PMID- 26377663 OWN - NLM STAT- MEDLINE DCOM- 20161011 LR - 20220321 IS - 1432-1068 (Electronic) IS - 1633-8065 (Linking) VI - 26 IP - 1 DP - 2016 Jan TI - Reliability analysis of Cobb angle measurements of congenital scoliosis using X-ray and 3D-CT images. PG - 53-7 LID - 10.1007/s00590-015-1701-7 [doi] AB - PURPOSE: Therapeutic decisions for congenital scoliosis rely on Cobb angle measurements on consecutive radiographs. There have been no studies documenting the variability of measuring the Cobb angle using 3D-CT images in children with congenital scoliosis. The purpose of this study was to compare the reliability and measurement errors using X-ray images and those utilizing 3D-CT images. MATERIALS AND METHODS: The X-ray and 3D-CT images of 20 patients diagnosed with congenital scoliosis were used to assess the reliability of the digital 3D-CT images for the measurement of the Cobb angle. Thirteen observers performed the measurements, and each image was analyzed by each observer twice with a minimum interval of 1 week between measurements. The analysis of intraobserver variation was expressed as the mean absolute difference (MAD) and standard deviation (SD) between measurements and the intraclass correlation coefficient (IaCC) of the measurements. In addition, the interobserver variation was expressed as the MAD and interclass correlation coefficient (IeCC). RESULTS: The average MAD and SD was 4.5 degrees and 3.2 degrees by the X-ray method and 3.7 degrees and 2.6 degrees by the 3D-CT method. The intraobserver and interobserver intraclass ICCs were excellent in both methods (X-ray: IaCC 0.835-0.994 IeCC 0.847, 3D-CT: IaCC 0.819-0.996 IeCC 0.893). There was no significant MAD difference between X-ray and 3D-CT images in measuring each type of congenital scoliosis by each observer. CONCLUSIONS: Results of Cobb angle measurements in patients with congenital scoliosis using X-ray images in the frontal plane could be reproduced with almost the same measurement variance (3 degrees -4 degrees measurement error) using 3D-CT images. This suggests that X-ray images are clinically useful for assessing any type of congenital scoliosis about measuring the Cobb angle alone. However, since 3D-CT can provide more detailed images of the anterior and posterior components of malformed vertebrae, the volume of information that can be obtained by evaluating them has contributed greatly to the development of strategies for the surgical treatment of congenital scoliosis. FAU - Tauchi, Ryoji AU - Tauchi R AD - Department of Orthopedics and Spine Surgery, Meijo Hospital, 1-3-1, Sannomaru, Naka-ku, Nagoya, 460-0001, Japan. FAU - Tsuji, Taichi AU - Tsuji T AD - Department of Orthopedics and Spine Surgery, Meijo Hospital, 1-3-1, Sannomaru, Naka-ku, Nagoya, 460-0001, Japan. FAU - Cahill, Patrick J AU - Cahill PJ AD - Department of Orthopedic Surgery, Shriners Hospitals for Children-Philadelphia, Philadelphia, PA, USA. FAU - Flynn, John M AU - Flynn JM AD - Division of Orthopaedics, Children's Hospital of Philadelphia, Philadelphia, PA, USA. FAU - Flynn, John M AU - Flynn JM AD - Department of Pediatric Orthopaedic Surgery, Hospital la Conception, San German, PR, USA. FAU - Glotzbecker, Michael AU - Glotzbecker M AD - Department of Orthopaedic Surgery, Children's Hospital Boston, Boston, MA, USA. FAU - El-Hawary, Ron AU - El-Hawary R AD - Division of Pediatric Orthopaedics, Isaac Walton Killam Health Centre, Halifax, NS, Canada. FAU - Heflin, John A AU - Heflin JA AD - Department of Orthopaedic Surgery, Emory University School of Medicine, Emory Spine Center, Atlanta, GA, USA. FAU - Imagama, Shiro AU - Imagama S AD - Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan. FAU - Joshi, Ajeya P AU - Joshi AP AD - South Texas Spinal Clinic, San Antonio, TX, USA. FAU - Nohara, Ayato AU - Nohara A AD - Department of Orthopedics and Spine Surgery, Meijo Hospital, 1-3-1, Sannomaru, Naka-ku, Nagoya, 460-0001, Japan. FAU - Ramirez, Norman AU - Ramirez N AD - Department of Pediatric Orthopaedic Surgery, Hospital la Conception, San German, PR, USA. FAU - Roye, David P Jr AU - Roye DP Jr AD - Department of Pediatric Orthopaedic Surgery, Columbia University Medical Center, New York, NY, USA. FAU - Saito, Toshiki AU - Saito T AD - Department of Orthopedics and Spine Surgery, Meijo Hospital, 1-3-1, Sannomaru, Naka-ku, Nagoya, 460-0001, Japan. FAU - Sawyer, Jeffrey R AU - Sawyer JR AD - Campbell Clinic, University of Tennessee, Memphis, TN, USA. FAU - Smith, John T AU - Smith JT AD - Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA. FAU - Kawakami, Noriaki AU - Kawakami N AD - Department of Orthopedics and Spine Surgery, Meijo Hospital, 1-3-1, Sannomaru, Naka-ku, Nagoya, 460-0001, Japan. nupriver@gmail.com. LA - eng PT - Comparative Study PT - Evaluation Study PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't DEP - 20150916 PL - France TA - Eur J Orthop Surg Traumatol JT - European journal of orthopaedic surgery & traumatology : orthopedie traumatologie JID - 9518037 SB - IM MH - Child MH - Female MH - Humans MH - Imaging, Three-Dimensional MH - Male MH - Observer Variation MH - Reproducibility of Results MH - Retrospective Studies MH - Scoliosis/congenital/diagnostic imaging/*pathology MH - Thoracic Vertebrae/diagnostic imaging MH - Tomography, X-Ray Computed OTO - NOTNLM OT - Children OT - Cobb angle OT - Computed tomography OT - Congenital scoliosis OT - Interobserver OT - Intraobserver OT - Measurement reliability OT - X-ray EDAT- 2015/09/18 06:00 MHDA- 2016/10/12 06:00 CRDT- 2015/09/18 06:00 PHST- 2015/03/31 00:00 [received] PHST- 2015/09/07 00:00 [accepted] PHST- 2015/09/18 06:00 [entrez] PHST- 2015/09/18 06:00 [pubmed] PHST- 2016/10/12 06:00 [medline] AID - 10.1007/s00590-015-1701-7 [pii] AID - 10.1007/s00590-015-1701-7 [doi] PST - ppublish SO - Eur J Orthop Surg Traumatol. 2016 Jan;26(1):53-7. doi: 10.1007/s00590-015-1701-7. Epub 2015 Sep 16.