European Network for Radiation-Free Spinal Deformity Assessment and Monitoring
Adolescent idiopathic scoliosis affects 2–4% of children worldwide. Current monitoring demands repeated full-spine radiographs throughout growth, accumulating ionising radiation during one of the most radiosensitive periods of life.
Global prevalence of adolescent idiopathic scoliosis [1]
Full-spine radiographs per patient during growth [2]
Estimated excess lifetime breast cancer risk from cumulative radiation [3]
European consensus guidelines for radiation-free assessment pathways
Each technology captures a unique dimension of spinal deformity that radiography alone cannot provide. RADFREE-SPINE aims to standardise their combined clinical use.
Volumetric reconstruction of posterior vertebral elements enables coronal and sagittal curve measurement without ionising radiation.
Three-dimensional trunk surface reconstruction via structured light or rasterstereography quantifies asymmetry, rotation, and sagittal profile.
Skin-surface devices guided along the spinous processes measure segmental inclination to calculate sagittal and frontal plane curvatures and mobility.
Wearable inertial sensors and force-platform systems quantify postural control, gait symmetry, and plantar load distribution affected by spinal deformity.
Wireless sEMG captures paraspinal and trunk muscle activation patterns, asymmetry indices, and neuromuscular fatigue profiles relevant to curve progression.
Low-cost, widely accessible screening instruments that quantify trunk rotation, postural indices, and surface asymmetry without imaging equipment.
RADFREE-SPINE welcomes all radiation-free spinal assessment technologies and is not limited to the devices listed above.
Each Working Group addresses a distinct pillar of the network’s mission, from measurement standardisation to policy translation.
Standardise acquisition protocols and establish multicentre reliability for non-ionising spinal imaging and surface reconstruction technologies.
Develop standardised protocols for instrumented spinal mobility measurement, functional assessment, and clinical screening, and translate evidence into practice guidelines.
Build FAIR-compliant multimodal datasets and develop machine learning models for scoliosis curve progression prediction.
The European Commission emphasises radiation dose reduction (ALARA principle) in paediatric imaging, creating a policy window for validated alternatives.
Multicentre clinical evidence is now mandatory for novel diagnostic devices. A networking action is essential to coordinate this evidence generation across borders.
Scoliosis screening programmes are being reassessed across Europe, creating demand for a standardised, radiation-free assessment toolkit.
Machine learning models for curve progression prediction need diverse, multimodal, multinational datasets that no single centre can produce alone.
A single-centre pilot study of 19 adolescents with idiopathic scoliosis comparing Scolioscan Air (3D ultrasound), Idiag M360 (electromechanical spinal measurement), and conventional radiography for thoracic kyphosis and lumbar lordosis. Results demonstrate strong thoracic correlation for the Idiag M360 (r = 0.884) and moderate correlation for Scolioscan (r = 0.689), with systematic lumbar underestimation by Scolioscan attributable to differences in anatomical reference layers.
RADFREE-SPINE brings together physiotherapists, orthopaedic surgeons, biomedical engineers, radiologists, and data scientists from across Europe. COST Inclusiveness Target Countries (ITC) are prioritised.
Researchers, clinicians, and institutions interested in joining the network are welcome to reach out.