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Wong YS, Lai KKL, Zheng YP, Wong LLN, Ng BKW, Hung ALH, Yip BHK, Chu WCW, Ng AWH, Qiu Y, Cheng JCY, Lam TP. Is Radiation-Free Ultrasound Accurate for Quantitative Assessment of Spinal Deformity in Idiopathic Scoliosis (IS): A Detailed Analysis With EOS Radiography on 952 Patients. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:2866-2877. [PMID: 31399250 DOI: 10.1016/j.ultrasmedbio.2019.07.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 06/21/2019] [Accepted: 07/05/2019] [Indexed: 06/10/2023]
Abstract
Radiation exposure with repeated radiography required at follow-up poses serious health concerns for scoliosis patients. Although spinous process angle (SPA) measurement of spinal curvatures with ultrasound has been reported with promising results, an evidence-based account on its accuracy for translational application remains undefined. This prospective study involved 952 idiopathic scoliosis patients (75.7% female, mean age 16.7 ± 3.0 y, Cobb 28.7 ± 11.6°). Among 1432 curves (88.1%) detected by ultrasound, there was good correlation between radiologic Cobb angles measured manually on EOS (E_Cobb) whole-spine radiographs and automatic ultrasound SPA measurement for upper spinal curves (USCs) (r = 0.873, apices T7-T12/L1 intervertebral disc) and lower spinal curves (LSCs) (r = 0.740, apices L1 or below) (p < 0.001). Taller stature was associated with stronger correlation. For E_Cobb <30°, 66.6% USCs and 62.4% LSCs had absolute differences between E_Cobb and predicted Cobb angle calculated from SPA ≤5°. Ultrasound could be a viable option in lieu of radiography for measuring coronal curves with apices at T7 or lower and Cobb angle <30°.
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Affiliation(s)
- Yi-Shun Wong
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR
| | - Kelly Ka-Lee Lai
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Yong-Ping Zheng
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Lyn Lee-Ning Wong
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR
| | - Bobby Kin-Wah Ng
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR
| | - Alec Lik-Hang Hung
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR
| | - Benjamin Hon-Kei Yip
- Division of Family Medicine and Primary Health Care, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR
| | - Winnie Chiu-Wing Chu
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR
| | - Alex Wing-Hung Ng
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR
| | - Yong Qiu
- Spine Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China; Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, Nanjing, China
| | - Jack Chun-Yiu Cheng
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR; Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, Nanjing, China; SH Ho Scoliosis Research Laboratory, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR
| | - Tsz-Ping Lam
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR; Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, Nanjing, China; SH Ho Scoliosis Research Laboratory, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR.
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