Medimaps Group S.A., a global developer of AI-based bone microarchitecture imaging solutions, has presented its new software TBS Reveal, an opportunistic screening tool designed to assess bone fragility directly from routine X-ray images. The software was showcased at the Radiological Society of North America (RSNA) 2025 Annual Meeting in Chicago.
TBS Reveal builds on Medimaps Group’s established Trabecular Bone Score (TBS) technology and is positioned to complement the company’s DXA-based solution, TBS Osteo Advanced, launched earlier this year. Together, the two applications support early detection of bone fragility using both X-ray and DXA modalities.
AI-Based Bone Fragility Assessment from Routine X-Ray
TBS Reveal applies artificial intelligence to evaluate combined bone microarchitecture and bone mass from standard X-ray exams. Designed to integrate into existing PACS workflows, the software enables opportunistic screening without changing clinical routines or requiring additional imaging.
Its performance has been validated in external studies using paired DXA and X-ray datasets from patients aged 20 and older. Reported metrics include 90% accuracy, 95% specificity, and an AUC of 85%. TBS Reveal has been submitted to the U.S. Food and Drug Administration (FDA) under the 510(k) review process.
“Conventional X-rays are among the most common imaging modalities in clinical practice, yet they are rarely used to assess bone fragility, a missed opportunity given the vast number of images processed and already stored in PACS systems,” said Univ-Prof. Dr. Didier Hans, CEO and Co-founder of Medimaps Group. “By applying AI to analyze these X-ray images with our TBS technology, TBS Reveal* can help flag patients at elevated risk of bone fracture and guide them toward early diagnostic assessment. Because it captures bone quality, not just density, it provides a far more powerful view of bone fragility from a routine X-ray.”
Role of TBS in Clinical Practice
TBS is a proprietary method developed by Medimaps Group to extract a grey-level texture index from DXA images, and now X-ray, to assess bone microarchitecture. The technology is referenced in more than 1,500 scientific publications and 35 clinical guidelines, and is used internationally as a complementary tool for fracture risk prediction.
Source: Medimaps Group
