Semi-automatic Measurement of Scoliotic Angle Using a Freehand 3-D Ultrasound System Scolioscan

  • Guang-Quan Zhou
  • Wei-Wei Jiang
  • Ka-Lee Lai
  • Tsz-Ping Lam
  • Jack Chun-Yiu Cheng
  • Yong-Ping Zheng
Conference paper
Part of the IFMBE Proceedings book series (IFMBE, volume 57)


Ultrasound volume projection imaging (VPI), developed with free-hand 3-D ultrasound system, has been advanced to assess scoliosis, a medical condition defined as lateral spine curvature > 10°. Ultrasound VPI provides a coronal view of spine for manual measurement of spine curvature, achieving a performance comparable to the standard posteroanterior standing radiograph. However, the subjective manual measurements still restricted its wider applications in the diagnosis of scoliosis. In this study, we proposed a semi-automatic method to assess the spine curvature by using the polynomial curve fitting to the manual input curve points perceived on the spinous column profile in VPI images obtained from the Scolioscan, a freehand 3-D ultrasound system. The spine curvature angle was automatically calculated according to the inflection points on the curve. Totally 70 subjects (age: 15.9 ± 2.7 years) with different degrees of scoliosis were recruited to evaluate the performance of proposed semi-automatic measurement method. The curvatures obtained using the semi-automatic method had a signifi- cant correlation with those by the manual method (slope = 0.96, r = 0.9; p < 0.001). The proposed semi-automatic framework is capable of measuring the spine curvature based on the coronal images obtained with free-hand 3-D ultrasound system, expediting the application of Scolioscan in scoliosis diagnosis.


Scoliosis Freehand 3-D ultrasound Volume projection imaging Polynomial curve fitting 


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  1. 1.
    Horne JP, Flannery R, Usman S (2014) Adolescent Idiopathic Scoliosis: Diagnosis and Management. Am Fam Physician 89:193-198Google Scholar
  2. 2.
    Tang S, Cheng J, Ng B, Lam T (2003) Adolescent Idiopathic Scoliosis (AIS): An Overview of the Etiology and Basic Management Principles. HK J Paediatr (new series) 8:299-306Google Scholar
  3. 3.
    Asher MA, Burton DC (2006) Adolescent idiopathic scoliosis: natural history and long term treatment effects. Scoliosis 1:2-2. doi:10.1186/1748-7161-1-2Google Scholar
  4. 4.
    Burton MS (2013) Diagnosis and Treatment of Adolescent Idiopathic Scoliosis. Pediatric Annals 42:224-228. doi:10.3928/00904481-20131022-09Google Scholar
  5. 5.
    Cobb J (1948) Outline for the study of scoliosis.. American Academy of Orthopaedic Surgeons Instructional Course Lectures 5:15Google Scholar
  6. 6.
    Carman DL, Browne RH, Birch JG (1990) Measurement of scoliosis and kyphosis radiographs - Intraobserver and interobserver variation. J Bone Joint Surg-Am Vol 72A:328-333Google Scholar
  7. 7.
    Morrissy RT, Goldsmith GS, Hall EC, Kehl D, Cowie GH (1990) Measurement of the Cobb angle on radiographs of patients who have scoliosis: evalution of intrinsic error. J Bone Joint Surg-Am Vol 72A:320-327Google Scholar
  8. 8.
    Doody MM, Lonstein JE, Stovall M, Hacker DG, Luckyanov N, Land CE, Collab USSCS (2000) Breast cancer mortality after diagnostic radiography - Findings from the US Scoliosis Cohort Study. Spine 25:2052-2063Google Scholar
  9. 9.
    Kim H, Kim HS, Moon ES, Yoon CS, Chung TS, Song HT, Suh JS, Lee YH, Kim S (2010) Scoliosis Imaging: What Radiologists Should Know. Radiographics 30:1823-1842. doi:10.1148/rg.307105061Google Scholar
  10. 10.
    Thometz JG, Lamdan R, Liu XC, Lyon R (2000) Relationship between Quantec measurement and Cobb angle in patients with idiopathic scoliosis. J Pediatr Orthop 20:512-516. doi:10.1097/00004694-200007000-00017Google Scholar
  11. 11.
    Knott P, Mardjetko S, Nance D, Dunn M (2006) Electromagnetic topographical technique of curve evaluation for adolescent idiopathic scoliosis. Spine 31:E911-E915. doi:10.1097/01.brs.0000245924.82359.abGoogle Scholar
  12. 12.
    Thomsen M, Abel R (2006) Imaging in scoliosis from the orthopaedic surgeon’s point of view. Eur J Radiol 58:41-47. doi:10.1016/j.ejrad.2005.12.003Google Scholar
  13. 13.
    Fortin C, Feldman DE, Cheriet F, Labelle H (2013) Differences in Standing and Sitting Postures of Youth with Idiopathic Scoliosis from Quantitative Analysis of Digital Photographs. Phys Occup Ther Pediatr 33:313-326. doi:10.3109/01942638.2012.747582Google Scholar
  14. 14.
    Yazici M, Acaroglu ER, Alanay A, Deviren V, Cila A, Surat A (2001) Measurement of vertebral rotation in standing versus supine position in adolescent idiopathic scoliosis. J Pediatr Orthop 21:252-256. doi:10.1097/00004694-200103000-00025Google Scholar
  15. 15.
    Cheung CWJ, Zheng YP (2010) Development of 3-D Ultrasound System for Assessment of Adolescent Idiopathic Scoliosis (AIS). In: Lim CT, Goh JCH (eds) 6th World Congress of Biomechanics, vol 31. IFMBE Proceedings. Springer, New York, pp 584-587Google Scholar
  16. 16.
    Cheung CWJ, Law SY, Zheng YP (2013) Development of 3-D Ultrasound System for Assessment of Adolescent Idiopathic Scoliosis (AIS) and System Validation. Paper presented at the Engineering in Medicine and Biology Society (EMBC), 2013 35th Annual International Conference of the IEEE, Osaka, Japan, 3-7 July 2013Google Scholar
  17. 17.
    Ungi T, King F, Kempston M, Keri Z, Lasso A, Mousavi P, Rudan J, Borschneck DP, Fichtinger G (2014) Spinal Curvature Measurement by Tracked Ultrasound Snapshots. Ultrasound in Medicine & Biology 40:447-454. doi: Scholar
  18. 18.
    Cheung C-WJ, Zhou G-Q, Law S-Y, Lai K-L, Jiang W-W, Zheng Y-P (2015) Freehand three-dimensional ultrasound system for assessment of scoliosis. Journal of Orthopaedic Translation 3:123-133. doi: Scholar
  19. 19.
    Chen W, Lou EHM, Le LH Using ultrasound imaging to identify landmarks in vertebra models to assess spinal deformity. In, Boston, MA, 2011. 33rd Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS 2011. pp 8495-8498Google Scholar
  20. 20.
    Cheung CWJ, Zhou GQ, Law SY, Mak TM, Lai KL, Zheng YP (2015) Ultrasound Volume Projection Imaging for Assessment of Scoliosis. IEEE Transactions on Medical Imaging 34:1760-1768. doi:10.1109/TMI.2015.2390233Google Scholar
  21. 21.
    Chen W, Lou EM, Zhang P, Le L, Hill D (2013) Reliability of assessing the coronal curvature of children with scoliosis by using ultrasound images. J Child Orthop 7:521-529. doi:10.1007/s11832-013-0539-yGoogle Scholar
  22. 22.
    Young M, Hill DL, Zheng R, Lou E (2015) Reliability and accuracy of ultrasound measurements with and without the aid of previous radiographs in adolescent idiopathic scoliosis (AIS). Eur Spine J 24:1427-1433. doi:10.1007/s00586-015-3855-8Google Scholar
  23. 23.
    Zheng Y-P, Lee TT-Y, Lai KK-L, Yip BH-K, Zhou G-Q, Jiang W-W, Cheung JC-W, Wong M-S, Ng BK-W, Cheng JC-Y, Lam T-P (2015) A Reliability and Validity Study forScolioscan: A Radiation-Free Scoliosis Assessment System using 3D Ultrasound Imaging. Ultrasound in Medicine & Biology. SubmittedGoogle Scholar
  24. 24.
    Krejci J, Gallo J, Stepanik P, Salinger J (2012) Optimization of the examination posture in spinal curvature assessment. Scoliosis 7:10Google Scholar
  25. 25.
    Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1:307-310Google Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Guang-Quan Zhou
    • 1
  • Wei-Wei Jiang
    • 1
  • Ka-Lee Lai
    • 1
  • Tsz-Ping Lam
    • 2
  • Jack Chun-Yiu Cheng
    • 2
  • Yong-Ping Zheng
    • 1
  1. 1.Interdisciplinary Division of Biomedical EngineeringThe Hong Kong Polytechnic UniversityHong KongChina
  2. 2.Department of Orthopaedics and TraumatologyThe Chinese University of Hong KongHong KongChina

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