Cargando…
A reliability and validity study for Scolioscan: a radiation-free scoliosis assessment system using 3D ultrasound imaging
BACKGROUND: Radiographic evaluation for patients with scoliosis using Cobb method is the current gold standard, but radiography has radiation hazards. Several groups have recently demonstrated the feasibility of using 3D ultrasound for the evaluation of scoliosis. Ultrasound imaging is radiation-fre...
Autores principales: | , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2016
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4900244/ https://www.ncbi.nlm.nih.gov/pubmed/27299162 http://dx.doi.org/10.1186/s13013-016-0074-y |
_version_ | 1782436603610791936 |
---|---|
author | Zheng, Yong-Ping Lee, Timothy Tin-Yan Lai, Kelly Ka-Lee Yip, Benjamin Hon-Kei Zhou, Guang-Quan Jiang, Wei-Wei Cheung, James Chung-Wai Wong, Man-Sang Ng, Bobby King-Wah Cheng, Jack Chun-Yiu Lam, Tsz-Ping |
author_facet | Zheng, Yong-Ping Lee, Timothy Tin-Yan Lai, Kelly Ka-Lee Yip, Benjamin Hon-Kei Zhou, Guang-Quan Jiang, Wei-Wei Cheung, James Chung-Wai Wong, Man-Sang Ng, Bobby King-Wah Cheng, Jack Chun-Yiu Lam, Tsz-Ping |
author_sort | Zheng, Yong-Ping |
collection | PubMed |
description | BACKGROUND: Radiographic evaluation for patients with scoliosis using Cobb method is the current gold standard, but radiography has radiation hazards. Several groups have recently demonstrated the feasibility of using 3D ultrasound for the evaluation of scoliosis. Ultrasound imaging is radiation-free, comparatively more accessible, and inexpensive. However, a reliable and valid 3D ultrasound system ready for clinical scoliosis assessment has not yet been reported. Scolioscan is a newly developed system targeted for scoliosis assessment in clinics by using coronal images of spine generated by a 3D ultrasound volume projection imaging method. The aim of this study is to test the reliability of spine deformity measurement of Scolioscan and its validity compared to the gold standard Cobb angle measurements from radiography in adolescent idiopathic scoliosis (AIS) patients. METHODS: Prospective study divided into two stages: 1) Investigation of intra- and inter- reliability between two operators for acquiring images using Scolioscan and among three raters for measuring spinal curves from those images; 2) Correlation between the Cobb angle obtained from radiography by a medical doctor and the spine curve angle obtained using Scolioscan (Scolioscan angle). The raters for ultrasound images and the doctors for evaluating radiographic images were mutually blinded. The two stages of tests involved 20 (80 % females, total of 26 angles, age of 16.4 ± 2.7 years, and Cobb angle of 27.6 ± 11.8°) and 49 (69 % female, 73 angles, 15.8 ± 2.7 years and 24.8 ± 9.7°) AIS patients, respectively. Intra-class correlation coefficients (ICC) and Bland-Altman plots and root-mean-square differences (RMS) were employed to determine correlations, which interpreted based on defined criteria. RESULTS: We demonstrated a very good intra-rater and intra-operator reliability for Scolioscan angle measurement with ICC larger than 0.94 and 0.88, respectively. Very good inter-rater and inter-operator reliability was also demonstrated, with both ICC larger than 0.87. For the thoracic deformity measurement, the RMS were 2.5 and 3.3° in the intra- and inter-operator tests, and 1.5 and 3.6° in the intra- and inter-rater tests, respectively. The RMS differences were 3.1, 3.1, 1.6, 3.7° in the intra- and inter-operator and intra- and inter-rater tests, respectively, for the lumbar angle measurement. Moderate to strong correlations (R(2) > 0.72) were observed between the Scolioscan angles and Cobb angles for both the thoracic and lumbar regions. It was noted that the Scolioscan angle slightly underestimated the spinal deformity in comparison with Cobb angle, and an overall regression equation y = 1.1797x (R(2) = 0.76) could be used to translate the Scolioscan angle (x) to Cobb angle (y) for this group of patients. The RMS difference between Scolioscan angle and Cobb angle was 4.7 and 6.2°, with and without the correlation using the overall regression equation. CONCLUSIONS: We showed that Scolioscan is reliable for measuring coronal deformity for patients with AIS and appears promising in screening large numbers of patients, for progress monitoring, and evaluation of treatment outcomes. Due to it being radiation-free and relatively low-cost, Scolioscan has potential to be widely implemented and may contribute to reducing radiation dose during serial monitoring. |
format | Online Article Text |
id | pubmed-4900244 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-49002442016-06-13 A reliability and validity study for Scolioscan: a radiation-free scoliosis assessment system using 3D ultrasound imaging Zheng, Yong-Ping Lee, Timothy Tin-Yan Lai, Kelly Ka-Lee Yip, Benjamin Hon-Kei Zhou, Guang-Quan Jiang, Wei-Wei Cheung, James Chung-Wai Wong, Man-Sang Ng, Bobby King-Wah Cheng, Jack Chun-Yiu Lam, Tsz-Ping Scoliosis Spinal Disord Research BACKGROUND: Radiographic evaluation for patients with scoliosis using Cobb method is the current gold standard, but radiography has radiation hazards. Several groups have recently demonstrated the feasibility of using 3D ultrasound for the evaluation of scoliosis. Ultrasound imaging is radiation-free, comparatively more accessible, and inexpensive. However, a reliable and valid 3D ultrasound system ready for clinical scoliosis assessment has not yet been reported. Scolioscan is a newly developed system targeted for scoliosis assessment in clinics by using coronal images of spine generated by a 3D ultrasound volume projection imaging method. The aim of this study is to test the reliability of spine deformity measurement of Scolioscan and its validity compared to the gold standard Cobb angle measurements from radiography in adolescent idiopathic scoliosis (AIS) patients. METHODS: Prospective study divided into two stages: 1) Investigation of intra- and inter- reliability between two operators for acquiring images using Scolioscan and among three raters for measuring spinal curves from those images; 2) Correlation between the Cobb angle obtained from radiography by a medical doctor and the spine curve angle obtained using Scolioscan (Scolioscan angle). The raters for ultrasound images and the doctors for evaluating radiographic images were mutually blinded. The two stages of tests involved 20 (80 % females, total of 26 angles, age of 16.4 ± 2.7 years, and Cobb angle of 27.6 ± 11.8°) and 49 (69 % female, 73 angles, 15.8 ± 2.7 years and 24.8 ± 9.7°) AIS patients, respectively. Intra-class correlation coefficients (ICC) and Bland-Altman plots and root-mean-square differences (RMS) were employed to determine correlations, which interpreted based on defined criteria. RESULTS: We demonstrated a very good intra-rater and intra-operator reliability for Scolioscan angle measurement with ICC larger than 0.94 and 0.88, respectively. Very good inter-rater and inter-operator reliability was also demonstrated, with both ICC larger than 0.87. For the thoracic deformity measurement, the RMS were 2.5 and 3.3° in the intra- and inter-operator tests, and 1.5 and 3.6° in the intra- and inter-rater tests, respectively. The RMS differences were 3.1, 3.1, 1.6, 3.7° in the intra- and inter-operator and intra- and inter-rater tests, respectively, for the lumbar angle measurement. Moderate to strong correlations (R(2) > 0.72) were observed between the Scolioscan angles and Cobb angles for both the thoracic and lumbar regions. It was noted that the Scolioscan angle slightly underestimated the spinal deformity in comparison with Cobb angle, and an overall regression equation y = 1.1797x (R(2) = 0.76) could be used to translate the Scolioscan angle (x) to Cobb angle (y) for this group of patients. The RMS difference between Scolioscan angle and Cobb angle was 4.7 and 6.2°, with and without the correlation using the overall regression equation. CONCLUSIONS: We showed that Scolioscan is reliable for measuring coronal deformity for patients with AIS and appears promising in screening large numbers of patients, for progress monitoring, and evaluation of treatment outcomes. Due to it being radiation-free and relatively low-cost, Scolioscan has potential to be widely implemented and may contribute to reducing radiation dose during serial monitoring. BioMed Central 2016-05-31 /pmc/articles/PMC4900244/ /pubmed/27299162 http://dx.doi.org/10.1186/s13013-016-0074-y Text en © Zheng et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Zheng, Yong-Ping Lee, Timothy Tin-Yan Lai, Kelly Ka-Lee Yip, Benjamin Hon-Kei Zhou, Guang-Quan Jiang, Wei-Wei Cheung, James Chung-Wai Wong, Man-Sang Ng, Bobby King-Wah Cheng, Jack Chun-Yiu Lam, Tsz-Ping A reliability and validity study for Scolioscan: a radiation-free scoliosis assessment system using 3D ultrasound imaging |
title | A reliability and validity study for Scolioscan: a radiation-free scoliosis assessment system using 3D ultrasound imaging |
title_full | A reliability and validity study for Scolioscan: a radiation-free scoliosis assessment system using 3D ultrasound imaging |
title_fullStr | A reliability and validity study for Scolioscan: a radiation-free scoliosis assessment system using 3D ultrasound imaging |
title_full_unstemmed | A reliability and validity study for Scolioscan: a radiation-free scoliosis assessment system using 3D ultrasound imaging |
title_short | A reliability and validity study for Scolioscan: a radiation-free scoliosis assessment system using 3D ultrasound imaging |
title_sort | reliability and validity study for scolioscan: a radiation-free scoliosis assessment system using 3d ultrasound imaging |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4900244/ https://www.ncbi.nlm.nih.gov/pubmed/27299162 http://dx.doi.org/10.1186/s13013-016-0074-y |
work_keys_str_mv | AT zhengyongping areliabilityandvaliditystudyforscolioscanaradiationfreescoliosisassessmentsystemusing3dultrasoundimaging AT leetimothytinyan areliabilityandvaliditystudyforscolioscanaradiationfreescoliosisassessmentsystemusing3dultrasoundimaging AT laikellykalee areliabilityandvaliditystudyforscolioscanaradiationfreescoliosisassessmentsystemusing3dultrasoundimaging AT yipbenjaminhonkei areliabilityandvaliditystudyforscolioscanaradiationfreescoliosisassessmentsystemusing3dultrasoundimaging AT zhouguangquan areliabilityandvaliditystudyforscolioscanaradiationfreescoliosisassessmentsystemusing3dultrasoundimaging AT jiangweiwei areliabilityandvaliditystudyforscolioscanaradiationfreescoliosisassessmentsystemusing3dultrasoundimaging AT cheungjameschungwai areliabilityandvaliditystudyforscolioscanaradiationfreescoliosisassessmentsystemusing3dultrasoundimaging AT wongmansang areliabilityandvaliditystudyforscolioscanaradiationfreescoliosisassessmentsystemusing3dultrasoundimaging AT ngbobbykingwah areliabilityandvaliditystudyforscolioscanaradiationfreescoliosisassessmentsystemusing3dultrasoundimaging AT chengjackchunyiu areliabilityandvaliditystudyforscolioscanaradiationfreescoliosisassessmentsystemusing3dultrasoundimaging AT lamtszping areliabilityandvaliditystudyforscolioscanaradiationfreescoliosisassessmentsystemusing3dultrasoundimaging AT zhengyongping reliabilityandvaliditystudyforscolioscanaradiationfreescoliosisassessmentsystemusing3dultrasoundimaging AT leetimothytinyan reliabilityandvaliditystudyforscolioscanaradiationfreescoliosisassessmentsystemusing3dultrasoundimaging AT laikellykalee reliabilityandvaliditystudyforscolioscanaradiationfreescoliosisassessmentsystemusing3dultrasoundimaging AT yipbenjaminhonkei reliabilityandvaliditystudyforscolioscanaradiationfreescoliosisassessmentsystemusing3dultrasoundimaging AT zhouguangquan reliabilityandvaliditystudyforscolioscanaradiationfreescoliosisassessmentsystemusing3dultrasoundimaging AT jiangweiwei reliabilityandvaliditystudyforscolioscanaradiationfreescoliosisassessmentsystemusing3dultrasoundimaging AT cheungjameschungwai reliabilityandvaliditystudyforscolioscanaradiationfreescoliosisassessmentsystemusing3dultrasoundimaging AT wongmansang reliabilityandvaliditystudyforscolioscanaradiationfreescoliosisassessmentsystemusing3dultrasoundimaging AT ngbobbykingwah reliabilityandvaliditystudyforscolioscanaradiationfreescoliosisassessmentsystemusing3dultrasoundimaging AT chengjackchunyiu reliabilityandvaliditystudyforscolioscanaradiationfreescoliosisassessmentsystemusing3dultrasoundimaging AT lamtszping reliabilityandvaliditystudyforscolioscanaradiationfreescoliosisassessmentsystemusing3dultrasoundimaging |