Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
Shenzhen Yi-Yuan Intelligence Co., Ltd, Shenzhen, 518064, China.
Eur Spine J. 2019 Dec;28(12):3035-3043. doi: 10.1007/s00586-019-06115-w. Epub 2019 Aug 24.
To automatically measure the Cobb angle and diagnose scoliosis on chest X-rays, a computer-aided method was proposed and the reliability and accuracy were evaluated.
Two Mask R-CNN models as the core of a computer-aided method were used to separately detect and segment the spine and all vertebral bodies on chest X-rays, and the Cobb angle of the spinal curve was measured from the output of the Mask R-CNN models. To evaluate the reliability and accuracy of the computer-aided method, the Cobb angles on 248 chest X-rays from lung cancer screening were measured automatically using a computer-aided method, and two experienced radiologists used a manual method to separately measure Cobb angles on the aforementioned chest X-rays.
For manual measurement of the Cobb angle on chest X-rays, the intraclass correlation coefficients (ICC) of intra- and inter-observer reliability analysis was 0.941 and 0.887, respectively, and the mean absolute differences were < 3.5°. The ICC between the computer-aided and manual methods for Cobb angle measurement was 0.854, and the mean absolute difference was 3.32°. These results indicated that the computer-aided method had good reliability for Cobb angle measurement on chest X-rays. Using the mean value of Cobb angles in manual measurements > 10° as a reference standard for scoliosis, the computer-aided method achieved a high level of sensitivity (89.59%) and a relatively low level of specificity (70.37%) for diagnosing scoliosis on chest X-rays.
The computer-aided method has potential for automatic Cobb angle measurement and scoliosis diagnosis on chest X-rays. These slides can be retrieved under Electronic Supplementary Material.
为了自动测量 X 光胸片上的 Cobb 角并诊断脊柱侧凸，提出了一种计算机辅助方法，并对其可靠性和准确性进行了评估。
使用两个 Mask R-CNN 模型作为计算机辅助方法的核心，分别用于检测和分割 X 光胸片上的脊柱和所有椎体，并从 Mask R-CNN 模型的输出中测量脊柱曲线的 Cobb 角。为了评估计算机辅助方法的可靠性和准确性，使用计算机辅助方法自动测量 248 张来自肺癌筛查的 X 光胸片的 Cobb 角，并且两位有经验的放射科医生使用手动方法分别测量上述 X 光胸片的 Cobb 角。
对于手动测量 X 光胸片上的 Cobb 角，观察者内和观察者间可靠性分析的组内相关系数（ICC）分别为 0.941 和 0.887，平均绝对差异<3.5°。计算机辅助方法和手动方法测量 Cobb 角的 ICC 为 0.854，平均绝对差异为 3.32°。这些结果表明，计算机辅助方法对 X 光胸片 Cobb 角测量具有良好的可靠性。使用手动测量 Cobb 角的平均值>10°作为脊柱侧凸的参考标准，计算机辅助方法对 X 光胸片上的脊柱侧凸诊断具有较高的灵敏度（89.59%）和相对较低的特异性（70.37%）。
计算机辅助方法具有自动测量 X 光胸片 Cobb 角和诊断脊柱侧凸的潜力。这些幻灯片可以在电子补充材料中检索到。
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