Computer-Aided Cobb Measurement Based on Automatic Detection of Vertebral Slopes Using Deep Neural Network

OBJECTIVE: To develop a computer-aided method that reduces the variability of Cobb angle measurement for scoliosis assessment. METHODS: A deep neural network (DNN) was trained with vertebral patches extracted from spinal model radiographs. The Cobb angle of the spinal curve was calculated automatically from the vertebral slopes predicted by the DNN. Sixty-five in vivo radiographs and 40 model radiographs were analyzed. An experienced surgeon performed manual measurements on the aforementioned radiographs. Two examiners used both the proposed and the manual measurement methods to analyze the aforementioned radiographs. RESULTS: For model radiographs, the intraclass correlation coefficients were greater than 0.98, and the mean absolute differences were less than 3°. This indicates that the proposed system showed high repeatability for measurements of model radiographs. For the in vivo radiographs, the reliabilities were lower than those from the model radiographs, and the differences between the computer-aided measurement and the manual measurement by the surgeon were higher than 5°. CONCLUSION: The variability of Cobb angle measurements can be reduced if the DNN system is trained with enough vertebral patches. Training data of in vivo radiographs must be included to improve the performance of DNN. SIGNIFICANCE: Vertebral slopes can be predicted by DNN. The computer-aided system can be used to perform automatic measurements of Cobb angle, which is used to make reliable and objective assessments of scoliosis.