Loukas, Marios

ABSTRACT The term “clinical anatomy” is widely used in education and research, yet its conceptual boundaries continue to be interpreted in various ways. Prior consensus‐based efforts have emphasized integration, collaboration, and clinical relevance as central features of the field and have provided an important foundation for interdisciplinary engagement. At the same time, ongoing changes in academic structure, medical education, and interdisciplinary biomedical science raise important questions regarding how clinical anatomy can sustain its scientific identity and long‐term relevance. Building upon prior discussions, this article argues that the continued maturation of clinical anatomy depends on the integration of conceptual frameworks with the sustained production of rigorous, reproducible, and clinically meaningful scholarly contributions. Historical and contemporary examples alike demonstrate that the influence of clinical anatomy has been shaped through contributions that directly advanced clinical science and practice. Accordingly, continued emphasis on methodological rigor, reproducibility, clinically meaningful contribution, and educational accountability may be essential to the field's future development and relevance.

ABSTRACT Photogrammetry has emerged as a powerful tool in medical education, offering precise and cost‐effective 3D anatomical models that enhance spatial learning and accessibility. This systematic review synthesizes evidence from forty‐eight (48) peer‐reviewed studies (2000–2025) to evaluate photogrammetry's applications, technical workflows, and educational outcomes in anatomy and surgical training. Findings demonstrate its effectiveness across training levels, with high learner satisfaction (e.g., 96.4% preference over traditional methods) and sub‐millimeter accuracy in rendering complex structures like neuroanatomy and musculoskeletal systems. Photogrammetry's adaptability for remote learning and specimen preservation addresses critical gaps in resource‐limited settings. However, challenges persist, including the lack of tactile feedback and difficulties in visualizing deep anatomical relationships. Future directions should focus on integrating artificial intelligence (AI)‐assisted processing, hybrid digital–physical models, and immersive technologies like virtual reality (VR)/augmented reality (AR) to bridge these gaps. By balancing innovation with evidence‐based implementation, photogrammetry can further solidify its role as a transformative adjunct in modern medical curricula.

ABSTRACT Radiology education is critical for medical students' anatomical competence and clinical readiness. However, it remains insufficiently integrated in medical curricula as residency program directors describe interns' basic image interpretation as unsatisfactory. This review aims to assess the efficacy of ultrasound, CT, MRI, and X‐ray in facilitating the learning of anatomy among medical students. Following PRISMA guidelines, 983 articles were screened, and 52 studies published between 2000 and 2025 met the inclusion criteria by comparing radiology‐integrated anatomy education with traditional methods such as cadaver and atlas use. Data extraction covered study design, radiology modalities, and effect sizes. Both integrated and traditional methods consisted of medical student cohorts assessed on objective knowledge and skills with recorded quantitative outcomes. Included studies showed knowledge gains on multiple choice assessments (pooled Cohen's d = 0.99, 95% CI: 0.34–1.65) but with high heterogeneity among studies ( I 2 = 99.5%). Controlled designs were used in 21% of studies. Other investigations (68% of studies) used attitudinal surveys that revealed strong student preference for radiology‐integrated learning. Of the modalities present, ultrasound was predominant (85% of studies), with other modalities (CT: 15%; MRI/X‐ray: < 5%) substantially underrepresented despite clinical relevance. Radiology integration was shown to enhance anatomy education and clinical preparedness. The incorporation of radiology, specifically ultrasound, into anatomical education leads to a significant and substantial improvement in student learning outcomes. Future investigations can standardize assessments, expand multimodal research, and address global curricular disparities.

ABSTRACT At the 42nd Annual Meeting of the American Association of Clinical Anatomists (AACA) in Bellevue, Washington, June 2025, two inaugural events—the Clinical Anatomy Fireside Chat (CAFC) and the Clinical Anatomy Symposium: Head and Neck 2025 (CAS)—fostered rich dialogue on the evolving role and operational definition of clinical anatomy. Experts from various clinical and anatomical disciplines explored the meaning of clinical anatomy, highlighting the absence of a universal definition despite its frequent use in education and research. Through these interdisciplinary discussions, a consensus emerged: clinical anatomy is not defined solely by the possession of clinical credentials but by the integration of anatomical knowledge and clinical relevance, achieved most effectively through collaboration. Clinical anatomy education and research require different depths of clinical knowledge depending on the audience and objective, and meaningful collaboration can bridge gaps in expertise. The symposium further illustrated that high‐quality clinical anatomy emerges from mutual respect and reciprocal insight between clinicians and anatomists. This article presents a consensus statement developed by AACA representatives and invited speakers, affirming that collaboration is not only foundational to the practice of clinical anatomy but also fundamental to its definition. These conclusions aim to guide future educational models, research strategies, and interdisciplinary partnerships in the field of clinical anatomy.

ABSTRACT Determining an appropriate sample size in human cadaveric studies remains a long‐standing and unresolved challenge. Unlike other basic science fields, anatomical research is constrained by factors such as limited human donor availability, cultural considerations, and ethical restrictions. Despite these limitations, researchers are often asked to justify sample sizes, yet no standardized guidelines currently exist. To quantitatively assess sample sizes in recent human cadaveric studies and propose evidence‐based recommendations for future research, a PubMed search was conducted on February 26, 2024, using the term human cadaveric study . The articles published in 2023 and 2024 were screened, yielding 770 eligible studies. Data extracted included the total sample size, number of classified groups, and journal impact factor (IF). Descriptive statistics, linear regression, and correlation analyses were performed. Continuous variables were summarized using medians and interquartile ranges (IQR). The median sample size was 11.5 (IQR: 7–20), and 47.9% of studies used 10 or fewer specimens. The median number of classified groups was 3 (IQR: 2–4). Linear regression showed that studies dividing specimens into 2–6 groups often failed to meet the recommended sample size per group based on regression modeling. No significant correlation was found between sample size and journal IF ( r = −0.062, p = 0.115). Most cadaveric studies rely on small sample sizes due to inherent constraints, yet many still attempt a subgroup analysis without sufficient statistical power. Although flexibility is essential in anatomical research, we recommend a minimum total sample size of 10 for basic studies and at least five samples per group for those involving classification. Cadaveric sample size alone does not predict journal impact, highlighting the importance of methodological rigor over quantity.

ABSTRACTMost discussions about discrimination and bias in anatomical research papers have been limited to terminology relating to race/ethnicity and gender/sex. However, as editors of anatomical journals, the authors of this article have frequently observed broader instances of potential discrimination and bias within anatomical research. These often stem from differences among authors' backgrounds, traditions, cultures, religions, provenance/origins, and workplace affiliations. In view of the limited discourse on this topic, we seek in this article to establish a consensus among editors of anatomical journals and to propose new Guidelines Against Discrimination and Bias in Anatomical Research Papers (GDBARP). We have identified multiple factors that can contribute to discrimination and bias, underscoring the need for greater awareness and proactive measures. It is imperative in anatomical research to respect authors, reviewers, and editors regardless of their background, culture, traditions, sex, ethnicity, language, religion, or ethical perspectives.

ABSTRACT Anatomy education is a cornerstone of medical training and relies on cadaveric dissection and 2D illustrations. Technological advancements and integrated curricula have reduced the focus on detailed anatomy and challenged educators to engage Generation Z learners with interactive, tech‐driven methods. Advanced imaging and artificial intelligence (AI) offer a solution, providing virtual dissection simulations and personalized learning tools that mimic 3D anatomy and adapt to individual student needs. Machine learning, a subset of AI, enhances this process by enabling predictive analytics, adaptive feedback, and tailored learning pathways based on performance data, significantly improving anatomical comprehension. Despite its benefits, AI integration raises concerns about over‐reliance on technology, biases, and diminished human interaction in training. This review examines AI's transformative potential in anatomy education while emphasizing the need for balanced implementation and ethical oversight. A systematic review following PRISMA guidelines was conducted, utilizing PubMed and backward citation searches. The search yielded 56 studies, with 47 additional articles from citations, resulting in 61 included studies. These explored AI applications such as virtual dissection simulations, machine learning algorithms for adaptive feedback, and gamified learning experiences, which were shown to enhance engagement, personalize learning, and improve anatomical understanding. Concerns about over‐reliance on AI and the loss of human interaction were also raised. AI has the potential to enhance anatomy education, but careful consideration of ethical and practical implications is essential. A balanced approach combining traditional methods with AI and robust oversight is crucial for effective integration.

ABSTRACT The Lazarus sign is a well‐documented spinal reflex observed in brain‐dead patients, characterized by involuntary upper limb movements that can resemble voluntary gestures. Initially described during the 1980s, this phenomenon has contributed to ongoing discussions about the physiological basis of spinal reflexes and their role in assessing brain death. The Lazarus sign was once considered a diagnostic challenge, but recent research reports confirm that it originates solely from the spinal cord, independent of brainstem or cortical activity. However, recent studies also suggest that spinal reflexes in brain‐dead patients, including the Lazarus sign, can be more variable than previously thought, occurring in multiple limb regions beyond the upper limbs. Prolonged survival in brain‐dead patients exhibiting the Lazarus sign has also raised new questions about its physiological significance. Its recognition has helped refine brain death criteria, ensuring accurate diagnoses and minimizing misinterpretations in critical care and organ donation settings. PubMed‐indexed studies and backward citations were reviewed. Studies were included if they explicitly described spinal reflexes in brain‐dead patients, examined neurophysiological mechanisms, or provided clinical observations on the Lazarus sign. Exclusion criteria included studies focusing solely on brainstem activity without considering spinal reflexes or case reports lacking detailed methodology. These investigations explored the prevalence, neurophysiological mechanisms, and clinical significance of the Lazarus sign. Research highlights its variable presentation, its occurrence in up to 40% of brain‐dead patients, and its potential to be misunderstood by families and healthcare providers. The sign does not indicate residual brain function, but it reinforces the need for clear communication in end‐of‐life care. Future research should focus on standardizing diagnostic protocols, educating clinicians, and addressing ethical concerns. Integrating this knowledge into brain death assessments will enhance clinical decision‐making and patient management.

ABSTRACT Nowadays, consent to use donor bodies for medical education and research is obtained from the body donors and their families before the donation. Recently, the International Federation of Associations of Anatomists (IFAA) published guidelines that could restrict the appearance of cadaveric images in commercial anatomical resources such as textbooks and other educational products. These guidelines state that the donor must expressly consent to using such images for this purpose. Cadaveric photos and drawings made from dissections of cadavers have been used in anatomy textbooks and atlases for hundreds of years. They are invaluable for anatomy students and clinical/surgical practitioners. The IFAA guidelines should not restrict the use of those older books; to do so would infringe the rights of those seeking knowledge from these resources. As the images in such textbooks and atlases are anonymized and are used for teaching and research, and the donors and their families are informed about this before the donation, we believe no additional consent is needed. It is impossible to separate educational from “commercial” usage entirely in any situation, e.g., publications from publishers and the use of cadavers in medical schools. Therefore, our best efforts to avoid unethical use of cadaveric images by following traditional consent processes are still needed so that more people will reap the benefits from them. As senior textbook/atlas authors/editors from over 10 countries, we believe that using cadaveric images in anatomy textbooks is appropriate, and no additional consent should be necessary. Such usage falls within the good faith of professionals using these invaluable gifts.

Abstract Myocardial bridges are anatomical entities characterized by myocardium covering segments of coronary arteries. In some patients, the presence of a myocardial bridge is benign and is only incidentally found on autopsy. In other patients, however, myocardial bridges can lead to compression of the coronary artery during systolic contraction and delayed diastolic relaxation, resulting in myocardial ischemia. This ischemia in turn can lead to myocardial infarction, ventricular arrhythmias and sudden cardiac death. Myocardial bridges have also been linked to an increased incidence of atherosclerosis, which has been attributed to increased shear stress and the presence of vasoactive factors. Other studies however, demonstrated the protective roles of myocardial bridges. In this study, using systematic review and a meta‐analytical approach we investigate the prevalence and morphology of myocardial bridges in both clinical imaging and cadaveric dissections. We also discuss the pathophysiology, clinical significance, and management of these anatomical entities.