Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong.
Sensors (Basel). 2021 Apr 19;21(8):2858. doi: 10.3390/s21082858.
To diagnose scoliosis, the standing radiograph with Cobb's method is the gold standard for clinical practice. Recently, three-dimensional (3D) ultrasound imaging, which is radiation-free and inexpensive, has been demonstrated to be reliable for the assessment of scoliosis and validated by several groups. A portable 3D ultrasound system for scoliosis assessment is very much demanded, as it can further extend its potential applications for scoliosis screening, diagnosis, monitoring, treatment outcome measurement, and progress prediction. The aim of this study was to investigate the reliability of a newly developed portable 3D ultrasound imaging system, Scolioscan Air, for scoliosis assessment using coronal images it generated. The system was comprised of a handheld probe and tablet PC linking with a USB cable, and the probe further included a palm-sized ultrasound module together with a low-profile optical spatial sensor. A plastic phantom with three different angle structures built-in was used to evaluate the accuracy of measurement by positioning in 10 different orientations. Then, 19 volunteers with scoliosis (13F and 6M; Age: 13.6 ± 3.2 years) with different severity of scoliosis were assessed. Each subject underwent scanning by a commercially available 3D ultrasound imaging system, Scolioscan, and the portable 3D ultrasound imaging system, with the same posture on the same date. The spinal process angles (SPA) were measured in the coronal images formed by both systems and compared with each other. The angle phantom measurement showed the measured angles well agreed with the designed values, 59.7 ± 2.9 vs. 60 degrees, 40.8 ± 1.9 vs. 40 degrees, and 20.9 ± 2.1 vs. 20 degrees. For the subject tests, results demonstrated that there was a very good agreement between the angles obtained by the two systems, with a strong correlation (R = 0.78) for the 29 curves measured. The absolute difference between the two data sets was 2.9 ± 1.8 degrees. In addition, there was a small mean difference of 1.2 degrees, and the differences were symmetrically distributed around the mean difference according to the Bland-Altman test. Scolioscan Air was sufficiently comparable to Scolioscan in scoliosis assessment, overcoming the space limitation of Scolioscan and thus providing wider applications. Further studies involving a larger number of subjects are worthwhile to demonstrate its potential clinical values for the management of scoliosis.
为了诊断脊柱侧凸，Cobb 法的站立位 X 光片是临床实践的金标准。最近，一种无辐射且价格低廉的三维（3D）超声成像技术已被证明可用于评估脊柱侧凸，并得到了多个研究组的验证。便携式 3D 超声系统非常需要用于脊柱侧凸评估，因为它可以进一步扩展其在脊柱侧凸筛查、诊断、监测、治疗效果测量和进展预测方面的潜在应用。本研究旨在探讨一种新开发的便携式 3D 超声成像系统 Scolioscan Air 用于评估冠状图像的可靠性。该系统由手持探头和连接 USB 电缆的平板电脑组成，探头还包括一个手掌大小的超声模块和一个低轮廓光学空间传感器。使用内置三个不同角度结构的塑料体模来评估通过在 10 个不同位置定位进行测量的准确性。然后，对 19 名患有脊柱侧凸的志愿者（13 名女性和 6 名男性；年龄：13.6±3.2 岁）进行评估。每位受试者均在同一天以相同的姿势接受商用 3D 超声成像系统 Scolioscan 和便携式 3D 超声成像系统的扫描。在这两个系统形成的冠状图像中测量脊柱侧凸角度（SPA）并相互比较。角度体模测量结果表明，测量角度与设计值非常吻合，分别为 59.7±2.9°和 60°，40.8±1.9°和 40°，20.9±2.1°和 20°。对于受试者测试，结果表明两个系统获得的角度之间具有很好的一致性，29 个曲线的相关性很强（R=0.78）。两个数据集之间的绝对差值为 2.9±1.8°。此外，根据 Bland-Altman 检验，平均差值为 1.2°，差值对称分布在平均差值周围。Scolioscan Air 在脊柱侧凸评估方面与 Scolioscan 足够可比，克服了 Scolioscan 的空间限制，从而提供了更广泛的应用。进一步涉及更多受试者的研究将有助于证明其在脊柱侧凸管理方面的潜在临床价值。
