. It was not in the report.
Detection coverage
Detection coverage
CINA-VCF is an active triage tool. When it identifies a suspected moderate or severe vertebral compression fracture, it sends an alert to the radiologist’s worklist within approximately 23 seconds so the case can be prioritized. CINA-VCF Quantix is a quantification tool. It processes every qualifying CT, labels all visible T1-L5 vertebrae, measures vertebral height loss for each one, color-codes severity using the Genant scale, and estimates bone density from mean Hounsfield Units. It sends a passive notification when any vertebra exceeds the configured threshold. Both tools run on the same CT scan and can be deployed on the same infrastructure. CINA-VCF is CE-marked and FDA-cleared (US and OUS). CINA-VCF Quantix is CE-marked and available outside the United States only.
CINA-VCF is a triage and notification tool for adults aged 50 and over undergoing non-enhanced or contrast-enhanced CT of the chest and/or abdomen. It flags suspected moderate and severe vertebral compression fractures from T1 to L5 as incidental findings in scans ordered for other clinical reasons, such as oncology staging, respiratory workup, or routine abdominal investigation. It does not detect mild fractures (Grade 0) or cervical spine fractures. Cases with surgical hardware in the spinal region and vertebrae with cement from prior vertebroplasty or kyphoplasty are automatically excluded.
The scale of the reporting gap is documented. In one large study, 22% of patients aged 60 and over showed radiographic evidence of moderate or severe vertebral fractures on imaging. Of those, only 55% were mentioned in the radiology report. Nearly half of all visible, clinically significant vertebral fractures were present on the scan and absent from the report.
Two distinct failures explain this. The first is true non-detection: no imaging capable of revealing the fracture is acquired. The second, and the one that CT AI directly addresses, is detection without reporting: the fracture is present in the field of view of a chest or abdominal CT ordered for another reason. The radiologist’s mandate is to answer the clinical question that was asked. On an oncology staging CT, that question concerns the tumor, the nodes, and the treatment response. A vertebral compression fracture in the thoracic spine falls outside the primary focus and may not be formally captured in the report.
CINA-VCF flags every qualifying finding before the case is closed, ensuring the radiologist has the information needed to assess and report it as part of the same acquisition.
An unreported VCF means no treatment is initiated, no referral to an osteoporosis service, and no management of a fracture that is now shaping the patient’s future risk.
The cascade is well-documented. Women with severe vertebral fractures carry a 12.6-times greater risk of a new vertebral fracture. A prior vertebral fracture increases hip fracture risk 2.3-fold, and 55% of hip fracture patients have evidence of a prior vertebral fracture. Hip fractures carry a 20 to 24% first-year mortality rate. Among survivors, 40% are no longer able to walk independently and 33% require long-term institutional care.
An unreported vertebral compression fracture is not a missed secondary finding. It is an untreated entry point to a clinical cascade with serious consequences. CINA-VCF ensures the finding is not left out of the report by flagging it at the time of the scan, before the patient is discharged.
CINA-VCF and CINA-VCF Quantix are medical image analysis software and medical devices manufactured by Avicenna.CINA-VCF and CINA-VCF Quantix are medical image analysis software and medical devices manufactured by Avicenna.AI. These medical devices are reserved for health professionals. The performance and outputs of these tools may differ slightly according to the software version and applicable regulations.
These software have been designed and manufactured according to the EN ISO 13485 Quality management system. Read the instructions in the notice carefully before any use.
Instructions for Use for both products are available here.
Manufacturer: Avicenna.AI (France).
CINA-VCF: Medical device Class II following the Code of Federal Regulations of the United States of America 21CFR on Medical Devices.
CINA-VCF Quantix: Medical device Class IIb following the European Regulation on Medical Device (EU) 2017/745.
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