Measurement of scoliosis Cobb angle by end vertebra tilt angle method

Wang, Jing; Zhang, Jin; Xu, Rui; Chen, Tie Ge; Zhou, Kai; Zhang, Hai Hong

doi:10.1186/s13018-018-0928-5

Cited by 54 publications

(37 citation statements)

References 11 publications

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“…Even though radiologists received support from PACS, the variability that was caused by the defect in classic measurement of the Cobb angle still remained [17]. The Cobb angle was measured on the basis of the orientation of endplates in classic measurement [13]. Unlike radiographs of the spine, the endplates located behind the superior mediastinum are usually not apparent on chest X-rays.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of a computer-aided method for measuring the Cobb angle on chest X-rays

Pan

Chen²,

Chen

et al. 2019

Eur Spine J

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Objectives To automatically measure the Cobb angle and diagnose scoliosis on chest X-rays, a computer-aided method was proposed and the reliability and accuracy were evaluated. Methods Two Mask R-CNN models as the core of a computer-aided method were used to separately detect and segment the spine and all vertebral bodies on chest X-rays, and the Cobb angle of the spinal curve was measured from the output of the Mask R-CNN models. To evaluate the reliability and accuracy of the computer-aided method, the Cobb angles on 248 chest X-rays from lung cancer screening were measured automatically using a computer-aided method, and two experienced radiologists used a manual method to separately measure Cobb angles on the aforementioned chest X-rays. Results For manual measurement of the Cobb angle on chest X-rays, the intraclass correlation coefficients (ICC) of intra-and inter-observer reliability analysis was 0.941 and 0.887, respectively, and the mean absolute differences were < 3.5°. The ICC between the computer-aided and manual methods for Cobb angle measurement was 0.854, and the mean absolute difference was 3.32°. These results indicated that the computer-aided method had good reliability for Cobb angle measurement on chest X-rays. Using the mean value of Cobb angles in manual measurements > 10° as a reference standard for scoliosis, the computer-aided method achieved a high level of sensitivity (89.59%) and a relatively low level of specificity (70.37%) for diagnosing scoliosis on chest X-rays. Conclusion The computer-aided method has potential for automatic Cobb angle measurement and scoliosis diagnosis on chest X-rays.

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Section: Discussionmentioning

confidence: 99%

“…Manual measurement through PACS was the same as the classic measurement ( Fig. 3) [13], except for the automatic calculation of the Cobb angle. If the endplate was not seen clearly after enlargement and contrast adjustment, lines are drawn along the pedicles [14].…”

Section: Manual Methodsmentioning

confidence: 99%

Evaluation of a computer-aided method for measuring the Cobb angle on chest X-rays

Pan

Chen²,

Chen

et al. 2019

Eur Spine J

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“…(20,21) The diagnosis and management decision of scoliosis relies on the Cobb angle measurement and thus these measurements must be accurate and consistent. The measurement error for human subjects has already been exempli ed from various aspects (5,8,(22)(23)(24). However the effects of mouse positioning on angle measurement is unclear.…”

Section: Discussionmentioning

confidence: 99%

Proper positioning of mice for Cobb angle radiographic measurements

Chen

Song

Gao

2020

Preprint

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BackgroundThere is no recommended standard for positioning of a mouse for radiographic assessment of the spine. This is necessary to have reproducible radiographic data and avoid false positive results. The objective of this study was to investigate the impact of various postures on Cobb angle measurements and to set up a positioning standard for imaging mouse spines. MethodsThis study was conducted in three parts. Firstly, we identified the problem of lack of posture standardization for radiographs. We collected 77 C57BL/6J mice for spine radiographs and found a scoliosis prevalence of 28.6% with large variations in curve magnitude. Secondly, 24 C57BL/6J mice underwent 4 consecutive weekly radiographs and observed high variations (relative standard deviation: 125.3%) between radiographs. Thirdly, we collected another 82 C57BL/6J mice and designed 14 different postures that could take place during imaging. These postures were related to curling of the limbs, and head, pelvic and tail tilting. ResultsThe results showed that head and pelvic tilting significantly affects the curve magnitude with effect size (Glass’s delta) over 1.50. Avoiding these incorrect positions during radiographs is warranted. The standard recommended posture for mouse imaging entails positioning the snout, interorbital space, neck and whole spine in one line, and with the limbs placed symmetrical to the trunk, whilst avoiding stretching the body of the mouse. ConclusionsOur work exemplified the importance of standard protocol during imaging when using animal model in the scoliosis study. We recommend utilizing this standard in studying various disorders of the spine.

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“…Если большинство результатов исследований базировалось на анализе 14-49 рентгенограмм, то мы провели обучение сети на 300 цифровых рентгенограммах позвоночника больных идиопатическим сколиозом, предварительно расчерченных врачомрентгенологом [9][10][11][12][13][14]25]. Сопоставимый объем исследований прослежен только в работах J. Wang et al и Y. Pan et al [11,13]. Использование объемного датасета для обучения нейросети позволило обеспечить совпадение касательных, проведенных автоматически, с касательными, построенными опытным специалистом, более чем в 85 % случаев.…”

Section: Discussionunclassified

“…Анализ литературы показал, что за последние 10 лет выполнено большое количество работ, посвященных цифровым программным решениям при вычислении величины угла Кобба на рентгенограммах, причем увеличение количества таких исследований в первую очередь обусловлено развитием цифровой рентгенографии [9][10][11][12][13]. В то же время предлагаемые решения фактически являются либо полуавтоматическими в ситуациях, когда врач определяет начальный и конечный позвонки дуг, либо полностью ручными, но с использованием программного обеспечения, позволяющего увеличить изображение и более точно провести касательные к проекции тела позвонка [14].…”

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Automation analysis X-ray of the spine to objectify the assessment of the severity of scoliotic deformity in idiopathic scoliosis: a preliminary report

Lein¹,

Nechaeva²,

Mammadova³

et al. 2020

Pediatr Traum Orthop Reconstr Surg

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Background. A large number of studies have focused on automating the process of measuring the Cobb angle. Although there is no practical tool to assist doctors with estimating the severity of the curvature of the spine and determine the best suitable treatment type. Aim. We aimed to examine the algorithms used for distinguishing vertebral column, vertebrae, and for building a tangent on the X-ray photographs. The superior algorithms should be implemented into the clinical practice as an instrument of automatic analysis of the spine X-rays in scoliosis patients. Materials and methods. A total of 300 digital X-rays of the spine of children with idiopathic scoliosis were gathered. The X-rays were manually ruled by a radiologist to determine the Cobb angle. This data was included into the main dataset used for training and validating the neural network. In addition, the Sliding Window Method algorithm was implemented and compared with the machine learning algorithms, proving it to be vastly superior in the context of this research. Results. This research can serve as the foundation for the future development of an automated system for analyzing spine X-rays. This system allows processing of a large amount of data for achieving 85% in training neural network to determine the Cobb angle. Conclusions. This research is the first step toward the development of a modern innovative product that uses artificial intelligence for distinguishing the different portions of the spine on 2D X-ray images for building the lines required to determine the Cobb angle.

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Measurement of scoliosis Cobb angle by end vertebra tilt angle method

Cited by 54 publications

References 11 publications

Evaluation of a computer-aided method for measuring the Cobb angle on chest X-rays

Evaluation of a computer-aided method for measuring the Cobb angle on chest X-rays

Proper positioning of mice for Cobb angle radiographic measurements

Automation analysis X-ray of the spine to objectify the assessment of the severity of scoliotic deformity in idiopathic scoliosis: a preliminary report

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