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Intra- and Inter-rater Reliability of Coronal Curvature Measurement for Adolescent Idiopathic Scoliosis Using Ultrasonic Imaging Method—A Pilot Study

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Abstract

Study Design

Retrospective reliability study of the coronal curvature measurement on ultrasound (US) imaging in adolescent idiopathic scoliosis (AIS).

Objectives

To determine the intra- and inter-rater reliability and validity of the coronal curvature measurements obtained from US images.

Summary of Background Data

Cobb angle measurements on radiographs are the usual method to diagnose and monitor the progression of scoliosis. Repeated ionizing radiation exposure is a frequent concern of patients and their families. Use of US imaging method to measure coronal curvature in children who have idiopathic scoliosis has not been clinically validated.

Methods

The researchers scanned 26 subjects using a medical 3-dimensional US system. Spinal radiographs were obtained on the same day from the local scoliosis clinic. Three raters used the center of lamina method to measure the coronal curvature on the US images twice 1 week apart. The raters also measured the Cobb angle on the radiographs twice. Intra- and inter-rater reliability of the coronal curvature measurement from the US images was analyzed using intra-class correlation coefficients. The correlation coefficient of the US coronal curvature measurements was compared with the Cobb angles.

Results

The intra-class correlation coefficient (2,1) values of intra- and inter-rater reliability on the US method were greater than 0.80. Standard error of measurement on both of the intra- and inter-rater US methods was less than 2.8°. The correlation coefficient between the US and radiographic methods ranged between 0.78 and 0.84 among 3 raters.

Conclusions

The US method illustrated substantial intra- and inter-rater reliability. The measurement difference between radiography and the US method was within the range of clinically acceptable error (5°). The US method may be considered a radiation-free alternative to assess children with scoliosis of mild to moderate severity.

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References

  1. Morrissy RT, Weinstein SL. Lovell & Winter’s pediatric orthopedics. 6th ed. Lippincott Williams and Wilkins, Philadelphia, USA 2006;694–762.

    Google Scholar 

  2. Cobb J. Outline for the study of scoliosis. AAOS Instr Course Lect 1948;5:261–75.

    Google Scholar 

  3. Oestreich A, Young L, Poussaint T. Scoliosis circa 2000: radiologic imaging perspective. Skeletal Radiol 1998;27:591–605.

    Article  CAS  Google Scholar 

  4. Helenius I, Remes V, Yrjonen T, et al. Harrington and Cotrel-Dubousset instrumentation in adolescent idiopathic scoliosis. Longterm functional and radiographic outcomes. J Bone Joint Surg Am 2003;85:2303–9.

    Article  Google Scholar 

  5. Tan KJ, Moe MM, Vaithinathan R, et al. Curve progression in idio-pathic scoliosis: follow-up study to skeletal maturity. Spine (Phila Pa 1976) 2009;34:697–700.

    Article  Google Scholar 

  6. Morrissy RT, Goldsmith GS, Hall EC, et al. Measurement of the Cobb angle on radiographs of patients who have scoliosis: evaluation of intrinsic error. J Bone Joint Surg Am 1990;72:320–7.

    Article  CAS  Google Scholar 

  7. Shea KG, Stevens PM, Nelson M, et al. A comparison of manual versus computer-assisted radiographic measurement: intraobserver measurement variability for Cobb angles. Spine (Phila Pa 1976) 1998;23:551–5.

    Article  CAS  Google Scholar 

  8. Lonstein JE, Carlson JM. The prediction of curve progression in untreated idiopathic scoliosis during growth. J Bone Joint Surg Am 1984;66:1061–71.

    Article  CAS  Google Scholar 

  9. Hoffman DA, Lonstein JE, Morin MM, et al. Breast cancer in women with scoliosis exposed to multiple diagnostic x rays. J Natl Cancer Inst 1989;81:1307–12.

    Article  CAS  Google Scholar 

  10. Doody MM, Lonstein JE, Stovall M, et al. Breast cancer mortality after diagnostic radiography: findings from the U.S. Scoliosis Cohort Study. Spine (Phila Pa 1976) 2000;25:2052–63.

    Article  CAS  Google Scholar 

  11. Suzuki S, Yamamuro T, Shikata J, et al. Ultrasound measurement of vertebral rotation in idiopathic scoliosis. J Bone Joint Surg Br 1989;71:252–5.

    Article  CAS  Google Scholar 

  12. Furness G, Reilly MP, Kuchi S. An evaluation of ultrasound imaging for identification of lumbar intervertebral level. Anaesthesia 2002;57: 277–80.

    Article  CAS  Google Scholar 

  13. Burwell RG, Aujla RK, Kirby AS, et al. The early detection of adolescent idiopathic scoliosis in three positions using the scoliometer and real-time ultrasound: should the prone position also be used? Stud Health Technol Inform 2002;88:74–80.

    CAS  PubMed  Google Scholar 

  14. Burwell RG, Aujla RK, Cole AA, et al. Spine-rib rotation differences at the apex in preoperative patients with adolescent idiopathic scoliosis: evaluation of a three-level ultrasound method. Stud Health Tech-nol Inform 2002;91:246–50.

    CAS  Google Scholar 

  15. Burwell RG, Aujla RK, Cole AA, et al. Preliminary study of a new real-time ultrasound method for measuring spinal and rib rotation in preoperative patients with adolescent idiopathic scoliosis. Stud Health Technol Inform 2002;91:262–6.

    CAS  PubMed  Google Scholar 

  16. Burwell RG, Aujla KK, Cole AA, et al. Anterior universal spine system for adolescent idiopathic scoliosis: a follow-up study using sco-liometer, real-time ultrasound and radiographs. Stud Health Technol Inform 2002;91:473–6.

    CAS  PubMed  Google Scholar 

  17. Burwell RG, Aujla RK, Freeman BJ, et al. The posterior skeletal thorax: rib-vertebral angle and axial vertebral rotation asymmetries in adolescent idiopathic scoliosis. Stud Health Technol Inform 2008;140:263–8.

    CAS  PubMed  Google Scholar 

  18. Li M, Cheng J, Ying M, et al. Could clinical ultrasound improve the fitting of spinal orthosis for the patients with AIS? Eur Spine J 2012;10:1926–35.

    Article  Google Scholar 

  19. Li M, Cheng J, Ying M, etal. Applicationof 3-D ultrasound in assisting the fitting procedure of spinal orthosis to patients with adolescent idio-pathic scoliosis. Stud Health Technol Inform 2010;158:34–7.

    CAS  PubMed  Google Scholar 

  20. Chen W, Lou EH, Le L.H. Using ultrasound imagingtoidentify landmarks in vertebra models to assess spinal deformity. Conf Proc IEEE Eng Med Biol Soc 2011; Boston, MA, USA, Aug 30 the Sep 3rd, 2011:8495-8.

    Google Scholar 

  21. Chen W, Le L, Lou E. Ultrasound imaging of spinal vertebrae to study scoliosis. Open J Acoust 2012;2:95–103.

    Article  CAS  Google Scholar 

  22. Chen W, Lou EH, Zhang Q, et al. Reliability of assessing the coronal curvature of children with scoliosis by using ultrasound images. J Child Orthop 2013;7:521–9.

    Article  Google Scholar 

  23. Cheung CWJ, Law SY, Zheng YP. Development of 3-D ultrasound system for assessment of adolescent idiopathic scoliosis (AIS):system validation. Conf Proc IEEE Eng Med Biol Soc 2013; Osaka, Japan, July 3-7, 2013:6474-7.

    Google Scholar 

  24. Ungi T, King F, Kempston M, et al. Spinal curvature measurement by tracked ultrasound snapshots. Ultrasound Med Biol 2014;40:447–54.

    Article  Google Scholar 

  25. Currier DP. Elements of research in physical therapy. 3rd ed. Baltimore, MD: Williams & Wilkins; 1984. p. 160–71.

    Google Scholar 

  26. Mok JM, Berven SH, Diab M, et al. Comparison of observer variation in conventional and three digital radiographic methods used in the evaluation of patients with adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 2008;33:681–6.

    Article  Google Scholar 

  27. Kuklo TR, Potter BK, O’Brien MF, et al. Reliability analysis for digital adolescent idiopathic scoliosis measurements. J Spinal Disord Tech 2005;18):152–9.

    Article  Google Scholar 

  28. Gstoettner M, Sekyra K, Walochnik N, et al. Inter- and intraobserver reliability assessment of the Cobb angle: manual versus digital measurement tools. Eur Spine J 2007;16:1587–92.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, University of Alberta, 8440 - 112 Street, Edmonton, Canada, T6G 2B7

    Rui Zheng PhD, Amanda C. Y. Chan, Douglas L. Hill MBA, Douglas Hedden MD, Marc Moreau MD, James Mahood MD, Sarah Southon NP & Edmond Lou PhD

  2. Department of Biomedical Engineering, University of Alberta, 8308-114 Street, Edmonton, Canada, T6G 2V2

    Wei Chen PhD

  3. Glenrose Rehabilitation Hospital, Alberta Health Services, Glenrose Rehabilitation Research Centre, 10105 112 Avenue, Edmonton, Canada, T5G 0H1

    Douglas L. Hill MBA & Edmond Lou PhD

  4. Department of Radiology and Diagnostic Imaging, University of Alberta, 8440-112 Street, Edmonton, Canada, T6G 2B7

    Lawrence H. Le PhD

Authors
  1. Rui Zheng PhD
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  2. Amanda C. Y. Chan
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  3. Wei Chen PhD
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  4. Douglas L. Hill MBA
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  5. Lawrence H. Le PhD
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  6. Douglas Hedden MD
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  7. Marc Moreau MD
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  8. James Mahood MD
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  9. Sarah Southon NP
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  10. Edmond Lou PhD
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Corresponding author

Correspondence to Edmond Lou PhD.

Additional information

Author disclosures: RZ (none); ACYC (none); WC (none); DLH (none); LHL (none); DH (none); MM (none); JM (none); SS (none); EL (none).

This work was supported by the Women’s and Children’s Health Research Institute and the Edmonton Orthopaedic Research Society.

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Zheng, R., Chan, A.C.Y., Chen, W. et al. Intra- and Inter-rater Reliability of Coronal Curvature Measurement for Adolescent Idiopathic Scoliosis Using Ultrasonic Imaging Method—A Pilot Study. Spine Deform 3, 151–158 (2015). https://doi.org/10.1016/j.jspd.2014.08.008

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  • DOI: https://doi.org/10.1016/j.jspd.2014.08.008

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