{
  "abstract": "Rib-cage morphology is a determinant of thoracic biomechanics, ventilation, and injury response, yet statistical shape models (SSMs) of the rib cage have relied on small cohorts ([~]100s of individuals) imaged by clinical computed tomography, which over-represents injury and disease. We constructed a surface-based SSM of the complete 24-rib cage from 26,275 standardised whole-body magnetic resonance imaging (MRI) scans of adults aged 19-74 years from the population-based German National Cohort (NAKO). Ribs were segmented with a deep- learning pipeline (a rib-extended SPINEPS model), reconstructed as per-rib surface meshes, and brought into dense vertex-wise correspondence by Gaussian-process morphable registration in Scalismo; the aligned ensemble was summarised by generalised Procrustes analysis and principal component analysis (PCA). Fourteen per-rib geometric descriptors provided a quantitative cross- walk between the abstract PCA modes and named shape features, and associations with sex, age, body size and composition (including body-fat percentage), and smoking exposure were estimated by multivariable regression with Benjamini-Hochberg false-discovery-rate control. Shape variation was strongly concentrated: 28 modes captured 95% of the total variance, and the first three alone accounted for 69.4% (PC1, 42.6%; PC2, 16.3%; PC3, 10.5%) and admitted consistent anatomical readings - a sexually dimorphic axis (PC1), a slender-versus-stout body- habitus contrast (PC2), and a free-rib-size axis at ribs 11-12 (PC3). The sexes were nearly fully separated along PC1 (Cohens d = 2.52). Body mass and body-fat percentage were the dominant modifiable correlates of rib-cage shape, whereas the association with cumulative smoking exposure was comparatively small. The model is released as a population-representative geometric reference for benchmarking and morphing donor-derived finite-element human-body models and for further large-cohort shape analysis.",
  "abstract_shown": true,
  "affiliations": [
    "Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 20,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "A. Aicher"
    },
    {
      "name": "R. Graf"
    },
    {
      "name": "J. Kirschke"
    },
    {
      "name": "T. Frauenfelder"
    },
    {
      "name": "F. Ensle"
    },
    {
      "name": "B. Menze"
    },
    {
      "name": "J. Decker"
    },
    {
      "name": "T. Kröncke"
    },
    {
      "name": "J. Haubold"
    },
    {
      "name": "S. Ringhof"
    },
    {
      "name": "F. Bamberg"
    },
    {
      "name": "C. O. Schmidt"
    },
    {
      "name": "M. Wielpütz"
    },
    {
      "name": "M. Leitzmann"
    },
    {
      "name": "S. N. Willich"
    },
    {
      "name": "T. Keil"
    },
    {
      "name": "T. Niendorf"
    },
    {
      "name": "T. Pischon"
    },
    {
      "name": "C. Schlett"
    },
    {
      "name": "H. Möller"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9j1es1mm70e7m.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.09.01.26361964",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.09.01.26361964v1.full",
  "id": "9j1es1mm70e7m",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.09.01.26361964v1",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "radiology and imaging"
    ],
    [
      "openalex",
      "2608|Morphological variations and asymmetry"
    ]
  ],
  "openalex": "W7208791390",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.09.01.26361964v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-01",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/9j1es1mm70e7m.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:39Z",
      "native_id": "10.64898/2026.09.01.26361964",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.09.01.26361964v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:radiology and imaging",
      "subfield": "imaging"
    }
  ],
  "title": "How Sex, Age, Adiposity, and Smoking Shape the Human Rib Cage: Evidence from 26,275 Whole-Body MRIs across the German National Cohort (NAKO)",
  "title_text": "How Sex, Age, Adiposity, and Smoking Shape the Human Rib Cage: Evidence from 26,275 Whole-Body MRIs across the German National Cohort (NAKO)",
  "type": "preprint",
  "updated_at": "2026-10-30T12:17:39Z",
  "url": "https://research.draconitic.com/paper/9j1es1mm70e7m",
  "venue": "medRxiv",
  "versions": []
}