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Title: Is radiation-free ultrasound accurate for quantitative assessment of spinal deformity in idiopathic scoliosis (IS) : a detailed analysis with EOS radiography on 952 patients
Authors: Wong, YS
Lai, KKL 
Zheng, YP 
Wong, LLN
Ng, BKW
Hung, ALH
Yip, BHK
Chu, WCW
Ng, AWH
Qiu, Y
Cheng, JCY
Lam, TP
Issue Date: 2019
Source: Ultrasound in medicine and biology, Nov. 2019, v. 45, no. 11, p. 2866-2877
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 degrees). 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 degrees, 66.6% USCs and 62.4% LSCs had absolute differences between E_Cobb and predicted Cobb angle calculated from SPA <= 5 degrees. Ultrasound could be a viable option in lieu of radiography for mea- suring coronal curves with apices at T7 or lower and Cobb angle <30 degrees.
Keywords: Idiopathic scoliosis
Ultrasound
EOS radiography
Cobb angle
Spinous process angle
Publisher: Elsevier
Journal: Ultrasound in medicine and biology 
ISSN: 0301-5629
EISSN: 1879-291X
DOI: 10.1016/j.ultrasmedbio.2019.07.006
Rights: Copyright © 2019 The Author(s). Published by Elsevier Inc. on behalf of World Federation for Ultrasound in Medicine & Biology.This is an open access article under the CC BY-NC-ND license. (http://creativecommons.org/licenses/by-nc-nd/4.0/)
The following publication Wong, Y. S., Lai, K. K. L., Zheng, Y. P., Wong, L. L. N., Ng, B. K. W., Hung, A. L. H., . . . Lam, T. P. (2019). 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 and Biology, 45(11), 2866-2877 is available at https://dx.doi.org/10.1016/j.ultrasmedbio.2019.07.006
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