Boché André, Tabard-Fougère Anne, Bazin Ludmilla, Severyns Mathieu, Dayer Romain, Vendeuvre Tanguy
CHU de Poitiers, Service d'Orthopédie-Traumatologie, Poitiers, France.
Pediatric Orthopedics Unit, Pediatric Surgery Service, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
Front Bioeng Biotechnol. 2025 Aug 29;13:1629872. doi: 10.3389/fbioe.2025.1629872. eCollection 2025.
The close monitoring of the adolescent idiopathic scoliosis (AIS) population during the growing years is necessary and requires repetitive X-rays. This study aimed to evaluate the validity and test characteristics of the time-of-flight (TOF) camera, a novel radiation-free tool, for assessing trunk asymmetry in patients with AIS.
In this prospective diagnostic accuracy study, 94 AIS patients (10-18 years) underwent standardized TOF camera imaging (seated position). Among them, 81 also received an angle of trunk rotation (ATR) assessment using a scoliometer (forward-bending position). The average major Cobb angle (CA) in the cohort was 21.4°. The global trunk asymmetry (GTA) provided by the TOF camera and the scoliometer-based ATR were compared with the gold-standard major Cobb angle from 2D radiography (standing position) using Pearson correlation. Receiver operating characteristic (ROC) analysis evaluated the diagnostic accuracy of GTA for AIS diagnosis (CA > 10°) and brace indication (CA > 20°). Sensitivity (Se), specificity (Sp), and area under the curve (AUC) values were reported and compared for GTA and ATR.
GTA was significantly correlated with the radiographic CA (p < 0.001). For scoliosis diagnosis (CA ≥ 10°), the AUC was 0.87 (0.79-0.96) for GTA (threshold = 7°, Se = 80%, and Sp = 80%) and 0.95 (0.9-1.0) for ATR. The AUC values of GTA and ATR were not significantly different ( = 0.129), but sensitivity was significantly lower for GTA (76%) than for ATR (91%). For brace indication (CA ≥ 20°), the AUC was 0.92 (0.86-0.97) for GTA (threshold = 7.87, Se = 93%, and Sp = 76%).
The TOF camera appears to offer promising test characteristics for AIS diagnosis, with a high correlation to radiographic CA and competitive diagnostic accuracy using a scoliometer. Although the seated positioning differs from standard radiographs, this approach enhances reproducibility and patient compliance. The high sensitivity and specificity of the TOF camera for scoliosis diagnosis highlight its potential as a safe, fast, and reliable alternative to X-ray imaging in routine clinical settings. Further investigations (assessing solid screening characteristics and inter- and intra-individual repeatability and validity) are needed before it can replace repetitive radiographs for monitoring AIS progression in growing patients.
在青少年生长发育阶段对特发性脊柱侧弯（AIS）患者进行密切监测是必要的，且需要反复进行X线检查。本研究旨在评估飞行时间（TOF）相机这一新型无辐射工具在评估AIS患者躯干不对称性方面的有效性和测试特性。
在这项前瞻性诊断准确性研究中，94例年龄在10 - 18岁的AIS患者接受了标准化的TOF相机成像（坐姿）。其中，81例患者还使用脊柱侧凸测量仪（前屈位）进行了躯干旋转角度（ATR）评估。该队列中平均主 Cobb 角（CA）为21.4°。使用Pearson相关性分析，将TOF相机提供的整体躯干不对称性（GTA）和基于脊柱侧凸测量仪的ATR与二维X线摄影（站立位）的金标准主 Cobb 角进行比较。采用受试者操作特征（ROC）分析评估GTA对AIS诊断（CA > 10°）和支具适应证（CA > 20°）的诊断准确性。报告并比较GTA和ATR的敏感性（Se）、特异性（Sp）和曲线下面积（AUC）值。
GTA与X线片上的CA显著相关（p < 0.001）。对于脊柱侧弯诊断（CA≥10°），GTA的AUC为0.87（0.79 - 0.96）（阈值 = 7°，Se = 80%，Sp = 80%），ATR的AUC为0.95（0.9 - 1.0）。GTA和ATR的AUC值无显著差异（ = 0.129），但GTA的敏感性（76%）显著低于ATR（91%）。对于支具适应证（CA≥20°），GTA的AUC为0.92（0.86 - 0.97）（阈值 = 7.87，Se = 93%，Sp = 76%）。
TOF相机在AIS诊断方面似乎具有良好的测试特性，与X线片上的CA高度相关，且与使用脊柱侧凸测量仪的诊断准确性相当。尽管坐姿与标准X线片不同，但这种方法提高了可重复性和患者依从性。TOF相机在脊柱侧弯诊断方面的高敏感性和特异性突出了其在常规临床环境中作为X线成像安全、快速且可靠替代方法的潜力。在其能够替代反复的X线检查用于监测生长中患者的AIS进展之前，还需要进一步研究（评估可靠的筛查特性以及个体间和个体内的重复性和有效性）。
