Multidisciplinary Analysis of Ancient Human Skeletal Remains Using Computed Tomography: A Case Study from Cumae, Italy

Background: Radiology is a pivotal clinical method in anthropology, offering minmally destructive examination of ancient human remains. Archaeologists frequently rely on radiology to analyse anthropological and pathological findings without damaging osteological artefacts from archaeological excavations, including those intended for museum display. Imaging plays a critical role in assessing anthropological and pathological aspects of bones in osteoarchaeological studies, providing insights into sex, age at death, stature, and various pathologies such as infections, and neoplasmas, and trauma. This study, conducted at the University Hospital "Luigi Vanvitelli" in Naples, focuses on analyzing human skeletal remains excavated from the Acropolis of Cumae (Campania, Italy), fostering collaboration among archaeologists, physical and rehabilitation medicine physicians (i.e., physiatrists) with expertise in the management of metabolic bone diseases,and radiologists. The study aims to identify and assess anthropological and pathological features of skeletal remains using advanced imaging techniques. Additionally, it highlights the role of multidisciplinary collaboration for comprehensive analysis of ancient remains, laying the basis for future research to improve knowledge in this field. Materials and Methods: Human remains from the cemetery of the Christian Basilica of Cumae, were catalogued and examined utilizing conventional radiography (CR) and computed tomography (CT). CT scans were conducted on bone fragments to assess integrity, density alterations, fractures, and pathologies. Each bone fragment was analyzed separately, maintaining anatomical orientation. Dual-energy CT (DECT) scans were employed in select cases, enhancing bone lesion detection. Results: The collaboration between archaeologists and radiologists facilitated the reconstruction and the identification of skeletal fragments. CT analysis revealed diverse findings across cases, including fractures, osteosclerotic areas, and degenerative changes. Detailed observations from CT scans were complemented by X-ray examinations, contributing to comprehensive skeletal analyses. Discussion: Paleoradiology, coined in 1987, has evolved with CT advancements, enabling minimally invasive examination of ancient remains. CT imaging offers superior resolution and detail compared to conventional radiography, aiding in the identification of subtle pathologies. Multidisciplinary collaboration enhances diagnostic accuracy and ensures comprehensive analyses. Conclusions: CT analysis provides detailed insights into bone integrity and pathologies, facilitating comprehensive anthropological examinations. Multidisciplinary collaboration is essential for accurate interpretations of ancient human remains. This study represents a preliminary phase, laying the groundwork for further investigations into morpho-densitometric characteristics.