Three‐dimensional ultrasonography could be a potential non‐ionizing tool to evaluate vertebral rotation of subjects with adolescent idiopathic scoliosis

Abstract Background Three‐dimensional (3D) ultrasonography is nonionizing and has been demonstrated to be a reliable tool for scoliosis assessment, including coronal and sagittal curvatures. It shows a great potential for axial vertebral rotation (AVR) evaluation, yet its validity and reliability ne...

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Main Authors: Tin Yan Lee, De Yang, Kelly Ka‐Lee Lai, Rene M. Castelein, Tom P. C. Schlosser, Winnie Chu, Tsz‐Ping Lam, Yong‐Ping Zheng
Format: Article
Language:English
Published: Wiley 2023-09-01
Series:JOR Spine
Subjects:
Online Access:https://doi.org/10.1002/jsp2.1259
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author Tin Yan Lee
De Yang
Kelly Ka‐Lee Lai
Rene M. Castelein
Tom P. C. Schlosser
Winnie Chu
Tsz‐Ping Lam
Yong‐Ping Zheng
author_facet Tin Yan Lee
De Yang
Kelly Ka‐Lee Lai
Rene M. Castelein
Tom P. C. Schlosser
Winnie Chu
Tsz‐Ping Lam
Yong‐Ping Zheng
author_sort Tin Yan Lee
collection DOAJ
description Abstract Background Three‐dimensional (3D) ultrasonography is nonionizing and has been demonstrated to be a reliable tool for scoliosis assessment, including coronal and sagittal curvatures. It shows a great potential for axial vertebral rotation (AVR) evaluation, yet its validity and reliability need to be further demonstrated. Materials and Methods Twenty patients with adolescent idiopathic scoliosis (AIS) (coronal Cobb: 26.6 ± 9.1°) received 3D ultrasound scan for twice, 10 were scanned by the same operator, and the other 10 by different operators. EOS Bi‐planar x‐rays and 3D scan were conducted on another 29 patients on the same day. Two experienced 3D ultrasonographic researchers, with different experiences on AVR measurement, evaluated the 3D ultrasonographic AVR of the 29 patients (55 curves; coronal Cobb angle: 26.9 ± 11.3°). The gold standard AVR was determined from the 3D reconstruction of coronal and sagittal EOS radiographs. Intra‐class correlation coefficients (ICCs), mean absolute difference (MAD), standard error measurements (SEM), and Bland–Altman's bias were reported to evaluate the intra‐operator and inter‐operator/rater reliabilities of 3D ultrasonography. The reliability of 3D ultrasonographic AVR measurements was further validated using inter‐method with that of EOS. Results ICCs for intra‐operator and inter‐operator/rater reliability assessment were all greater than 0.95. MAD, SEM, and bias for the 3D ultrasonographic AVRs were no more than 2.2°, 2.0°, and 0.5°, respectively. AVRs between both modalities were strongly correlated (R2 = 0.901) and not significantly different (p = 0.205). Bland–Altman plot also shows that the bias was less than 1°, with no proportional bias between the difference and mean of expected and radiographic Cobb angles. Conclusion This study demonstrates that 3D ultrasonography is valid and reliable to evaluate AVR in AIS patients. 3D ultrasonography can be a potential tool for screening and following up subjects with AIS and evaluating the effectiveness of nonsurgical treatments.
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spelling doaj.art-d4e88dac3ded4fa18f622a8d178797db2023-09-29T14:33:35ZengWileyJOR Spine2572-11432023-09-0163n/an/a10.1002/jsp2.1259Three‐dimensional ultrasonography could be a potential non‐ionizing tool to evaluate vertebral rotation of subjects with adolescent idiopathic scoliosisTin Yan Lee0De Yang1Kelly Ka‐Lee Lai2Rene M. Castelein3Tom P. C. Schlosser4Winnie Chu5Tsz‐Ping Lam6Yong‐Ping Zheng7Department of Biomedical Engineering The Hong Kong Polytechnic University Hong Kong Hong KongDepartment of Biomedical Engineering The Hong Kong Polytechnic University Hong Kong Hong KongDepartment of Biomedical Engineering The Hong Kong Polytechnic University Hong Kong Hong KongDepartment of Orthopaedic Surgery University Medical Center Utrecht Utrecht The NetherlandsDepartment of Orthopaedic Surgery University Medical Center Utrecht Utrecht The NetherlandsDepartment of Imaging and Interventional Radiology The Chinese University of Hong Kong Hong Kong SAR ChinaSH Ho Scoliosis Research Lab, Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong Hong Kong Hong KongDepartment of Biomedical Engineering The Hong Kong Polytechnic University Hong Kong Hong KongAbstract Background Three‐dimensional (3D) ultrasonography is nonionizing and has been demonstrated to be a reliable tool for scoliosis assessment, including coronal and sagittal curvatures. It shows a great potential for axial vertebral rotation (AVR) evaluation, yet its validity and reliability need to be further demonstrated. Materials and Methods Twenty patients with adolescent idiopathic scoliosis (AIS) (coronal Cobb: 26.6 ± 9.1°) received 3D ultrasound scan for twice, 10 were scanned by the same operator, and the other 10 by different operators. EOS Bi‐planar x‐rays and 3D scan were conducted on another 29 patients on the same day. Two experienced 3D ultrasonographic researchers, with different experiences on AVR measurement, evaluated the 3D ultrasonographic AVR of the 29 patients (55 curves; coronal Cobb angle: 26.9 ± 11.3°). The gold standard AVR was determined from the 3D reconstruction of coronal and sagittal EOS radiographs. Intra‐class correlation coefficients (ICCs), mean absolute difference (MAD), standard error measurements (SEM), and Bland–Altman's bias were reported to evaluate the intra‐operator and inter‐operator/rater reliabilities of 3D ultrasonography. The reliability of 3D ultrasonographic AVR measurements was further validated using inter‐method with that of EOS. Results ICCs for intra‐operator and inter‐operator/rater reliability assessment were all greater than 0.95. MAD, SEM, and bias for the 3D ultrasonographic AVRs were no more than 2.2°, 2.0°, and 0.5°, respectively. AVRs between both modalities were strongly correlated (R2 = 0.901) and not significantly different (p = 0.205). Bland–Altman plot also shows that the bias was less than 1°, with no proportional bias between the difference and mean of expected and radiographic Cobb angles. Conclusion This study demonstrates that 3D ultrasonography is valid and reliable to evaluate AVR in AIS patients. 3D ultrasonography can be a potential tool for screening and following up subjects with AIS and evaluating the effectiveness of nonsurgical treatments.https://doi.org/10.1002/jsp2.1259adolescent idiopathic scoliosislaminaenonionizing axialthree‐dimensional ultrasonographyvertebral rotation
spellingShingle Tin Yan Lee
De Yang
Kelly Ka‐Lee Lai
Rene M. Castelein
Tom P. C. Schlosser
Winnie Chu
Tsz‐Ping Lam
Yong‐Ping Zheng
Three‐dimensional ultrasonography could be a potential non‐ionizing tool to evaluate vertebral rotation of subjects with adolescent idiopathic scoliosis
JOR Spine
adolescent idiopathic scoliosis
laminae
nonionizing axial
three‐dimensional ultrasonography
vertebral rotation
title Three‐dimensional ultrasonography could be a potential non‐ionizing tool to evaluate vertebral rotation of subjects with adolescent idiopathic scoliosis
title_full Three‐dimensional ultrasonography could be a potential non‐ionizing tool to evaluate vertebral rotation of subjects with adolescent idiopathic scoliosis
title_fullStr Three‐dimensional ultrasonography could be a potential non‐ionizing tool to evaluate vertebral rotation of subjects with adolescent idiopathic scoliosis
title_full_unstemmed Three‐dimensional ultrasonography could be a potential non‐ionizing tool to evaluate vertebral rotation of subjects with adolescent idiopathic scoliosis
title_short Three‐dimensional ultrasonography could be a potential non‐ionizing tool to evaluate vertebral rotation of subjects with adolescent idiopathic scoliosis
title_sort three dimensional ultrasonography could be a potential non ionizing tool to evaluate vertebral rotation of subjects with adolescent idiopathic scoliosis
topic adolescent idiopathic scoliosis
laminae
nonionizing axial
three‐dimensional ultrasonography
vertebral rotation
url https://doi.org/10.1002/jsp2.1259
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