Using Ultrasound for Quantitative Assessment of Scoliosis to Reduce Radiation Exposure: A Detailed Analysis of 952 Patients using EOS Radiography as Gold Standard
Refereed conference paper presented and published in conference proceedings


Repeated radiography poses health concerns for adolescent idiopathic scoliosis (AIS) subjects. Although radiation-free ultrasound was developed for measuring spinal curvatures with promising results reported, its accuracy with respect to curve severity, curve apical levels, genders, BMI, ages and heights remains undefined.

This prospective diagnostic accuracy study involved 952 AIS patients (75.7% female, mean age 16.7±3.0). Coronal Cobb angles (E_Cobb) were measured on standing posteroanterior EOS radiographs. Predicted_Cobb for predicting E_Cobb was calculated from Spinous Process Angle (SPA) obtained with automatic algorithm on volume projection images from ultrasound scanning of the spine. Intra-class correlation, linear regression, cross-tabulation, and Bland-Altman plot were used for analysis.

Inter-rater reliability was 0.949 for E_Cobb and 0.838 for SPA measurement respectively. 1625 structural curves were identified (E_Cobb 28.7±11.6°). Among 1432 curves (88.1%) detected by ultrasound, E_Cobb and SPA were significantly correlated (r=0.816, p<0.001). Correlation was stronger for upper spinal curves (USC, r=0.873, apices T7 to T12.5) and lower spinal curves (LSC, r=0.740, apices L1 or below) than upper thoracic curves (UTC, r=0.629, apices T6.5 or above) (all p<0.001). Taller stature was associated with stronger correlation. For E_Cobb<30°, 66.6% USC and 62.4% LSC had absolute differences between E_Cobb and Predicted_Cobb ≤5°. Predicted_Cobb underestimated E_Cobb by >5° in 6.0% USC and 7.2% LSC. Among 190 ultrasound false-negative curves (11.7%), 187 (96.9%) were UTC or with end-vertebra tilt angle<10°.

Ultrasound could be a viable option in lieu of conventional radiography for measuring coronal curves with apices at T7 or lower and Cobb angle<30°.
著者Yi-shun WONG, Kelly Ka-lee LAI, Yong-ping ZHENG, Lyn Lee-ning WONG, Bobby Kin-wah NG, Alec Lik-hang HUNG, Benjamin Hon-kei YIP, Winnie Chiu-wing CHU, Alex Wing-hung NG, Yong QIU, Jack Chun-yiu CHENG, Tsz-ping LAM
會議名稱Hong Kong Orthopaedic Association 38th Annual Congress 2018 (HKOA 2018)
會議地點Hong Kong
會議論文集題名The Proceedings of Hong Kong Orthopaedic Association 38th Annual Congress 2018 (HKOA 2018)
出版地Hong Kong
頁次92 - 92

上次更新時間 2019-17-06 於 15:23