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Roth C, Heyde CE, Schumann E, Voit D, Frahm J, Hirsch FW, Anders R, Gräfe D. As fast as an X-ray: real-time magnetic resonance imaging for diagnosis of idiopathic scoliosis in children and adolescents. Pediatr Radiol 2024; 54:1168-1179. [PMID: 38687346 PMCID: PMC11182802 DOI: 10.1007/s00247-024-05919-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 03/20/2024] [Accepted: 03/21/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Idiopathic scoliosis is common in adolescence. Due to the rapid growth of the spine, it must be monitored closely with radiographs to ensure timely intervention when therapy is needed. As these radiographs continue into young adulthood, patients are repeatedly exposed to ionizing radiation. OBJECTIVE This study aimed to investigate whether real-time magnetic resonance imaging (MRI) is equivalent to conventional radiography in juvenile idiopathic scoliosis for determining curvature, rotation and the Risser stage. Additionally, the time requirement should be quantified. MATERIALS AND METHODS Children with idiopathic scoliosis who had postero-anterior whole-spine radiography for clinical indications were included in this prospective study. A real-time spine MRI was performed at 3 tesla in the supine position, capturing images in both the coronal and sagittal planes. The scoliosis was assessed using Cobb angle, rotation was evaluated based on Nash and Moe criteria, and the Risser stage was determined for each modality. The correlations between modalities and a correction factor for the Cobb angle between the standing and supine position were calculated. RESULTS A total of 33 children (aged 5-17 years), who met the inclusion criteria, were recruited. The Cobb angle (R2 = 0.972; P < 0.01) was positively correlated with a correction factor of 1.07 between modalities. Additionally, the degree of rotation (R2 = 0.92; P < 0.01) and the Risser stage (R2 = 0.93; P < 0.01) demonstrated a strong correlation. CONCLUSION Real-time MRI is equivalent to conventional radiography in determining baseline parameters. Furthermore, it is radiation-free and less time-consuming.
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Affiliation(s)
- Christian Roth
- Institut für Kinderradiologie, Liebigstr. 20a, 04103, Leipzig, Germany.
| | - Christoph-Eckhard Heyde
- Department of Orthopedic and Trauma Surgery, Spine Department, University of Leipzig, Leipzig, Germany
| | - Eckehard Schumann
- Department of Orthopedic and Trauma Surgery, Spine Department, University of Leipzig, Leipzig, Germany
| | - Dirk Voit
- Biomedizinische NMR, Max-Planck-Institut Für Multidisziplinäre Naturwissenschaften, Göttingen, Germany
| | - Jens Frahm
- Biomedizinische NMR, Max-Planck-Institut Für Multidisziplinäre Naturwissenschaften, Göttingen, Germany
| | - Franz W Hirsch
- Institut für Kinderradiologie, Liebigstr. 20a, 04103, Leipzig, Germany
| | - Rebecca Anders
- Institut für Kinderradiologie, Liebigstr. 20a, 04103, Leipzig, Germany
| | - Daniel Gräfe
- Institut für Kinderradiologie, Liebigstr. 20a, 04103, Leipzig, Germany
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Abdel-Aziem AA, El-Basatiny HMY, Draz AH, Aglan DAAA. Back geometry and mobility function changes in cerebral palsy children after backward walking training: arandomized controlled trial. Dev Neurorehabil 2024; 27:8-16. [PMID: 38597393 DOI: 10.1080/17518423.2024.2340461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 04/03/2024] [Indexed: 04/11/2024]
Abstract
AIM To compare the effects of backward (BW) and forward (FW) walking training on back geometry and mobility function in children with hemiparetic cerebral palsy (CP). METHODS Fifty-five children with hemiparetic CP participated in this study. They were randomly assigned into two groups. For 12 weeks, both groups got a conventional physical therapy program three days/week. Groups A and B got a specifically developed FW walking training (25 minutes/session) and a specially designed BW walking training (25 minutes/session), respectively. RESULTS The trunk imbalance, lateral deviation, pelvic tilting, pelvic torsion, surface motion, and dynamic gait index of group B improved significantly more than group A (p < .05). Both groups showed significant improvements in all measured variables (p < .05). CONCLUSION BW walking training might be considered as an effective therapy modality for improving back geometry and mobility function in hemiparetic CP children compared with FW walking training combined with a typical program.
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Affiliation(s)
- Amr Almaz Abdel-Aziem
- Department of Physical Therapy, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Heba Mohamed Youssr El-Basatiny
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
- Department of Physical Therapy, College of Applied Medical Sciences, Najran University, Saudi Arabia
| | - Amira Husien Draz
- Department of Basic Sciences, Faculty of physical therapy, Cairo university, Giza, Egypt
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Mehta B, Chockalingam N, Shannon T, Jevtic N, Lazic F, Jasani V, Eddison N, Healy A, Needham R. Non-Invasive Assessment of Back Surface Topography: Technologies, Techniques and Clinical Utility. SENSORS (BASEL, SWITZERLAND) 2023; 23:8485. [PMID: 37896577 PMCID: PMC10610923 DOI: 10.3390/s23208485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/09/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023]
Abstract
(1) Background: Frequent exposure to ionising radiation is often used to determine the diagnosis of adolescent idiopathic scoliosis (AIS), a lateral curvature of the spine in those aged between 10 and 18 years, and a treatment plan according to Cobb angle. This narrative review outlines the clinical utility of surface topography (ST), a radiation-free imaging modality. (2) Methods: Publicly available databases were searched to yield literature related to ST. Identified articles were classified based on the equipment used and in order of how it was developed, i.e., historical, recent developments, and state-of-the-art developments. (3) Conclusions: ST is a reliable cost-effective non-invasive technique that provides an alternative to radiation-based imaging to aid with the diagnosis and potential screening of AIS. Several scanning methods are available, which allows ST to be used in several clinical environments. Limitations of inter-reliability and differences of apparatus resulting in variations of data have been noted through this narrative review.
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Affiliation(s)
- Bhavna Mehta
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke on Trent ST4 2DF, UK; (B.M.); (T.S.); (N.E.); (A.H.); (R.N.)
| | - Nachiappan Chockalingam
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke on Trent ST4 2DF, UK; (B.M.); (T.S.); (N.E.); (A.H.); (R.N.)
| | - Thomas Shannon
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke on Trent ST4 2DF, UK; (B.M.); (T.S.); (N.E.); (A.H.); (R.N.)
| | - Nikola Jevtic
- ScolioCentar, Novisad, 403916 Novi Sad, Serbia; (N.J.); (F.L.)
| | - Filip Lazic
- ScolioCentar, Novisad, 403916 Novi Sad, Serbia; (N.J.); (F.L.)
| | - Vinay Jasani
- Centre for Biomechanics, University Hospitals of North Midlands NHS Trust, Stoke on Trent ST4 6QG, UK;
| | - Nicola Eddison
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke on Trent ST4 2DF, UK; (B.M.); (T.S.); (N.E.); (A.H.); (R.N.)
- Royal Wolverhampton NHS Trust, Wolverhampton WV10 0QP, UK
| | - Aoife Healy
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke on Trent ST4 2DF, UK; (B.M.); (T.S.); (N.E.); (A.H.); (R.N.)
| | - Robert Needham
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke on Trent ST4 2DF, UK; (B.M.); (T.S.); (N.E.); (A.H.); (R.N.)
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Trandzhiev M, Vezirska DI, Maslarski I, Milev MD, Laleva L, Nakov V, Cornelius JF, Spiriev T. Photogrammetry Applied to Neurosurgery: A Literature Review. Cureus 2023; 15:e46251. [PMID: 37908958 PMCID: PMC10614469 DOI: 10.7759/cureus.46251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2023] [Indexed: 11/02/2023] Open
Abstract
Photogrammetry refers to the process of creating 3D models and taking measurements through the use of photographs. Photogrammetry has many applications in neurosurgery, such as creating 3D anatomical models and diagnosing and evaluating head shape and posture deformities. This review aims to summarize the uses of the technique in the neurosurgical practice and showcase the systems and software required for its implementation. A literature review was done in the online database PubMed. Papers were searched using the keywords "photogrammetry", "neurosurgery", "neuroanatomy", "craniosynostosis" and "scoliosis". The identified articles were later put through primary (abstracts and titles) and secondary (full text) screening for eligibility for inclusion. In total, 86 articles were included in the review from 315 papers identified. The review showed that the main uses of photogrammetry in the field of neurosurgery are related to the creation of 3D models of complex neuroanatomical structures and surgical approaches, accompanied by the uses for diagnosis and evaluation of patients with structural deformities of the head and trunk, such as craniosynostosis and scoliosis. Additionally, three instances of photogrammetry applied for more specific aims, namely, cervical spine surgery, skull-base surgery, and radiosurgery, were identified. Information was extracted on the software and systems used to execute the method. With the development of the photogrammetric method, it has become possible to create accurate 3D models of physical objects and analyze images with dedicated software. In the neurosurgical setting, this has translated into the creation of anatomical teaching models and surgical 3D models as well as the evaluation of head and spine deformities. Through those applications, the method has the potential to facilitate the education of residents and medical students and the diagnosis of patient pathologies.
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Affiliation(s)
- Martin Trandzhiev
- Department of Neurosurgery, Acibadem City Clinic University Hospital Tokuda, Sofia, BGR
| | - Donika I Vezirska
- Department of Neurosurgery, Acibadem City Clinic University Hospital Tokuda, Sofia, BGR
| | - Ivan Maslarski
- Department of Anatomy and Histology, Pathology, and Forensic Medicine, University Hospital Lozenetz, Medical Faculty, Sofia University, Sofia, BGR
| | - Milko D Milev
- Department of Neurosurgery, Acibadem City Clinic University Hospital Tokuda, Sofia, BGR
| | - Lili Laleva
- Department of Neurosurgery, Acibadem City Clinic University Hospital Tokuda, Sofia, BGR
| | - Vladimir Nakov
- Department of Neurosurgery, Acibadem City Clinic University Hospital Tokuda, Sofia, BGR
| | - Jan F Cornelius
- Department of Neurosurgery, University Hospital of Düsseldorf, Heinrich Heine University, Düsseldorf, DEU
| | - Toma Spiriev
- Department of Neurosurgery, Acibadem City Clinic University Hospital Tokuda, Sofia, BGR
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San Román Gaitero A, Shoykhet A, Spyrou I, Stoorvogel M, Vermeer L, Schlösser TPC. Imaging Methods to Quantify the Chest and Trunk Deformation in Adolescent Idiopathic Scoliosis: A Literature Review. Healthcare (Basel) 2023; 11:healthcare11101489. [PMID: 37239775 DOI: 10.3390/healthcare11101489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/05/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
Background context: Scoliosis is a three-dimensional deformity of the spine with the most prevalent type being adolescent idiopathic scoliosis (AIS). The rotational spinal deformation leads to displacement and deformation of the ribs, resulting in a deformity of the entire chest. Routine diagnostic imaging is performed in order to define its etiology, measure curve severity and progression during growth, and for treatment planning. To date, all treatment recommendations are based on spinal parameters, while the esthetic concerns and cardiopulmonary symptoms of patients are mostly related to the trunk deformation. For this reason, there is a need for diagnostic imaging of the patho-anatomical changes of the chest and trunk in AIS. Aim: The aim of this review is to provide an overview, as complete as possible, of imaging modalities, methods and image processing techniques for assessment of chest and trunk deformation in AIS. Methods: Here, we present a narrative literature review of (1) image acquisition techniques used in clinical practice, (2) a description of various relevant methods to measure the deformity of the thorax in patients with AIS, and (3) different image processing techniques useful for quantifying 3D chest wall deformity. Results: Various ionizing and non-ionizing imaging modalities are available, but radiography is most widely used for AIS follow-up. A disadvantage is that these images are only acquired in 2D and are not effective for acquiring detailed information on complex 3D chest deformities. While CT is the gold standard 3D imaging technique for assessment of in vivo morphology of osseous structures, it is rarely obtained for surgical planning because of concerns about radiation exposure and increased risk of cancer during later life. Therefore, different modalities with less or without radiation, such as biplanar radiography and MRI are usually preferred. Recently, there have been advances in the field of image processing for measurements of the chest: Anatomical segmentations have become fully automatic and deep learning has been shown to be able to automatically perform measurements and even outperform experts in terms of accuracy. Conclusions: Recent advancements in imaging modalities and image processing techniques make complex 3D evaluation of chest deformation possible. Before introduction into daily clinical practice, however, there is a need for studies correlating image-based chest deformation parameters to patient-reported outcomes, and for technological advancements to make the workflow cost-effective.
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Affiliation(s)
| | - Andrej Shoykhet
- Master's Medical Imaging, Utrecht University, 3584 CS Utrecht, The Netherlands
| | - Iraklis Spyrou
- Master's Medical Imaging, Utrecht University, 3584 CS Utrecht, The Netherlands
| | - Martijn Stoorvogel
- Master's Medical Imaging, Utrecht University, 3584 CS Utrecht, The Netherlands
| | - Lars Vermeer
- Master's Medical Imaging, Utrecht University, 3584 CS Utrecht, The Netherlands
| | - Tom P C Schlösser
- Department of Orthopedic Surgery, University Medical Center Utrecht, G05.228, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
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Ichikawa S, Muto H, Imao M, Nonaka T, Sakekawa K, Sato Y. Low-dose whole-spine imaging using slot-scan digital radiography: a phantom study. BMC Med Imaging 2023; 23:17. [PMID: 36710344 PMCID: PMC9885656 DOI: 10.1186/s12880-023-00971-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 01/16/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Slot-scan digital radiography (SSDR) is equipped with detachable scatter grids and a variable copper filter. In this study, this function was used to obtain parameters for low-dose imaging for whole-spine imaging. METHODS With the scatter grid removed and the beam-hardening (BH) filters (0.0, 0.1, 0.2, or 0.3 mm) inserted, the tube voltage (80, 90, 100, 110, or 120 kV) and the exposure time were adjusted to 20 different parameters that produce equivalent image quality. Slot-scan radiographs of an acrylic phantom were acquired with the set parameters, and the optimal parameters (four types) for each filter were determined using the figure of merit. For the four types of parameters obtained in the previous section, SSDR was performed on whole-spine phantoms by varying the tube current, and the parameter with the lowest radiation dose was determined by visual evaluation. RESULTS The parameters for each filter according to the FOM results were 90 kV, 400 mA, and 2.8 ms for 0.0 mm thickness; 100 kV, 400 mA, and 2.0 ms for 0.1 mm thickness; 100 kV, 400 mA, and 2.8 ms for 0.2 mm thickness; and 110 kV, 400 mA, and 2.2 ms for 0.3 mm thickness. Visual evaluation of the varying tube currents was performed using these four parameters when the BH filter thicknesses were 0.0, 0.1, 0.2, and 0.3 mm. The entrance surface dose was 59.44 µGy at 90 kV, 125 mA, and 2.8 ms; 57.39 µGy at 100 kV, 250 mA, and 2.0 ms; 46.89 µGy at 100 kV, 250 mA, and 2.8 ms; and 39.48 µGy at 110 kV, 250 mA, and 2.2 ms, indicating that the 0.3-mm BH filter was associated with the minimum dose. CONCLUSION Whole-spine SSDR could reduce the dose by 79% while maintaining the image quality.
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Affiliation(s)
- Shigeji Ichikawa
- grid.412879.10000 0004 0374 1074Suzuka University of Medical Science, Graduate School of Health Science Division of Health Science, 1001-1,Kishioka, Suzuka, Mie 510-0293 Japan ,grid.412879.10000 0004 0374 1074Graduate School of Health Science, Suzuka University of Medical Science, 1001-1, Kishioka, Suzuka, Mie 510-0293 Japan
| | - Hiroe Muto
- grid.412879.10000 0004 0374 1074Suzuka University of Medical Science, Graduate School of Health Science Division of Health Science, 1001-1,Kishioka, Suzuka, Mie 510-0293 Japan
| | - Masashi Imao
- Department of Radiology, Faculty of Health Science, Gunma Paz University, 1-7-1 Tonyamachi, Takasaki, Gunma 370-0006 Japan
| | - Takashi Nonaka
- Department of Radiological Technology, Fussa Hospital, 1-6-1 Kamidaira, Fussa-ku, Tokyo, 197-0012 Japan
| | - Kouji Sakekawa
- Department of Radiological Technology, Fussa Hospital, 1-6-1 Kamidaira, Fussa-ku, Tokyo, 197-0012 Japan
| | - Yasutaka Sato
- Department of Radiological Technology, Fussa Hospital, 1-6-1 Kamidaira, Fussa-ku, Tokyo, 197-0012 Japan
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Brage K, Mussmann B, Geijer M, Larsen P, Jensen J. Clinical application of EOS imaging system: a scoping review protocol. JBI Evid Synth 2023; 21:1009-1015. [PMID: 36633464 DOI: 10.11124/jbies-22-00213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE The objective of this scoping review is to examine and map the existing literature on the clinical application of the EOS imaging system and to identify related evidence gaps. INTRODUCTION The EOS imaging system was originally developed to conduct imaging for medical conditions, such as scoliosis and anisomelia. However, recent research suggests that the modality has other clinical uses that may benefit patients via reduced radiation dose and, thus, improve patient safety. INCLUSION CRITERIA This scoping review will consider all quantitative study designs, including systematic reviews and meta-analyses. Imaging phantom studies and conference abstracts will be excluded. METHODS Databases that will be searched include Embase, MEDLINE, CINAHL Complete, Scopus, Cochrane Library, Academic Search Premier, and OpenGrey. Relevant secondary material will be identified using citation searching (backwards and forwards) of included studies through Google Scholar. In addition, we will search by author name where more than 3 included studies from the same first author are identified. Articles published from 2003 in English, Danish, Norwegian, Swedish, French, and German will be included. Two independent reviewers will perform title/abstract screening, followed by full-text screening. Data extraction will include study type and design, age of participants, anatomical/physiological region, pathology, clinical endpoint, outcome measures, sample size, and clinical application. Data will be presented in tabular format and as a narrative summary. REVIEW REGISTRATION NUMBER Open Science Framework https://osf.io/yc85j/.
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Affiliation(s)
- Karen Brage
- Education of Radiography, UCL University College, Odense, Denmark.,Health Sciences Research Centre, UCL University College, Odense, Denmark
| | - Bo Mussmann
- Department of Radiology, Odense University Hospital, Odense, Denmark.,Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.,Research and Innovation Unit of Radiology, University of Southern Denmark, Odense, Denmark
| | - Mats Geijer
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Radiology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Palle Larsen
- Health Sciences Research Centre, UCL University College, Odense, Denmark
| | - Janni Jensen
- Department of Radiology, Odense University Hospital, Odense, Denmark.,Research and Innovation Unit of Radiology, University of Southern Denmark, Odense, Denmark
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Jarrett DY, Ecklund K. EOS Imaging of Scoliosis, Leg Length Discrepancy and Alignment. Semin Roentgenol 2021; 56:228-244. [PMID: 34281677 DOI: 10.1053/j.ro.2021.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Delma Y Jarrett
- Assistant Professor of Clinical Radiology, Department of Radiology, New York-Presbyterian Hospital, Weill Cornell Medicine, New York, NY.
| | - Kirsten Ecklund
- Assistant Professor of Radiology, Pediatric Radiology Division Chief, Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA
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Lai KKL, Lee TTY, Lee MKS, Hui JCH, Zheng YP. Validation of Scolioscan Air-Portable Radiation-Free Three-Dimensional Ultrasound Imaging Assessment System for Scoliosis. SENSORS (BASEL, SWITZERLAND) 2021; 21:2858. [PMID: 33921592 PMCID: PMC8073843 DOI: 10.3390/s21082858] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/12/2021] [Accepted: 04/14/2021] [Indexed: 12/03/2022]
Abstract
To diagnose scoliosis, the standing radiograph with Cobb's method is the gold standard for clinical practice. Recently, three-dimensional (3D) ultrasound imaging, which is radiation-free and inexpensive, has been demonstrated to be reliable for the assessment of scoliosis and validated by several groups. A portable 3D ultrasound system for scoliosis assessment is very much demanded, as it can further extend its potential applications for scoliosis screening, diagnosis, monitoring, treatment outcome measurement, and progress prediction. The aim of this study was to investigate the reliability of a newly developed portable 3D ultrasound imaging system, Scolioscan Air, for scoliosis assessment using coronal images it generated. The system was comprised of a handheld probe and tablet PC linking with a USB cable, and the probe further included a palm-sized ultrasound module together with a low-profile optical spatial sensor. A plastic phantom with three different angle structures built-in was used to evaluate the accuracy of measurement by positioning in 10 different orientations. Then, 19 volunteers with scoliosis (13F and 6M; Age: 13.6 ± 3.2 years) with different severity of scoliosis were assessed. Each subject underwent scanning by a commercially available 3D ultrasound imaging system, Scolioscan, and the portable 3D ultrasound imaging system, with the same posture on the same date. The spinal process angles (SPA) were measured in the coronal images formed by both systems and compared with each other. The angle phantom measurement showed the measured angles well agreed with the designed values, 59.7 ± 2.9 vs. 60 degrees, 40.8 ± 1.9 vs. 40 degrees, and 20.9 ± 2.1 vs. 20 degrees. For the subject tests, results demonstrated that there was a very good agreement between the angles obtained by the two systems, with a strong correlation (R2 = 0.78) for the 29 curves measured. The absolute difference between the two data sets was 2.9 ± 1.8 degrees. In addition, there was a small mean difference of 1.2 degrees, and the differences were symmetrically distributed around the mean difference according to the Bland-Altman test. Scolioscan Air was sufficiently comparable to Scolioscan in scoliosis assessment, overcoming the space limitation of Scolioscan and thus providing wider applications. Further studies involving a larger number of subjects are worthwhile to demonstrate its potential clinical values for the management of scoliosis.
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Affiliation(s)
| | | | | | | | - Yong-Ping Zheng
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong; (K.K.-L.L.); (T.T.-Y.L.); (M.K.-S.L.); (J.C.-H.H.)
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10
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Lyu J, Bi X, Banerjee S, Huang Z, Leung FHF, Lee TTY, Yang DD, Zheng YP, Ling SH. Dual-task ultrasound spine transverse vertebrae segmentation network with contour regularization. Comput Med Imaging Graph 2021; 89:101896. [PMID: 33752079 DOI: 10.1016/j.compmedimag.2021.101896] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 03/03/2021] [Accepted: 03/06/2021] [Indexed: 11/27/2022]
Abstract
3D ultrasound imaging has become one of the common diagnosis ways to assess scoliosis since it is radiation-free, real-time, and low-cost. Spine curvature angle measurement is an important step to assess scoliosis precisely. One way to calculate the angle is using the vertebrae features of the 2-D coronal images to identify the most tilted vertebrae. To do the measurement, the segmentation of the transverse vertebrae is an important step. In this paper, we propose a dual-task ultrasound transverse vertebrae segmentation network (D-TVNet) based on U-Net. First, we arrange an auxiliary shape regularization network to learn the contour segmentation of the bones. It improves the boundary segmentation and anti-interference ability of the U-Net by fusing some of the features of the auxiliary task and the main task. Then, we introduce the atrous spatial pyramid pooling (ASPP) module to the end of the down-sampling stage of the main task stream to improve the relative feature extraction ability. To further improve the boundary segmentation, we extendedly fuse the down-sampling output features of the auxiliary network in the ASPP. The experiment results show that the proposed D-TVNet achieves the best dice score of 86.68% and the mean dice score of 86.17% based on cross-validation, which is an improvement of 5.17% over the baseline U-Net. An automatic ultrasound spine bone segmentation network with promising results has been achieved.
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Affiliation(s)
- Juan Lyu
- College of Information and Communication Engineering, Harbin Engineering University, Harbin, China
| | - Xiaojun Bi
- College of Information and Communication Engineering, Harbin Engineering University, Harbin, China; College of Information Engineering, Minzu University of China, Beijing, China
| | - Sunetra Banerjee
- School of Biomedical Engineering, University of Technology Sydney, Ultimo, NSW 2007, Australia
| | - Zixun Huang
- Department of Electronic and Information Engineering, The Hong Kong Polytechnic University, Hung Hum, Hong Kong
| | - Frank H F Leung
- Department of Electronic and Information Engineering, The Hong Kong Polytechnic University, Hung Hum, Hong Kong
| | - Timothy Tin-Yan Lee
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hung Hum, Hong Kong
| | - De-De Yang
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hung Hum, Hong Kong
| | - Yong-Ping Zheng
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hung Hum, Hong Kong
| | - Sai Ho Ling
- School of Biomedical Engineering, University of Technology Sydney, Ultimo, NSW 2007, Australia.
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Albano D, Messina C, Gambino A, Gurgitano M, Sciabica C, Oliveira Pavan GR, Gitto S, Sconfienza LM. Segmented lordotic angles to assess lumbosacral transitional vertebra on EOS. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2020; 29:2470-2476. [PMID: 32783082 DOI: 10.1007/s00586-020-06565-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 06/29/2020] [Accepted: 08/04/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE To test the vertical posterior vertebral angles (VPVA) of the most caudal lumbar segments measured on EOS to identify and classify the lumbosacral transitional vertebra (LSTV). METHODS We reviewed the EOS examinations of 906 patients to measure the VPVA at the most caudal lumbar segment (cVPVA) and at the immediately proximal segment (pVPVA), with dVPVA being the result of their difference. Mann-Whitney, Chi-square, and ROC curve statistics were used. RESULTS 172/906 patients (19%) had LSTV (112 females, mean age: 43 ± 21 years), and 89/172 had type I LSTV (52%), 42/172 type II (24%), 33/172 type III (19%), and 8/172 type IV (5%). The cVPVA and dVPVA in non-articulated patients were significantly higher than those of patients with LSTV, patients with only accessory articulations, and patients with only bony fusion (all p < .001). The cVPVA and dVPVA in L5 sacralization were significantly higher than in S1 lumbarization (p < .001). The following optimal cutoff was found: cVPVA of 28.2° (AUC = 0.797) and dVPVA of 11.1° (AUC = 0.782) to identify LSTV; cVPVA of 28.2° (AUC = 0.665) and dVPVA of 8° (AUC = 0.718) to identify type II LSTV; cVPVA of 25.5° (AUC = 0.797) and dVPVA of - 7.5° (AUC = 0.831) to identify type III-IV LSTV; cVPVA of 20.4° (AUC = 0.693) and dVPVA of - 1.8° (AUC = 0.665) to differentiate type II from III-IV LSTV; cVPVA of 17.9° (AUC = 0.741) and dVPVA of - 4.5° (AUC = 0.774) to differentiate L5 sacralization from S1 lumbarization. CONCLUSION The cVPVA and dVPVA measured on EOS showed good diagnostic performance to identify LSTV, to correctly classify it, and to differentiate L5 sacralization from S1 lumbarization.
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Affiliation(s)
- Domenico Albano
- IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milano, Italy. .,Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli Studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy.
| | - Carmelo Messina
- IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milano, Italy.,Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Pascal 36, 20133, Milano, Italy
| | - Angelo Gambino
- IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milano, Italy
| | - Martina Gurgitano
- Divisione di Radiologia, IEO Istituto Europeo di Oncologia IRCCS, Via Ripamonti 435, 20141, Milano, Italy
| | - Carmelo Sciabica
- Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli Studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy
| | | | - Salvatore Gitto
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Pascal 36, 20133, Milano, Italy
| | - Luca Maria Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milano, Italy.,Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Pascal 36, 20133, Milano, Italy
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Michalik R, Knod M, Siebers H, Gatz M, Dirrichs T, Eschweiler J, Quack V, Betsch M. Introduction and evaluation of a novel multi-camera surface topography system. Gait Posture 2020; 80:367-373. [PMID: 32619923 DOI: 10.1016/j.gaitpost.2020.06.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 06/10/2020] [Accepted: 06/11/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Surface topography can be used for the evaluation of spinal deformities without any radiation. However, so far this technique is limited to posterior trunk measurements due to the use of a single posterior camera. RESEARCH QUESTION Purpose of this study was to introduce a new multi camera surface topography system and to test its reliability and validity. METHODS The surface topograph uses a two-camera system for imaging and evaluating the subjects front and back simultaneously. Inter- and intra-rater reliability was tested on 40 human subjects by two observers. For validation human, subjects were scanned by MRI and surface-topography. For additional validation we used a phantom with an anthropomorphic body which was scanned by CT and surface topography. RESULTS Inter- (0.97-0.99) and intra-rater reliability (0.81-0.98) testing revealed good and excellent results in the detection of the body surface structures and measurement of areas and volumes. CT based validation revealed good correspondence between systems in the imaging and evaluation of the phantom model (0.61-10.52 %). Results on validation of human subjects revealed good to moderate results in the detection and measurements of almost all body surface structures (1.36-13.34 %). Only measurements using jugular notch as a reference showed moderate results in validity (0.62-27.5%) testing. SIGNIFICANCE We have introduced a novel and innovative surface topography system that allows for simultaneous anterior and posterior trunk measurements. The results of our reliability and validity tests are satisfactory. However, in particular around the jugular notch region further improvements in the surface topography reconstruction are needed.
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Affiliation(s)
- R Michalik
- Department for Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Aachen, Germany..
| | - M Knod
- Department of Orthopaedic Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - H Siebers
- Department of Orthopaedic Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - M Gatz
- Department of Orthopaedic Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - T Dirrichs
- Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Aachen, Germany
| | - J Eschweiler
- Department of Orthopaedic Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - V Quack
- Department of Orthopaedic Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - M Betsch
- Department of Orthopaedic Surgery, University Hospital RWTH Aachen, Aachen, Germany
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