Large-scale EOS 3D X-ray imaging: The objective of this work package is to establish a comprehensive collection of innovative skeletal imaging assessments to advance research on skeletal fragility. To accomplish this, we will acquire an EOS® medical imaging system to perform whole-body scans on the entire Rotterdam Study population-based cohort (n~12,000), as well as offer EOS measurements to the patient collections described in WP5. This unprecedented collection of weight-bearing (standing) whole-body skeletal images on such a large scale will revolutionize imaging research, allowing us to approach the skeleton as a “whole organ”.

This initiative will provide invaluable insights for skeletal research by enabling examination of multiple established and novel parameters, such as sagittal balance, proportionality of osteoarticular dimensions, and interrelationships between skeletal sites, across healthy and diseased individuals. Moreover, this approach opens the door to the development of novel assessments, including texture, shape, and geometry. We will achieve these goals through collaboration with the device manufacturer and a supportive team from the department of Medical Informatics at Erasmus MC.

The integration of these newly generated imaging data with clinical factors, genomic information, and novel analytical techniques will yield unparalleled discoveries benefiting the field of skeletal research. While the feasibility of this approach is evident, the high cost of the device makes it a high-risk investment with the potential for high returns.