Comparison of 3D and 2D characterization of spinal geometry from biplanar X-rays: a large cohort study

Quantitative Imaging in Medicine and Surgery

article

Zongshan Hu¹  Winnie C. W. Chu⁴  Jack C. Y. Cheng²  Wafa Skalli⁵  Claudio Vergari⁵  Laurent Gajny⁵  Zhen Liu¹  Tsz-Ping Lam¹  Zezhang Zhu¹  Yong Qiu¹  Gene C. W. Man²  Kwong-Hang Yeung³ 

[1] Department of Spine Surgery, Drum Tower Hospital of Nanjing University Medical School;Department of Orthopaedics and Traumatology, The Prince of Wales Hospital, The Chinese University of Hong Kong;The Joint Scoliosis Research Center of the Chinese University of Hong Kong-Nanjing University, Faculty of Medicine, The Chinese University of Hong Kong;Department of Imaging and Interventional Radiology, The Prince of Wales Hospital, The Chinese University of Hong Kong;Arts et Métiers Institute of Technology, Université Sorbonne Paris Nord, Institut de Biomécanique Humaine Georges Charpak (IBHGC), HESAM Université

关键词: Scoliosis;    spine;    three-dimensional reconstruction (3D reconstruction);    automatic measurement;    sagittal parameter;   

DOI  :  10.21037/qims-20-861

学科分类：外科医学

来源: AME Publications

【 摘 要 】

Background: Biplanar X-ray system providing anteroposterior and sagittal plane with an ultra-low radiation dose and in weight-bearing position is increasingly used for spine imaging. The original three-dimensional (3D) reconstruction method from biplanar X-rays has been widely used for clinical parameters, however, the main issue is that manual adjustments of the 3D model was quite time-consuming and limited to thoracolumbar spine. A quasi-automated 3D reconstruction method of the spine from cervical vertebra to pelvis was proposed, which proved fast and accurate in 57 patients with adolescent idiopathic scoliosis. The aim of this study was to compare the newly developed technique of quasi-automatic 3D measurement with classical 2D measurements in a large cohort. Methods: A total of 494 adults with biplanar EOS X-ray scanning were included in this study and divided into health and deformity group according to the presence of spinal deformity. The proposed method of quasi-automatic 3D measurement was applied to all these subjects. The radiographic parameters included: thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT), sagittal vertical axis (SVA), T1 pelvic angle (TPA) in sagittal plane, and cobb angle in coronal plane. Comparison was made between quasi-automatic and manual measurement. Results: The mean age was 53.7±19.9 years old. In the whole population, the mean differences between the two methods were 3.9° for TK (30.5°±9.9° vs. 26.5°±9.3°, P30°, respectively. Correlation analysis showed r2 for all clinical parameters ranged from 0.667 to 0.923. On average, the new method takes 5 minutes to compute all the parameters for one case. Conclusions: In conclusion, this ergonomic and efficient quasi-automatic method for full spine proved fast and accurate measurement in a large population, which showed great potential in extensive clinical application.

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