{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T07:26:55Z","timestamp":1777879615673,"version":"3.51.4"},"reference-count":33,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"funder":[{"DOI":"10.13039\/501100000780","name":"European Commission","doi-asserted-by":"publisher","award":["PNRR-MAD-2022-12376692_VADALA\\u2019 - CUP F83C22002470001"],"award-info":[{"award-number":["PNRR-MAD-2022-12376692_VADALA\\u2019 - CUP F83C22002470001"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Biomedical Signal Processing and Control"],"published-print":{"date-parts":[[2026,8]]},"DOI":"10.1016\/j.bspc.2026.110177","type":"journal-article","created":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T07:53:30Z","timestamp":1775721210000},"page":"110177","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["Artificial intelligence based intervertebral discs grading: From unsupervised detection to explainable Pfirrmann classification"],"prefix":"10.1016","volume":"121","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9239-7786","authenticated-orcid":false,"given":"Paolo","family":"Giaccone","sequence":"first","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7377-5462","authenticated-orcid":false,"given":"Federico","family":"D\u2019Antoni","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5462-2727","authenticated-orcid":false,"given":"Luca","family":"Bacco","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8566-8952","authenticated-orcid":false,"given":"Fabrizio","family":"Russo","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4140-738X","authenticated-orcid":false,"given":"Giuseppe Francesco","family":"Papalia","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7142-1660","authenticated-orcid":false,"given":"Gianluca","family":"Vadal\u00e0","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6069-4871","authenticated-orcid":false,"given":"Rocco","family":"Papalia","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7900-5415","authenticated-orcid":false,"given":"Leandro","family":"Pecchia","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4739-9795","authenticated-orcid":false,"given":"Vincenzo","family":"Denaro","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9406-2397","authenticated-orcid":false,"given":"Mario","family":"Merone","sequence":"additional","affiliation":[]}],"member":"78","reference":[{"issue":"9814","key":"10.1016\/j.bspc.2026.110177_b1","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1016\/S0140-6736(11)60610-7","article-title":"Non-specific low back pain","volume":"379","author":"Balagu\u00e9","year":"2012","journal-title":"Lancet"},{"issue":"10294","key":"10.1016\/j.bspc.2026.110177_b2","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/S0140-6736(21)00733-9","article-title":"Low back pain","volume":"398","author":"Knezevic","year":"2021","journal-title":"Lancet (London, England)"},{"issue":"8","key":"10.1016\/j.bspc.2026.110177_b3","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1002\/jor.23195","article-title":"Molecular mechanisms of biological aging in intervertebral discs","volume":"34","author":"Vo","year":"2016","journal-title":"J. Orthop. Res."},{"issue":"3S","key":"10.1016\/j.bspc.2026.110177_b4","doi-asserted-by":"crossref","first-page":"S46","DOI":"10.1093\/neuros\/nyw078","article-title":"Intervertebral disk degeneration and repair","volume":"80","author":"Dowdell","year":"2017","journal-title":"Neurosurgery"},{"issue":"17","key":"10.1016\/j.bspc.2026.110177_b5","doi-asserted-by":"crossref","first-page":"1873","DOI":"10.1097\/00007632-200109010-00011","article-title":"Magnetic resonance classification of lumbar intervertebral disc degeneration","volume":"26","author":"Pfirrmann","year":"2001","journal-title":"Spine"},{"issue":"24","key":"10.1016\/j.bspc.2026.110177_b6","doi-asserted-by":"crossref","first-page":"E708","DOI":"10.1097\/BRS.0b013e31815a59a0","article-title":"Modified pfirrmann grading system for lumbar intervertebral disc degeneration","volume":"32","author":"Griffith","year":"2007","journal-title":"Spine"},{"issue":"12","key":"10.1016\/j.bspc.2026.110177_b7","doi-asserted-by":"crossref","first-page":"2394","DOI":"10.3174\/ajnr.A4498","article-title":"MRI findings of disc degeneration are more prevalent in adults with low back pain than in asymptomatic controls: a systematic review and meta-analysis","volume":"36","author":"Brinjikji","year":"2015","journal-title":"Am. J. Neuroradiol."},{"issue":"20","key":"10.1016\/j.bspc.2026.110177_b8","doi-asserted-by":"crossref","first-page":"10909","DOI":"10.3390\/ijerph182010909","article-title":"Artificial intelligence and computer vision in low back pain: a systematic review","volume":"18","author":"D\u2019Antoni","year":"2021","journal-title":"Int. J. Environ. Res. Public Health"},{"issue":"10","key":"10.1016\/j.bspc.2026.110177_b9","doi-asserted-by":"crossref","first-page":"5971","DOI":"10.3390\/ijerph19105971","article-title":"Artificial intelligence and computer aided diagnosis in chronic low back pain: A systematic review","volume":"19","author":"D\u2019Antoni","year":"2022","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"10.1016\/j.bspc.2026.110177_b10","doi-asserted-by":"crossref","DOI":"10.3389\/fsurg.2022.957085","article-title":"Natural language processing in low back pain and spine diseases: a systematic review","volume":"9","author":"Bacco","year":"2022","journal-title":"Front. Surg."},{"issue":"1","key":"10.1016\/j.bspc.2026.110177_b11","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1186\/s12891-025-08356-x","article-title":"Prevention and management of degenerative lumbar spine disorders through artificial intelligence-based decision support systems: a systematic review","volume":"26","author":"Giaccone","year":"2025","journal-title":"BMC Musculoskelet. Disord."},{"issue":"4","key":"10.1016\/j.bspc.2026.110177_b12","doi-asserted-by":"crossref","first-page":"663","DOI":"10.3390\/diagnostics13040663","article-title":"Automatic detection, classification, and grading of lumbar intervertebral disc degeneration using an artificial neural network model","volume":"13","author":"Liawrungrueang","year":"2023","journal-title":"Diagnostics"},{"issue":"6","key":"10.1016\/j.bspc.2026.110177_b13","doi-asserted-by":"crossref","first-page":"552","DOI":"10.22603\/ssrr.2024-0154","article-title":"Artificial intelligence classification for detecting and grading lumbar intervertebral disc degeneration","volume":"8","author":"Liawrungrueang","year":"2024","journal-title":"Spine Surg. Relat. Res."},{"issue":"3","key":"10.1016\/j.bspc.2026.110177_b14","doi-asserted-by":"crossref","DOI":"10.1002\/jsp2.1353","article-title":"Automated magnetic resonance imaging-based grading of the lumbar intervertebral disc and facet joints","volume":"7","author":"Nikpasand","year":"2024","journal-title":"JOR Spine"},{"key":"10.1016\/j.bspc.2026.110177_b15","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.media.2017.07.002","article-title":"SpineNet: automated classification and evidence visualization in spinal MRIs","volume":"41","author":"Jamaludin","year":"2017","journal-title":"Med. Image Anal."},{"key":"10.1016\/j.bspc.2026.110177_b16","first-page":"1","article-title":"Automated three-dimensional imaging and pfirrmann classification of intervertebral disc using a graphical neural network in sagittal magnetic resonance imaging of the lumbar spine","author":"Baur","year":"2024","journal-title":"J. Imaging Informatics Med."},{"key":"10.1016\/j.bspc.2026.110177_b17","series-title":"Recent Advances in Computational Methods and Clinical Applications for Spine Imaging","first-page":"119","article-title":"Automated radiological grading of spinal MRI","author":"Lootus","year":"2015"},{"key":"10.1016\/j.bspc.2026.110177_b18","doi-asserted-by":"crossref","first-page":"2721","DOI":"10.1007\/s00586-016-4654-6","article-title":"Intervertebral disc classification by its degree of degeneration from T2-weighted magnetic resonance images","volume":"25","author":"Castro-Mateos","year":"2016","journal-title":"Eur. Spine J."},{"issue":"5","key":"10.1016\/j.bspc.2026.110177_b19","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0302067","article-title":"Lumbar spine MRI annotation with intervertebral disc height and pfirrmann grade predictions","volume":"19","author":"Natalia","year":"2024","journal-title":"PLoS One"},{"issue":"2","key":"10.1016\/j.bspc.2026.110177_b20","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1097\/RLI.0000000000000709","article-title":"A deep learning model for the accurate and reliable classification of disc degeneration based on MRI data","volume":"56","author":"Niemeyer","year":"2021","journal-title":"Invest. Radiol."},{"key":"10.1016\/j.bspc.2026.110177_b21","series-title":"International Conference on Medical Image Computing and Computer-Assisted Intervention","first-page":"234","article-title":"U-net: Convolutional networks for biomedical image segmentation","author":"Ronneberger","year":"2015"},{"key":"10.1016\/j.bspc.2026.110177_b22","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.wneu.2022.07.041","article-title":"Convolutional neural networks in spinal magnetic resonance imaging: a systematic review","volume":"166","author":"Baur","year":"2022","journal-title":"World Neurosurg."},{"issue":"2","key":"10.1016\/j.bspc.2026.110177_b23","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1177\/21925682231200783","article-title":"An automatized deep segmentation and classification model for lumbar disk degeneration and clarification of its impact on clinical decisions","volume":"15","author":"Soydan","year":"2025","journal-title":"Glob. Spine J."},{"key":"10.1016\/j.bspc.2026.110177_b24","doi-asserted-by":"crossref","DOI":"10.1016\/j.media.2022.102567","article-title":"Grayscale self-adjusting network with weak feature enhancement for 3D lumbar anatomy segmentation","volume":"81","author":"Liu","year":"2022","journal-title":"Med. Image Anal."},{"issue":"1","key":"10.1016\/j.bspc.2026.110177_b25","doi-asserted-by":"crossref","first-page":"14993","DOI":"10.1038\/s41598-024-64580-w","article-title":"Automated detection, labelling and radiological grading of clinical spinal MRIs","volume":"14","author":"Windsor","year":"2024","journal-title":"Sci. Rep."},{"key":"10.1016\/j.bspc.2026.110177_b26","doi-asserted-by":"crossref","DOI":"10.1016\/j.cmpbup.2022.100081","article-title":"A deep learning pipeline for automatized assessment of spinal MRI","volume":"2","author":"Balzer","year":"2022","journal-title":"Comput. Methods Programs Biomed. Updat."},{"key":"10.1016\/j.bspc.2026.110177_b27","doi-asserted-by":"crossref","unstructured":"Joseph Redmon, Santosh Divvala, Ross Girshick, Ali Farhadi, You only look once: Unified, real-time object detection, in: Proceedings of the IEEE Conference on Computer Vision and Pattern Recognition, 2016, pp. 779\u2013788.","DOI":"10.1109\/CVPR.2016.91"},{"issue":"3","key":"10.1016\/j.bspc.2026.110177_b28","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1002\/jmri.27400","article-title":"Automated grading of lumbar disc degeneration using a push-pull regularization network based on MRI","volume":"53","author":"Gao","year":"2021","journal-title":"J. Magn. Reson. Imaging"},{"key":"10.1016\/j.bspc.2026.110177_b29","unstructured":"Tsung-Yi Lin, Priya Goyal, Ross Girshick, Kaiming He, Piotr Doll\u00e1r, Focal loss for dense object detection, in: Proceedings of the IEEE International Conference on Computer Vision, 2017, pp. 2980\u20132988."},{"key":"10.1016\/j.bspc.2026.110177_b30","doi-asserted-by":"crossref","unstructured":"Ramprasaath R Selvaraju, Michael Cogswell, Abhishek Das, Ramakrishna Vedantam, Devi Parikh, Dhruv Batra, Grad-cam: Visual explanations from deep networks via gradient-based localization, in: Proceedings of the IEEE International Conference on Computer Vision, 2017, pp. 618\u2013626.","DOI":"10.1109\/ICCV.2017.74"},{"key":"10.1016\/j.bspc.2026.110177_b31","doi-asserted-by":"crossref","first-page":"159","DOI":"10.2307\/2529310","article-title":"The measurement of observer agreement for categorical data","author":"Landis","year":"1977","journal-title":"Biometrics"},{"key":"10.1016\/j.bspc.2026.110177_b32","doi-asserted-by":"crossref","unstructured":"Cecilia Panigutti, Andrea Beretta, Fosca Giannotti, Dino Pedreschi, Understanding the impact of explanations on advice-taking: a user study for AI-based clinical Decision Support Systems, in: Proceedings of the 2022 CHI Conference on Human Factors in Computing Systems, 2022, pp. 1\u20139.","DOI":"10.1145\/3491102.3502104"},{"key":"10.1016\/j.bspc.2026.110177_b33","doi-asserted-by":"crossref","unstructured":"Cecilia Panigutti, Ronan Hamon, Isabelle Hupont, David Fernandez Llorca, Delia Fano Yela, Henrik Junklewitz, Salvatore Scalzo, Gabriele Mazzini, Ignacio Sanchez, Josep Soler Garrido, et al., The role of explainable AI in the context of the AI Act, in: Proceedings of the 2023 ACM Conference on Fairness, Accountability, and Transparency, 2023, pp. 1139\u20131150.","DOI":"10.1145\/3593013.3594069"}],"container-title":["Biomedical Signal Processing and Control"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1746809426007317?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1746809426007317?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T23:48:44Z","timestamp":1777592924000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1746809426007317"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":33,"alternative-id":["S1746809426007317"],"URL":"https:\/\/doi.org\/10.1016\/j.bspc.2026.110177","relation":{},"ISSN":["1746-8094"],"issn-type":[{"value":"1746-8094","type":"print"}],"subject":[],"published":{"date-parts":[[2026,8]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Artificial intelligence based intervertebral discs grading: From unsupervised detection to explainable Pfirrmann classification","name":"articletitle","label":"Article Title"},{"value":"Biomedical Signal Processing and Control","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.bspc.2026.110177","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Published by Elsevier Ltd.","name":"copyright","label":"Copyright"}],"article-number":"110177"}}