Assessment of Scoliotic Deformity Using Spinous Processes: Comparison of Different Analysis Methods of an Ultrasonographic System

Koo, Terry K.; Guo, Jingjing; Ippolito, Christina; Bedle, Jamie C.

doi:10.1016/j.jmpt.2014.09.007

Cited by 17 publications

(12 citation statements)

References 19 publications

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“…The second method is to measure the spine curvature based on the 3D volume ultrasound data, with different visualization methods for the spine anatomy, such as maximum intensity projection [ 28 ] and volume projection imaging (VPI) [ 32 ]. Koo et al [ 33 ] compared different methods for measuring spinal curvature of spine phantoms using data collected with 3D ultrasound imaging.…”

Section: Introductionmentioning

confidence: 99%

A reliability and validity study for Scolioscan: a radiation-free scoliosis assessment system using 3D ultrasound imaging

et al. 2016

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BackgroundRadiographic evaluation for patients with scoliosis using Cobb method is the current gold standard, but radiography has radiation hazards. Several groups have recently demonstrated the feasibility of using 3D ultrasound for the evaluation of scoliosis. Ultrasound imaging is radiation-free, comparatively more accessible, and inexpensive. However, a reliable and valid 3D ultrasound system ready for clinical scoliosis assessment has not yet been reported. Scolioscan is a newly developed system targeted for scoliosis assessment in clinics by using coronal images of spine generated by a 3D ultrasound volume projection imaging method. The aim of this study is to test the reliability of spine deformity measurement of Scolioscan and its validity compared to the gold standard Cobb angle measurements from radiography in adolescent idiopathic scoliosis (AIS) patients.MethodsProspective study divided into two stages: 1) Investigation of intra- and inter- reliability between two operators for acquiring images using Scolioscan and among three raters for measuring spinal curves from those images; 2) Correlation between the Cobb angle obtained from radiography by a medical doctor and the spine curve angle obtained using Scolioscan (Scolioscan angle). The raters for ultrasound images and the doctors for evaluating radiographic images were mutually blinded. The two stages of tests involved 20 (80 % females, total of 26 angles, age of 16.4 ± 2.7 years, and Cobb angle of 27.6 ± 11.8°) and 49 (69 % female, 73 angles, 15.8 ± 2.7 years and 24.8 ± 9.7°) AIS patients, respectively. Intra-class correlation coefficients (ICC) and Bland-Altman plots and root-mean-square differences (RMS) were employed to determine correlations, which interpreted based on defined criteria.ResultsWe demonstrated a very good intra-rater and intra-operator reliability for Scolioscan angle measurement with ICC larger than 0.94 and 0.88, respectively. Very good inter-rater and inter-operator reliability was also demonstrated, with both ICC larger than 0.87. For the thoracic deformity measurement, the RMS were 2.5 and 3.3° in the intra- and inter-operator tests, and 1.5 and 3.6° in the intra- and inter-rater tests, respectively. The RMS differences were 3.1, 3.1, 1.6, 3.7° in the intra- and inter-operator and intra- and inter-rater tests, respectively, for the lumbar angle measurement. Moderate to strong correlations (R2 > 0.72) were observed between the Scolioscan angles and Cobb angles for both the thoracic and lumbar regions. It was noted that the Scolioscan angle slightly underestimated the spinal deformity in comparison with Cobb angle, and an overall regression equation y = 1.1797x (R2 = 0.76) could be used to translate the Scolioscan angle (x) to Cobb angle (y) for this group of patients. The RMS difference between Scolioscan angle and Cobb angle was 4.7 and 6.2°, with and without the correlation using the overall regression equation.ConclusionsWe showed that Scolioscan is reliable for measuring coronal deformity for patients with AIS and appears ...

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Section: Introductionmentioning

confidence: 99%

A reliability and validity study for Scolioscan: a radiation-free scoliosis assessment system using 3D ultrasound imaging

et al. 2016

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“…The feasibility of using landmarks in cross-sectional B-mode ultrasound images acquired with continuous scanning approach, including laminae and transverse process (TP) as the landmarks, to assess spine curvature has been demonstrated in in vitro experiments [21] , [22] , [23] . A number of 3-D ultrasound systems have been advanced to overcome the limitations of 2-D viewing of 3-D anatomy [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] . Purnama et al [29] showed that imaging of the human spine using freehand 3-D ultrasound was feasible, but no measurement of spine curvature angle was conducted.…”

Section: Introductionmentioning

confidence: 99%

Freehand three-dimensional ultrasound system for assessment of scoliosis

Cheung

Zhou

Law

et al. 2015

Journal of Orthopaedic Translation

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SummaryBackground/ObjectiveStanding radiograph with Cobb's method is routinely used to diagnose scoliosis, a medical condition defined as a lateral spine curvature > 10° with concordant vertebral rotation. However, radiation hazard and two-dimensional (2-D) viewing of 3-D anatomy restrict the application of radiograph in scoliosis examination.MethodsIn this study, a freehand 3-D ultrasound system was developed for the radiation-free assessment of scoliosis. Bony landmarks of the spine were manually extracted from a series of ultrasound images with their spatial information recorded to form a 3-D spine model for measuring its curvature. To validate its feasibility, in vivo measurements were conducted in 28 volunteers (age: 28.0 ± 13.0 years, 9 males and 19 females). A significant linear correlation (R2 = 0.86; p < 0.001) was found between the spine curvatures as measured by Cobb's method and the 3-D ultrasound imaging with transverse process and superior articular process as landmarks. The intra- and interobserver tests indicated that the proposed method is repeatable.ResultsThe 3-D ultrasound method using bony landmarks tended to underestimate the deformity, and a proper scaling is required. Nevertheless, this study demonstrated the feasibility of the freehand 3-D ultrasound system to assess scoliosis in the standing posture with the proposed methods and 3-D spine profile.ConclusionFurther studies are required to understand the variations that exist between the ultrasound and radiograph results with a larger number of volunteers, and to demonstrate its potential clinical applications for monitoring of scoliosis patients. Through further clinical trials and development, the reported 3-D ultrasound imaging system can potentially be used for scoliosis mass screening and frequent monitoring of progress and treatment outcome because of its radiation-free and easy accessibility feature.

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“…A freehand 3D ultrasound system developed by our group 16 is used to acquire a 3D ultrasound dataset of the lumbar spine. The system consists of an ultrasound scanner (Ultramark 400c; ATL Ultrasound Inc., Bothell, WA) with a 3.5-5 MHz curvilinear transducer to image the lumbar spine, an optoelectronic measurement system (Northern Digital Inc., Waterloo, Canada) to track the transducer, and a personal computer with a frame grabber (PCI-1411) and a data acquisition card (PCI 6024E) (National Instruments Corporation, Austin, TX) installed to capture ultrasound images and synchronize with the tracking data.…”

Section: D Ultrasoundmentioning

confidence: 99%

Hierarchical CT to Ultrasound Registration of the Lumbar Spine: A Comparison with Other Registration Methods

Koo

Kwok

2016

Ann Biomed Eng

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Three-dimensional (3D) measurement of the spine can provide important information for functional, developmental, diagnostic, and treatment-effect evaluations. However, existing measurement techniques are either 2-dimensional, highly invasive, or involve a high radiation dose, prohibiting their widespread and repeated use in both research and clinical settings. Non-invasive, non-ionizing, 3D measurement of the spine is still beyond the current state-of-the-art. Towards this goal, we developed an intensity-based hierarchical CT-ultrasound registration approach to quantify the 3D positions and orientations of lumbar vertebrae from 3D freehand ultrasound and one-time computed tomography. The method was validated using a human dry bone specimen (T12-L5) and a porcine cadaver (L2-L6) by comparing the registration results with a gold standard fiducial-based registration. Mean (SD) target registration error and percentage of successful registration were 1.2 (0.6) mm and 100% for the human dry bone specimen, and 2.18 (0.82) mm and 92% for the porcine cadaver, indicating that the method is accurate and robust under clinically realistic conditions. Given that the use of ultrasound eliminates ionizing radiation during pose measurements, we believe that the hierarchical CT-ultrasound registration method is an attractive option for quantifying 3D poses of individual vertebra and motion segment, and thus warrants further investigations.

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Assessment of Scoliotic Deformity Using Spinous Processes: Comparison of Different Analysis Methods of an Ultrasonographic System

Cited by 17 publications

References 19 publications

A reliability and validity study for Scolioscan: a radiation-free scoliosis assessment system using 3D ultrasound imaging

A reliability and validity study for Scolioscan: a radiation-free scoliosis assessment system using 3D ultrasound imaging

Freehand three-dimensional ultrasound system for assessment of scoliosis

Hierarchical CT to Ultrasound Registration of the Lumbar Spine: A Comparison with Other Registration Methods

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