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Semiautomatic superimposition improves radiological assessment of curve flexibility in scoliosis


Farshad-Amacker, Nadja A; Nguyen, T D; Farshad, M; Andreisek, G; Min, K; Frauenfelder, T (2015). Semiautomatic superimposition improves radiological assessment of curve flexibility in scoliosis. European Radiology, 25(3):860-864.

Abstract

OBJECTIVE: Assessment of scoliotic curve flexibility and stiffness is essential for planning surgical treatment in adolescent idiopathic scoliosis (AIS). Measurement of curve flexibility is currently insufficiently precise. The purpose of this study was to introduce and validate a novel method of superimposing radiographs for more reliable measurement of curve flexibility.
MATERIAL AND METHODS: Two independent radiologists measured Cobb angles separately on standard anterior-posterior (AP) (n = 48) and supine bending radiographs (n = 48), in patients with AIS, who were randomly included from a surgical database. The same readers repeated the measurements after the bending radiographs were semi-automatically superimposed on the AP radiographs by fusing the caudad end vertebra. Curve flexibility was calculated. Inter-reader agreement between the two independent readers was calculated using interclass correlation coefficient (ICC).
RESULTS: A moderate inter-reader agreement was achieved in the upper curve (ICC = 0.57) and a good agreement in the lower curve (ICC = 0.72) with the standard method of assessing curve flexibility. With the use of the semiautomatic superimposition, however, almost perfect agreement was achieved for both the upper and the lower curves flexibilities (ICC = 0.93 and 0.97, respectively).
CONCLUSION: The introduced semi-automatic superimposition technique for measurement of scoliotic curve flexibility in AIS is more precise and reliable than the current standard method.
KEY POINTS: • A technique using semiautomatic superimposition of anterior-posterior and bending radiographs is introduced • Almost perfect agreement was achieved for scoliotic curves flexibilities measurements • This method is more precise and reliable than the current standard method.

Abstract

OBJECTIVE: Assessment of scoliotic curve flexibility and stiffness is essential for planning surgical treatment in adolescent idiopathic scoliosis (AIS). Measurement of curve flexibility is currently insufficiently precise. The purpose of this study was to introduce and validate a novel method of superimposing radiographs for more reliable measurement of curve flexibility.
MATERIAL AND METHODS: Two independent radiologists measured Cobb angles separately on standard anterior-posterior (AP) (n = 48) and supine bending radiographs (n = 48), in patients with AIS, who were randomly included from a surgical database. The same readers repeated the measurements after the bending radiographs were semi-automatically superimposed on the AP radiographs by fusing the caudad end vertebra. Curve flexibility was calculated. Inter-reader agreement between the two independent readers was calculated using interclass correlation coefficient (ICC).
RESULTS: A moderate inter-reader agreement was achieved in the upper curve (ICC = 0.57) and a good agreement in the lower curve (ICC = 0.72) with the standard method of assessing curve flexibility. With the use of the semiautomatic superimposition, however, almost perfect agreement was achieved for both the upper and the lower curves flexibilities (ICC = 0.93 and 0.97, respectively).
CONCLUSION: The introduced semi-automatic superimposition technique for measurement of scoliotic curve flexibility in AIS is more precise and reliable than the current standard method.
KEY POINTS: • A technique using semiautomatic superimposition of anterior-posterior and bending radiographs is introduced • Almost perfect agreement was achieved for scoliotic curves flexibilities measurements • This method is more precise and reliable than the current standard method.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Diagnostic and Interventional Radiology
Dewey Decimal Classification:610 Medicine & health
Date:March 2015
Deposited On:01 Oct 2014 14:36
Last Modified:08 Dec 2017 07:17
Publisher:Springer
ISSN:0938-7994
Publisher DOI:https://doi.org/10.1007/s00330-014-3433-1
PubMed ID:25231133

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