Automated Cobb Angle Measurement for Adolescent Idiopathic Scoliosis Using Convolutional Neural Network.

Wahyu Caesarendra,Wahyu Rahmaniar,Ady Thien,John Mathew

doi:10.3390/diagnostics12020396

Wahyu Caesarendra, Wahyu Rahmaniar + Show 2 more

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https://doi.org/10.3390/diagnostics12020396

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Abstract

The Cobb angle measurement of the scoliotic spine is prone to inter- and intra-observer variations in the clinical setting. This paper proposes a deep learning architecture for detecting spine vertebrae from X-ray images to evaluate the Cobb angle automatically. The public AASCE MICCAI 2019 anterior-posterior X-ray image dataset and local images were used to train and test the proposed convolutional neural network architecture. Sixty-eight landmark features of the spine were detected from the input image to obtain seventeen vertebrae on the spine. The vertebrae locations obtained were processed to automatically measure the Cobb angle. The proposed method can measure the Cobb angle with accuracies up to 93.6% and has excellent reliability compared to clinicians’ measurement (intraclass correlation coefficient > 0.95). The proposed deep learning architecture may be used as a tool to augment Cobb angle measurement in X-ray images of patients with adolescent idiopathic scoliosis in a real-world clinical setting.

Highlights

Diagnostics 2022, 12, 396. https://Scoliosis is a structural abnormality in which the spine curves from side to side and rotates
Children aged 10 to 17 years old who present with scoliosis of unknown cause are categorized as having Adolescent Idiopathic Scoliosis (AIS) [1]
If the curvature progresses during the growth spurt, discomfort, pain, and symptoms related to abnormal chest wall growth and difference in shoulder height can lead to decreased quality of life [2]

Summary

Introduction

Scoliosis is a structural abnormality in which the spine curves from side to side and rotates. If the curvature progresses during the growth spurt, discomfort, pain, and symptoms related to abnormal chest wall growth and difference in shoulder height can lead to decreased quality of life [2]. AIS can cause respiratory symptoms, such as shortness of breath when the curvature exceeds 50◦ , and patients are at a high risk of significant lung function abnormalities if the curvature is more than 100◦ [3]. The Cobb measuring method is the gold standard used in quantifying the scoliotic curve. The Cobb Angle (CA) is measured from the most tilted vertebra (end vertebra) above and below the apex (most laterally placed vertebra) of the curve on radiographs taken either in the anterior-posterior or the posterior-anterior view on the coronal plane [4]. Reported accuracies of measuring CA vary from 2◦ to 11◦ [5,6,7], with measurements differing up to 5◦ even with the same end vertebrae selected [2,8]

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