Taichung Veterans General Hospital and Acer Medical secured Taiwan FDA approval for VeriOsteo OP, an AI-powered osteoporosis screening tool. Using routine chest X-rays, the software can detect bone density within 30 seconds with nearly 90% accuracy—addressing critical staff shortages and enabling early intervention. With Taiwanese certification, VeriOsteo OP is already expanding into Southeast Asia and aims for U.S. approval. This collaboration is transforming TCVGH from a hospital into an AI-driven medical innovation hub.
Left to right: TCVGH deputy superintendent Dr. Cheng-Hung Lee, superintendent Dr. Shih-Ann Chen, and orthopedics chairman Dr. Kun-Huei Chen.
“When I answered the phone, I realized Stan Shih, the founder of Acer, was on the line,” recalls Dr. Shih-Ann Chen, superintendent of Taichung Veterans General Hospital (TCVGH). Shih had a bold request: “Dr. Chen, the rate of video transmission has to speed up. Today, I told my board we’d get approval in three months.”
In late November 2023, VeriOsteo OP, an AI-powered osteoporosis screening system jointly developed by TCVGH and Acer Medical, secured certification from the Taiwan Food and Drug Administration after submitting its application in just about three months—a process that normally takes six to twelve months.
The breakthrough software can detect bone density from a single chest X-ray in just 30 seconds, with nearly 90% accuracy. Beyond speed, it addresses a critical issue: the shortage of trained osteoporosis screening personnel.
Osteoporosis: The Silent Epidemic
Often called the “silent killer,” osteoporosis ranks second only to cardiovascular disease on the World Health Organization’s list of global health concerns. In Taiwan, it affects 16% of adults over 60, according to the Ministry of Health and Welfare.
The disease is insidious—most patients don’t know they have it until a bone fractures, often with life-threatening consequences. Yet fewer than one in three Taiwanese undergo bone density testing.
“Too often, patients and their families only discover osteoporosis after a fracture,” says Dr. Cheng-Hung Lee, deputy superintendent of TCVGH. “By then, it’s too late.”
TCVGH, as part of the International Osteoporosis Foundation’s “Capture the Fracture” initiative, had long been searching for earlier detection tools to enable timely treatment and better outcomes.
Rethinking the Chest X-ray
“One day we had an epiphany,” Lee recalls. “What if the chest X-rays people already get could also detect osteoporosis?”
That idea came to life through collaboration with Acer Medical, a subsidiary specializing in Software as a Medical Device (SaMD).
Traditionally, osteoporosis is diagnosed with DXA scans—low-radiation machines available only in hospitals—or with ultrasound, which measures heel bone density but is only about 66% accurate. Acer and TCVGH sought a simpler, more accurate method.
The key insight: standard chest X-rays capture not only the lungs and heart but also part of the thoracic and lumbar spine. “We realized those vertebrae could serve as indicators for osteoporosis,” Lee explains.
This reimagining of the X-ray turned a routine medical test into a powerful screening tool. But there was a challenge: processing and annotating massive amounts of data.
Annotating 9,000 Images a Week
The project required clinical evidence—over 9,000 X-ray images. Downloading alone strained the hospital’s bandwidth. “We had to do it manually at night so we wouldn’t crash the system,” says Dr. Kun-Huei Chen, chairman of orthopedics.
Chen also shouldered the task of image annotation. To speed the process, he asked Acer’s engineers to build a custom tool allowing eight images to be reviewed at once. They delivered it in two days. “With that tool, we reviewed more than 9,000 images in less than a week,” Chen says.
Data integrity posed another hurdle. Some readings were impossibly negative, raising doubts about accuracy. Acer’s engineers traced the problem to variations between X-ray machine models. By calibrating results against specific machines, accuracy improved significantly.
Diversity in patient data was also essential. Since bone loss depends on age, gender, health conditions, and medications, training an AI model required a heterogeneous dataset. TCVGH’s broad patient population proved invaluable, allowing the model to adapt to multiple scenarios.
Within three months, the AI was ready—and VeriOsteo OP won Taiwan FDA approval.
From Prediction to Prevention
The clinical value of the software was immediately clear. “Every orthopedic surgery patient gets a chest X-ray,” says Superintendent Chen. “If the system flags osteoporosis, we can recommend special screws or bone cement for stronger fixation.”
That early warning can be lifesaving. “Hip fractures in the elderly carry mortality rates comparable to late-stage cancer,” notes Lee. Recovery is often slow, incomplete, and disabling. By linking routine tests to preventive medicine, VeriOsteo OP helps avoid such devastating outcomes.
It also shifts healthcare from reactive treatment to proactive prevention—a critical step in aging societies.
Going Global
With Taiwanese certification secured, VeriOsteo OP is already entering international markets. In Southeast Asia, many countries accept Taiwan’s approval process as a reference, accelerating their own reviews.
The system has since been certified in Thailand, Indonesia, Malaysia, and Singapore, with U.S. certification targeted by year’s end.
A Hospital Transformed
Beyond the device itself, the collaboration reshaped TCVGH’s identity. “Hospitals are not just users or testing grounds,” Chen reflects. “We can be innovators and leaders.”
The hospital has since launched a Smart Healthcare Committee, overseeing more than 100 projects in areas ranging from big data and precision pathology to VR education, telemedicine, robotics, and industry-academia partnerships.
From frontline care provider to innovation hub, TCVGH now embodies Taiwan’s broader healthcare shift toward AI-driven medical solutions.
As Chen puts it, “A hospital doesn’t have to be just a testing ground for companies. It can be a designer of new medical devices.”
（Producer: Sophie Y. Wu／Writer: Chiyuan Chou／Adapted by Judy Lin／Editor: Lihua Wang)
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