Intra- and inter-rater reliabilities and differences of kyphotic angle measurements on ultrasound images versus radiographs for children with adolescent idiopathic scoliosis: a preliminary study

Sayed, Tehzeeb; Khodaei, Mahdieh; Hill, Doug; Lou, Edmond

doi:10.1007/s43390-021-00466-5

Cited by 9 publications

(2 citation statements)

References 23 publications

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“…Chen et al 3 proposed the COL method for assessing the coronal curvature of children with adolescent idiopathic scoliosis (AIS); the reliability and validity of using this COL method have been statistically evaluated and well-verified over the years for both scoliosis deformity assessment and vertebral rotation measurements. [14][15][16][17] Sayed et al 18 also proved the reliability of measuring kyphotic angles on ultrasound images using the COL method for identifying the spinous process landmarks.…”

Section: Related Workmentioning

confidence: 98%

Lamina landmark detection in ultrasound images: a preliminary study

Gauthier

Cheriet

et al. 2023

Medical Imaging 2023: Ultrasonic Imaging and Tomography

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Freehand (FH) 3D ultrasound (US) imaging is emerging as a promising modality for spine imaging because it is non-invasive and inexpensive. Among the vertebral landmarks that can be used to represent the spine, paired laminae can play a vital role in a transverse scan for 3D spine deformity analysis by providing symmetry information. However, there is currently no laminae landmark recognition algorithm that has been tested on poor-quality 2D US scans. In this study, we propose a deep learning framework to automatically and simultaneously assess the presence of two laminae and estimate their landmark coordinates for the purpose of live US-based assessment of spine shape. To label the training data, we propose a labeling protocol based on a weight distribution on the virtual bone surface to make the pixel representative most likely the closest pixel to the spinal cord. In total, 6 FH 3D US sequences of the spine covering vertebrae T1 to L5 were collected from 3 participants. They were labeled based on the proposed protocol and validated by two spine ultrasound experts. The performance of the deep learning-based lamina landmark detection method was assessed through K-Fold cross-validation, with results reaching a mean distance error of 2.1 ± 1.3(mm) and 1.8 ± 1.2(mm) in true-positive images for left and right lamina landmarks respectively. Our method could allow for live laminae landmark extraction during clinical US spine exams, which would be useful for spinal ultrasound image interpretation, vertebral level identification, and spine deformity analysis in 3D based on paired laminae landmarks projected on three anatomical planes.

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Section: Related Workmentioning

confidence: 98%

Lamina landmark detection in ultrasound images: a preliminary study

Gauthier

Cheriet

et al. 2023

Medical Imaging 2023: Ultrasonic Imaging and Tomography

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“… 17 , 18 , 19 , 20 , 21 The advantages of 3D ultrasonography imaging are its nonionizing, readily accessible, and low‐cost nature. During the past decade, a 3D ultrasonography system has been developed and demonstrated to provide valid and reliable measurements to access coronal 17 , 19 , 20 , 21 , 22 and sagittal 23 , 24 , 25 curvatures using various landmarks of the posterior spinal elements such as spinous and transverse processes and laminae. Evaluation of AVR could also be assessed using these landmarks.…”

Section: Introductionmentioning

confidence: 99%

Three‐dimensional ultrasonography could be a potential non‐ionizing tool to evaluate vertebral rotation of subjects with adolescent idiopathic scoliosis

et al. 2023

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BackgroundThree‐dimensional (3D) ultrasonography is nonionizing and has been demonstrated to be a reliable tool for scoliosis assessment, including coronal and sagittal curvatures. It shows a great potential for axial vertebral rotation (AVR) evaluation, yet its validity and reliability need to be further demonstrated.Materials and MethodsTwenty patients with adolescent idiopathic scoliosis (AIS) (coronal Cobb: 26.6 ± 9.1°) received 3D ultrasound scan for twice, 10 were scanned by the same operator, and the other 10 by different operators. EOS Bi‐planar x‐rays and 3D scan were conducted on another 29 patients on the same day. Two experienced 3D ultrasonographic researchers, with different experiences on AVR measurement, evaluated the 3D ultrasonographic AVR of the 29 patients (55 curves; coronal Cobb angle: 26.9 ± 11.3°). The gold standard AVR was determined from the 3D reconstruction of coronal and sagittal EOS radiographs. Intra‐class correlation coefficients (ICCs), mean absolute difference (MAD), standard error measurements (SEM), and Bland–Altman's bias were reported to evaluate the intra‐operator and inter‐operator/rater reliabilities of 3D ultrasonography. The reliability of 3D ultrasonographic AVR measurements was further validated using inter‐method with that of EOS.ResultsICCs for intra‐operator and inter‐operator/rater reliability assessment were all greater than 0.95. MAD, SEM, and bias for the 3D ultrasonographic AVRs were no more than 2.2°, 2.0°, and 0.5°, respectively. AVRs between both modalities were strongly correlated (R2 = 0.901) and not significantly different (p = 0.205). Bland–Altman plot also shows that the bias was less than 1°, with no proportional bias between the difference and mean of expected and radiographic Cobb angles.ConclusionThis study demonstrates that 3D ultrasonography is valid and reliable to evaluate AVR in AIS patients. 3D ultrasonography can be a potential tool for screening and following up subjects with AIS and evaluating the effectiveness of nonsurgical treatments.

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Validity and accuracy of automatic cobb angle measurement on 3D spinal ultrasonographs for children with adolescent idiopathic scoliosis: SOSORT 2024 award winner

Wong,

Reformat,

Parent

et al. 2024

Eur Spine J

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Purpose Ultrasonography for scoliosis is a novel imaging method that does not expose children with adolescent idiopathic scoliosis (AIS) to radiation. A single ultrasound scan provides 3D spinal views directly. However, measuring ultrasonograph parameters is challenging, time-consuming, and requires considerable training. This study aimed to validate a machine learning method to measure the coronal curve angle on ultrasonographs automatically. Methods A total of 144 3D spinal ultrasonographs were extracted to train and validate a machine learning model. Among the 144 images, 70 were used for training, and 74 consisted of 144 curves for testing. Automatic coronal curve angle measurements were validated by comparing them with manual measurements performed by an experienced rater. The inter-method intraclass correlation coefficient (ICC2,1), standard error of measurement (SEM), and percentage of measurements within clinical acceptance (≤ 5°) were analyzed. Results The automatic method detected 125/144 manually measured curves. The averages of the 125 manual and automatic coronal curve angle measurements were 22.4 ± 8.0° and 22.9 ± 8.7°, respectively. Good reliability was achieved with ICC2,1 = 0.81 and SEM = 1.4°. A total of 75% (94/125) of the measurements were within clinical acceptance. The average measurement time per ultrasonograph was 36 ± 7 s. Additionally, the algorithm displayed the predicted centers of laminae to illustrate the measurement. Conclusion The automatic algorithm measured the coronal curve angle with moderate accuracy but good reliability. The algorithm’s quick measurement time and interpretability can make ultrasound a more accessible imaging method for children with AIS. However, further improvements are needed to bring the method to clinical use.

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Intra- and inter-rater reliabilities and differences of kyphotic angle measurements on ultrasound images versus radiographs for children with adolescent idiopathic scoliosis: a preliminary study

Cited by 9 publications

References 23 publications

Lamina landmark detection in ultrasound images: a preliminary study

Lamina landmark detection in ultrasound images: a preliminary study

Three‐dimensional ultrasonography could be a potential non‐ionizing tool to evaluate vertebral rotation of subjects with adolescent idiopathic scoliosis

Validity and accuracy of automatic cobb angle measurement on 3D spinal ultrasonographs for children with adolescent idiopathic scoliosis: SOSORT 2024 award winner

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