Is Radiation-Free Diagnostic Monitoring of Adolescent Idiopathic Scoliosis Feasible Using Upright Positional Magnetic Resonance Imaging?

Diefenbach, C.; Lonner, Baron S.; Auerbach, Joshua D.; Bharucha, Neil J.; Dean, Laura

doi:10.1097/brs.0b013e318286b18a

Cited by 18 publications

(19 citation statements)

References 20 publications

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“…Open MRI machines permit scanning from a standing patient position, making these images suitable for scoliosis angle measurement. Unfortunately, MRI is less accessible than X-ray due to its high cost and the patient has to stand motionless for several minutes while the scanner captures the entire spinal column, which further limits its use for routine monitoring in an adolescent population [9].…”

Section: Scoliosis Monitoring Techniquesmentioning

confidence: 99%

Portable Optically Tracked Ultrasound System for Scoliosis Measurement

Carbajal

Gómez

Fichtinger

et al. 2015

Recent Advances in Computational Methods and Clinical Applications for Spine Imaging

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Monitoring spinal curvature in adolescent kyphoscoliosis requires regular radiographic examinations; however, the applied ionizing radiation increases the risk of cancer. Ultrasound imaging is favorable over X-ray because it does not emit ionizing radiation. It has been shown in the past that tracked ultrasound can be used to localize vertebral transverse processes as landmarks along the spine to measure curvature angles. Tests have been performed with spine phantoms, but scanning protocol, tracking system, data acquisition and processing time has not been considered in human subjects yet. In this paper, a portable optically tracked ultrasound system for scoliosis measurement is presented. It provides a simple way to acquire data in the clinical environment with the aim of comparing results to current X-ray-based measurement. The workflow of the procedure was tested on volunteers. The customized open-source software is shared with the community as part of our effort to make a clinically practical system.

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Section: Scoliosis Monitoring Techniquesmentioning

confidence: 99%

Portable Optically Tracked Ultrasound System for Scoliosis Measurement

Carbajal

Gómez

Fichtinger

et al. 2015

Recent Advances in Computational Methods and Clinical Applications for Spine Imaging

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“…The major drawbacks of these methods are their unreliability, poor reproducibility, inability to assess vertebral body rotation, inability to assess anything apart from the main structural curve, and no capability to assess the sagittal profile. [37][38][39][40] However, it was shown that in the clinical setting, this method and other methods using the similar principle can be applied in particular to pregnant scoliotic patients for whom radiography is contraindicated 41 and in cases that do not need surgical intervention as a screening and monitoring tool. 37,42 Therefore, this method does offer another approach to monitoring changes of curvatures in AIS subjects.…”

Section: Radiographymentioning

confidence: 99%

“…Additionally, real-time in vivo assessment of the spinal curves magnitude, sagittal alignment, rotational/axial spine measurements, and intervertebral disk health are made possible. 40 Diefenbach et al 40 in the first ever study to use upright position MRI found that upright MRI was not only reliable, reproducible, and accurate, but it showed outstanding correlation between the gold standard standing radiographic and upright MRI measurements (i.e., Cobb angles and vertebral rotation).…”

Section: Magnetic Resonance Technologymentioning

confidence: 99%

Weight-bearing Imaging in Adolescent Idiopathic Scoliosis

Chiyanika

2019

Semin Musculoskelet Radiol

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This article reviews the weight-bearing imaging methods in the diagnosis and monitoring of patients with adolescent idiopathic scoliosis (AIS), a three-dimensional (3D) deformity of the spine with unknown etiology. The apical vertebrae in AIS rotate away from the midline in a complex 3D pattern that formerly could only be appreciated by computed tomography (CT). Despite its superb anatomical delineation, CT is not ideal due to high radiation and scanning in either the supine or prone position; hence the full effect of gravity on the spinal curvature cannot be assessed. The introduction of low-dose stereoradiography with the capacity of 3D reconstruction has recently opened up a new era of assessment of the scoliotic spine in the upright position at multiple time points during the preoperative and postoperative period. The handheld 3D ultrasound imaging system also provides a radiation-free alternative for close monitoring for disease progression and treatment outcomes for AIS. Upright magnetic resonance imaging is radiation free and superb for the assessment of spinal cord and intervertebral disks; however, its utilization in scoliosis is limited by high cost and limited availability.

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“…Two-dimension analysis usually underestimates spine deformation [2] and is considered of limited reliability and accuracy in assessment of vertebral rotation [3][4][5][6][7][8]. Computed tomography (CT) and magnetic resonance (MR) scanning have been proposed as an alternative to quantify vertebral rotation [9,10]. However, as CT and MR are performed in a supine position, vertebral rotational information obtained may not accurately reflect deformation in the usual upright position [9,10].…”

Section: Introductionmentioning

confidence: 98%

“…Computed tomography (CT) and magnetic resonance (MR) scanning have been proposed as an alternative to quantify vertebral rotation [9,10]. However, as CT and MR are performed in a supine position, vertebral rotational information obtained may not accurately reflect deformation in the usual upright position [9,10]. Furthermore, the radiation dose associated with CT remains significant [11] [12], especially for children.…”

Section: Introductionmentioning

confidence: 98%