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The accuracy of Cobb angle measurement on CT scan projection radiograph images

Alrehily, F; Hogg, P; Twiste, M; Johansen, S; Tootell, AK

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Authors

F Alrehily

S Johansen

AK Tootell



Abstract

Introduction: Adolescent idiopathic scoliosis (AIS) is a spinal deformity that can affect young children. It requires frequent exposure to X-rays to monitor the deformity, which can lead to the development of radiation-induced cancer later in life. The aim of this study is to test the accuracy of using scan projection radiography (SPR) in computed tomography (CT) scans for AIS assessment. This scanning mode delivers low radiation compared with conventional radiography.

Method: A bespoke phantom with a 14°scoliotic spine was scanned in CT SPR mode using 18 imaging acquisitions. These images were visually evaluated against set criteria to determine their suitability for Cobb angle measurements Those deemed of insufficient quality were excluded from the study (n=8, excluded). Cobb angle measurements were then performed on the remaining images (n=10, included) by 13 observers.

Results: On average, the difference between the measured Cobb angle andthe known angle was –2.75°(SD 1.46°). The agreement between the observers was good (p = 0.861, 95% CI 0.70-0.95)and comparable to similar studies on other imaging modalities which are used for Cobb angle estimation.

Conclusion: CT SPR images can be usedfor AIS assessment with the 5°margin of error that is clinically acceptable.

Implications for practice: The outcome is promising for patients and health providers because it provides an opportunity to reduce patient dose, achieve clinically acceptable Cobb angle measurements whilst using existing (CT) technology that is available in most hospital.

Citation

Alrehily, F., Hogg, P., Twiste, M., Johansen, S., & Tootell, A. (2020). The accuracy of Cobb angle measurement on CT scan projection radiograph images. Radiography, 26(2), e73-e77. https://doi.org/10.1016/j.radi.2019.11.001

Journal Article Type Article
Acceptance Date Nov 3, 2019
Online Publication Date Nov 20, 2019
Publication Date May 1, 2020
Deposit Date Nov 13, 2019
Publicly Available Date Nov 20, 2020
Journal Radiography
Print ISSN 1078-8174
Electronic ISSN 1532-2831
Publisher Elsevier
Volume 26
Issue 2
Pages e73-e77
DOI https://doi.org/10.1016/j.radi.2019.11.001
Publisher URL https://doi.org/10.1016/j.radi.2019.11.001
Related Public URLs https://www.journals.elsevier.com/radiography

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