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Reliability and accuracy of scoliotic parameters on using a wireless handheld 3D ultrasound for children with adolescent idiopathic scoliosis: a pilot study

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Abstract

Purpose

To report the accuracy and reliability of Cobb angle (CA), axial vertebral rotation (AVR), kyphotic and lordotic angles (KA and LA) measurements on using a new 3D ultrasound (US) system.

Methods

Forty participants (34 F, 6 M, aged 14.0 ± 2.3 years) were recruited. The first 20 participants were scanned by the validated US system and the new US system. The other 20 participants were scanned with the new US system only. Two raters (R1 and R2) performed the measurements: R1 has 10 years of experience in radiology but is new in ultrasound scoliosis, while R2 has 30 years of scoliosis experience. All US images were measured twice by R1, and once by R2. Forty posteroanterior and 30 lateral standing radiographs were obtained and measured once by R1. Statistical analysis consisted of mean absolute difference (MAD), intraclass correlation coefficient (ICC (2,1)), and Bland-Altman plots.

Results

R1 showed excellent intra-rater and inter-rater reliability for US measurements with ICCs(2,1) ≥ 0.91. The inter-method reliability was good between the two US systems for all parameters with ICCs(2,1) ≥ 0.85 and maximum MAD of 3.4°. The new US showed good reliability and accuracy compared to radiographs for CA, AVR and KA with ICCs(2,1) ≥ 0.81 and maximum MAD of 5.8°, but poor results for LA with ICCs(2,1) of 0.27–0.35 and MADs of 14.0°-15.4°.

Conclusion

The new 3D US system showed good reliability and accuracy for CA, AVR and KA measurements, but a large measurement discrepancy on LA. A new measurement method for US LA may need to investigate.

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Data availability

Data will be available upon request.

Code Availability

Not applicable.

Abbreviations

3D:

Three-dimensional

AIS:

Adolescent Idiopathic Scoliosis

AVR:

Axial Vertebral Rotation

CA:

Cobb Angle

CI:

Confidence Interval

COL:

Center of Lamina

ICC:

Intra-class Correlation Coefficient

KA:

Kyphotic Angle

LA:

Lordotic Angle

LOA:

Limit of Agreement

MAD:

Mean Absolute Difference

R1:

Rater 1

R2:

Rater 2

SD:

Standard Deviation

SP:

Spinous Process

US:

Ultrasound

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Acknowledgements

The authors would like to thank the financial support from the Alberta Innovates and the Alberta Orthopaedic Society. We would like to thank the participants for their time and contribution to our study.

Funding

This study was supported by the Alberta Innovates and the Alberta Orthopaedic Society.

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Authors and Affiliations

  1. University of Alberta, Edmonton, AB, T6G 2R3, Canada

    Thi N.N. Nguyen, Lawrence H. Le, Derek J. Emery, Kyle Stampe & Edmond Lou

  2. Alberta Health Services, Edmonton, AB, T5G 0B7, Canada

    Sarah Hryniuk Southon

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  1. Thi N.N. Nguyen
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Correspondence to Edmond Lou.

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Ethics approval was granted by the University of Alberta Health Research Ethics Board (Pro00005707).

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Nguyen, T.N., Le, L.H., Emery, D.J. et al. Reliability and accuracy of scoliotic parameters on using a wireless handheld 3D ultrasound for children with adolescent idiopathic scoliosis: a pilot study. Eur Spine J (2024). https://doi.org/10.1007/s00586-024-08445-w

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