Ultrasound Volume Projection Imaging for Assessment of Scoliosis

Chung Wai James Cheung, Guang Quan Zhou, Siu Yin Law, Tak Man Mak, Ka Lee Lai, Yongping Zheng

Research output: Journal article publicationJournal articleAcademic researchpeer-review

79 Citations (Scopus)


The standing radiograph is used as a gold standard to diagnose spinal deformity including scoliosis, a medical condition defined as lateral spine curvature >10°. However, the health concern of X-ray and large inter-observer variation of measurements on X-ray images have significantly restricted its application, particularly for scoliosis screening and close follow-up for adolescent patients. In this study, a radiation-free freehand 3-D ultrasound system was developed for scoliosis assessment using a volume projection imaging method. Based on the obtained coronal view images, two measurement methods were proposed using transverse process and spinous profile as landmarks, respectively. As a reliability study, 36 subjects (age: 30.1 14.5; male: 12; female: 24) with different degrees of scoliosis were scanned using the system to test the inter-and intra-observer repeatability. The intra-and inter-observer tests indicated that the new assessment methods were repeatable, with ICC larger than 0.92. Small intra-and inter-observer variations of measuring spine curvature were observed for the two measurement methods (intra-: 1.4 1.0° and 1.4 1.1° ; inter-: 2.2 1.6° and 2.5 1.6°). The results also showed that the spinal curvature obtained by the new method had good linear correlations with X-ray Cobb's method (R2 = 0.8, p < 0.001, 29 subjects). These results suggested that the ultrasound volume projection imaging method can be a promising approach for the assessment of scoliosis, and further research should be followed up to demonstrate its potential clinical applications for mass screening and curve progression and treatment outcome monitoring of scoliosis patients.
Original languageEnglish
Article number7006775
Pages (from-to)1760-1768
Number of pages9
JournalIEEE Transactions on Medical Imaging
Issue number8
Publication statusPublished - 1 Aug 2015


  • Cobb angle
  • coronal view
  • freehand 3-D ultrasound
  • nonplanar volume rendering
  • scoliosis
  • spine deformity
  • ultrasound imaging

ASJC Scopus subject areas

  • Software
  • Radiological and Ultrasound Technology
  • Computer Science Applications
  • Electrical and Electronic Engineering


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