Convolutional Neural Network to Segment Laminae on 3D Ultrasound Spinal Images to Assist Cobb Angle Measurement.

A recent innovation in scoliosis monitoring is the use of ultrasonography, which provides true 3D information in one scan and does not emit ionizing radiation. Measuring the severity of scoliosis on ultrasonographs requires identifying lamina pairs on the most tilted vertebrae, which is difficult and time-consuming. To expedite and automate measurement steps, this paper detailed an automatic convolutional neural network-based algorithm for identifying the laminae on 3D ultrasonographs. The predicted laminae were manually paired to measure the lateral spinal curvature on the coronal view, called the Cobb angle. In total, 130 spinal ultrasonographs of adolescents with idiopathic scoliosis recruited from a scoliosis clinic were selected, with 70 for training and 60 for testing. Data augmentation increased the effective training set size to 140 ultrasonographs. Semi-automatic Cobb measurements were compared to manual measurements on the same ultrasonographs. The semi-automatic measurements demonstrated good inter-method reliability (ICC 3,1 = 0.87) and performed better on thoracic (ICC 3,1 = 0.91) than lumbar curves (ICC 3,1 = 0.81). The mean absolute difference and standard deviation between semi-automatic and manual was 3.6° ± 3.0°. In conclusion, the semi-automatic method to measure the Cobb angle on ultrasonographs is feasible and accurate. This is the first algorithm that automates steps of Cobb angle measurement on ultrasonographs.