Freehand three-dimensional ultrasound system for assessment of scoliosis

Abstract

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.

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

“…Moderate to strong linear correlations were demonstrated between the Scolioscan angles and X-ray Cobb angles for the thoracic and lumbar regions and thoracic-lumbar data combined with coefficients of determination R 2 larger than 0.72. Similar results were reported earlier using different laboratory prototypes of 3D ultrasound imaging system for scoliosis assessment [ 26 , 30 , 31 , 34 , 36 ]. It was found that the Scolioscan angle slightly underestimated the spinal deformity in comparison with Cobb angle for both the thoracic and lumbar regions.…”

“…During the scanning, Scolioscan actually acquires volumetric images of spine. It has been demonstrated in earlier studies that it is feasible to extract bony landmarks from the volumetric image data set to form virtual 3D spine model for the assessment of scoliotic deformity [ 25 , 30 , 31 ]. Further studies are going on to integrate this function into the system so that the evaluation of scoliotic deformity in 3D can be achieved using Scolioscan, including the measurement of spinal axial rotation and the deformity in sagittal plane.…”

“…In one method, spine curvature was estimated through manually locating the transverse processes in some ultrasound images with 3D spatial information. These ultrasound images were manually selected from a pile of recorded 2D raw B-mode images [ 30 , 31 ] or captured in real-time while locating the target from observations [ 29 ]. This method is relatively time-consuming as each required body landmark has to be manually identified in B-mode images, but it can form a virtual 3D model of the whole or a part of spine using the detected landmarks.…”

“…The feasibility and potential of using the 3D ultrasound imaging methods have been clearly demonstrated in recent studies for the measurement of scoliotic deformity in vivo [ 31 , 32 , 34 , 35 ] as well as for the improvement of brace fitting for scoliosis patients [ 36 , 37 ]. Being a radiation-free and cost-effective imaging modality, ultrasound imaging has potential to be widely used for scoliosis assessment; its popularity will be enhanced with improved portability of the ultrasound scanner.…”

Convolutional Neural Network untuk Pendeteksian Patah Tulang Femur pada Citra Ultrasonik B–Mode

“…Penggunaan fungsi fuzzy-connectedness pada citra US janin berhasil memprediksi kontur dan ukuran tulang janin [24]. Implementasi metode Cobbs pada citra US telah dipergunakan pula untuk mendeteksi terjadinya skoliosis pada tulang belakang [25]. Juga telah dilakukan segmentasi tulang dengan menggunakan kombinasi berbagai macam filter, seperti Wiener, Gaussian, dan wavelet untuk bonemusculoskeletal ultrasonography [26], [27].…”