Development of a model for measuring sagittal plane parameters in 10-18-year old adolescents with idiopathic scoliosis based on RTMpose deep learning technology.

PURPOSE

The study aimed to develop a deep learning model for rapid, automated measurement of full-spine X-rays in adolescents with Adolescent Idiopathic Scoliosis (AIS). A significant challenge in this field is the time-consuming nature of manual measurements and the inter-individual variability in these measurements. To address these challenges, we utilized RTMpose deep learning technology to automate the process.

METHODS

We conducted a retrospective multicenter diagnostic study using 560 full-spine sagittal plane X-ray images from five hospitals in Inner Mongolia. The model was trained and validated using 500 images, with an additional 60 images for independent external validation. We evaluated the consistency of keypoint annotations among different physicians, the accuracy of model-predicted keypoints, and the accuracy of model measurement results compared to manual measurements.

RESULTS

The consistency percentages of keypoint annotations among different physicians and the model were 90-97% within the 4-mm range. The model's prediction accuracies for key points were 91-100% within the 4-mm range compared to the reference standards. The model's predictions for 15 anatomical parameters showed high consistency with experienced physicians, with intraclass correlation coefficients ranging from 0.892 to 0.991. The mean absolute error for SVA was 1.16 mm, and for other parameters, it ranged from 0.22° to 3.32°. A significant challenge we faced was the variability in data formats and specifications across different hospitals, which we addressed through data augmentation techniques. The model took an average of 9.27 s to automatically measure the 15 anatomical parameters per X-ray image.

CONCLUSION

The deep learning model based on RTMpose can effectively enhance clinical efficiency by automatically measuring the sagittal plane parameters of the spine in X-rays of patients with AIS. The model's performance was found to be highly consistent with manual measurements by experienced physicians, offering a valuable tool for clinical diagnostics.