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Manual bone segmentation was performed using ITK-SNAP. A modified 3D U-Net was trained and clinically evaluated through multireader analysis using ordinal scales from 1 (perfect) to 4 (not usable) bone subtraction (B-rating) and erosion of non-target structures (V-rating) in addition to a vessel assessment (VA-rating), categorizing the subtracted image as \u201cbetter\u201d (1), \u201csame\u201d (2), or \u201cworse\u201d (3). Quantitative metrics include S\u00f8rensen\u2013Dice coefficient and intersection over union (IoU).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The software demonstrated high accuracy with a B-rating of 1.01\u2009\u00b1\u20090.07 and a V-rating of 1.02\u2009\u00b1\u20090.13, indicating minimal erosion of non-target structures. A VA-rating of 1.0\u2009\u00b1\u20090 suggests an improved vessel assessment and the depiction of contrast material deposition, enhancing the diagnostic quality of CBCT images. Quantitative analysis closely matched the manual expert delineation (S\u00f8rensen\u2013Dice coefficient 0.95\u2009\u00b1\u20090.02, IoU of 0.9\u2009\u00b1\u20090.03).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The software provides robust, fully automated bone removal in CBCT scans. This technology may enhance vascular system visualization without compromising non-target structures, potentially improving the accuracy and efficiency of interventional and diagnostic radiology procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical Abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s00270-025-04293-3","type":"journal-article","created":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T23:10:53Z","timestamp":1767741053000},"page":"636-645","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Automatic Bone Removal in CBCT Scans of the Body Trunk: Thorax, Abdomen, and Pelvis"],"prefix":"10.1007","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6283-8042","authenticated-orcid":false,"given":"Hinrich","family":"Winther","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabine","family":"Maschke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lena","family":"Becker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cornelia","family":"Dewald","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcel","family":"Eicke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tobias","family":"Jakobs","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roman","family":"Kloeckner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Axel","family":"Schmid","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank","family":"Wacker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernhard","family":"Meyer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,1,6]]},"reference":[{"key":"4293_CR1","doi-asserted-by":"publisher","first-page":"534","DOI":"10.1016\/j.crad.2009.01.007","volume":"64","author":"K Deng","year":"2009","unstructured":"Deng K, Liu C, Ma R, Sun C, Wang X-m, Ma Z-T, et al. 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