Recent Advances in Musculoskeletal Radiology: Bridging Innovation and Clinical Application.

Journal: Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine
Published Date: Dec 25, 2025

Abstract

Recent advances in musculoskeletal (MSK) radiology have markedly improved diagnostic accuracy through innovations in MRI, CT, and artificial intelligence (AI). This review summarizes 7 key domains shaping current MSK imaging: (1) CT-like contrast MRI techniques for bone visualization, (2) quantitative MRI approaches, (3) AI applications in image reconstruction and diagnostic support, (4) MR spectroscopy (MRS) for metabolic assessment, (5) whole-body MRI for systemic disease evaluation, (6) positron emission tomography (PET) for metabolic and inflammatory imaging, and (7) advanced CT techniques such as weight-bearing CT. Zero echo time and ultrashort echo time MRI sequences enable the visualization and quantitative assessment of short-T2 tissues such as cortical bone, tendons, and fibrocartilage. Deep learning-based image reconstruction improves SNR and shortens scan time, enhancing image quality and diagnostic confidence. In parallel, AI-driven diagnostic support systems, including convolutional neural networks for lesion detection and natural language processing for report generation, are transforming workflow efficiency and consistency. MRS offers metabolic insights into muscle disorders such as sarcopenia, and whole-body-MRI provides comprehensive, radiation-free evaluation of tumor burden and inflammatory joint or enthesis involvement, making it valuable in oncology and rheumatic diseases. PET complements MRI by identifying metabolically active or inflammatory lesions. CT-based innovations further contribute to evaluating joint biomechanics with high spatial resolution. Together, these technological developments are enabling earlier disease detection, more precise diagnosis, and improved treatment monitoring, representing a paradigm shift in MSK imaging and clinical practice.

Authors

  • Satoru Ide
    Department of Radiology, University of Occupational and Environmental Health, School of Medicine.
  • Takatoshi Aoki
    Department of Radiology, University of Occupational and Environmental Health School of Medicine, Iseigaoka 1-1, Yahatanishi-ku, Kitakyushu-shi, Fukuoka 807-8555, Japan.
  • Ryo Kurokawa
    Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Masahiro Yanagawa
    Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
  • Tsukasa Saida
    Department of Radiology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
  • Shunsuke Sugawara
    Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan.
  • Kentaro Nishioka
    Department of Radiation Medical Science and Engineering, Faculty of Medicine, Hokkaido University, Sapporo, Japan.
  • Seitaro Oda
    Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto 860-8556, Japan (T.N., N.Y., N.K., Y.N., H.U., M.K., S.O., T.H.).
  • Tadashi Watabe
    Department of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine, Osaka, Japan.
  • Kenji Hirata
    Department of Diagnostic Imaging, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
  • Rintaro Ito
    Department of Innovative Biomedical Visualization, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Japan.
  • Daiju Ueda
    Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan. [email protected].
  • Koji Takumi
    Department of Radiology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan.
  • Maya Honda
    From the Department of Fundamental Development for Advanced Low Invasive Diagnostic Imaging, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan (M.I.); Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan (M.I., M.K., M.H., Y.N.); A.I. System Research, Kyoto, Japan (R.M.); Kyoto University Faculty of Medicine, Kyoto, Japan (K.T., T.Y.); Department of Diagnostic Radiology, Kyoto City Hospital, Kyoto, Japan (A.M.); Department of Diagnostic Radiology, Kansai Electric Power Hospital, Osaka, Japan (M.H.); e-Growth, Kyoto, Japan (K.I.); and Department of Breast Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan (M.T.).
  • Akihiko Sakata
    Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku Kyoto 606-8507, Japan.
  • Mariko Kawamura
    Department of Radiology, Nagoya University Graduate School of Medicine.
  • Keitaro Sofue
    Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe City, Hyogo 650-0017, Japan.
  • Mami Iima
    Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University, Graduate School of Medicine, Kyoto, Japan.
  • Shinji Naganawa
    Department of Radiology, Nagoya University Graduate School of Medicine.

Keywords

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