A novel portable and radiation-free method for assessing scoliosis: an accurate and reproducible study

Abstract Background This study aimed to evaluate the accuracy and reproducibility of a newly developed portable and radiation-free three-dimensional spine sensing system (3D-SSS) for scoliosis assessment. Methods A total of 145 patients underwent full-spine imaging using the EOS imaging system, and...

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Main Authors: Hui Wang, Yunfeng Zhu, Qiyuan Bao, Yong Lu, Fuhua Yan, Lianjun Du, Le Qin
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Musculoskeletal Disorders
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Online Access:https://doi.org/10.1186/s12891-025-08415-3
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author Hui Wang
Yunfeng Zhu
Qiyuan Bao
Yong Lu
Fuhua Yan
Lianjun Du
Le Qin
author_facet Hui Wang
Yunfeng Zhu
Qiyuan Bao
Yong Lu
Fuhua Yan
Lianjun Du
Le Qin
author_sort Hui Wang
collection DOAJ
description Abstract Background This study aimed to evaluate the accuracy and reproducibility of a newly developed portable and radiation-free three-dimensional spine sensing system (3D-SSS) for scoliosis assessment. Methods A total of 145 patients underwent full-spine imaging using the EOS imaging system, and 3D-SSS data were collected between February 2023 and April 2023. A radiologist used sterEOS software to reconstruct the spine in 3D and obtain the Cobb angle. One radiologist and one orthopedist independently measured the patients using 3D-SSS, with the orthopedist performing two measurements per patient. The 3D-SSS post-processing system automatically generated the Cobb angle. Results The mean Cobb angles obtained from EOS and 3D-SSS were 13.7 ± 9.9° (0.5∽45.7°) and 12.5 ± 8.6° (0.4∽40°), respectively. The intraclass correlation coefficient (ICC) for reliability between EOS and 3D-SSS was 0.921, indicating excellent agreement. Bland–Altman analysis revealed a bias of -1.171° between EOS and 3D-SSS, with only 10 patients outside the limits of agreement (-8.3∽6.0°). The root mean square error between EOS and 3D-SSS was 3.2°. A strong correlation was observed between the Cobb angles measured by EOS and 3D-SSS (r = 0.931, P < 0.001). The receiver operating characteristics curve showed that the diagnostic performance of 3D-SSS for scoliosis was 0.953 (P < 0.001). The sensitivity, specificity, positive predictive value, and negative predictive value of 3D-SSS for diagnosing scoliosis were 87.8%, 92.1%, 93.5%, and 85.3%, respectively. The intraobserver and interobserver ICCs for Cobb angles derived from 3D-SSS were 0.969 and 0.934, respectively, demonstrating excellent reproducibility. Conclusions The portable and radiation-free 3D-SSS accurately measured scoliosis and provided highly reproducible data. This system offers a novel method for clinicians to screen and monitor scoliosis in young patients.
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spelling doaj-art-a9334bd7f7e9401b95214c6f7c1c19082025-08-20T02:16:22ZengBMCBMC Musculoskeletal Disorders1471-24742025-02-012611810.1186/s12891-025-08415-3A novel portable and radiation-free method for assessing scoliosis: an accurate and reproducible studyHui Wang0Yunfeng Zhu1Qiyuan Bao2Yong Lu3Fuhua Yan4Lianjun Du5Le Qin6Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Orthopedics, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineAbstract Background This study aimed to evaluate the accuracy and reproducibility of a newly developed portable and radiation-free three-dimensional spine sensing system (3D-SSS) for scoliosis assessment. Methods A total of 145 patients underwent full-spine imaging using the EOS imaging system, and 3D-SSS data were collected between February 2023 and April 2023. A radiologist used sterEOS software to reconstruct the spine in 3D and obtain the Cobb angle. One radiologist and one orthopedist independently measured the patients using 3D-SSS, with the orthopedist performing two measurements per patient. The 3D-SSS post-processing system automatically generated the Cobb angle. Results The mean Cobb angles obtained from EOS and 3D-SSS were 13.7 ± 9.9° (0.5∽45.7°) and 12.5 ± 8.6° (0.4∽40°), respectively. The intraclass correlation coefficient (ICC) for reliability between EOS and 3D-SSS was 0.921, indicating excellent agreement. Bland–Altman analysis revealed a bias of -1.171° between EOS and 3D-SSS, with only 10 patients outside the limits of agreement (-8.3∽6.0°). The root mean square error between EOS and 3D-SSS was 3.2°. A strong correlation was observed between the Cobb angles measured by EOS and 3D-SSS (r = 0.931, P < 0.001). The receiver operating characteristics curve showed that the diagnostic performance of 3D-SSS for scoliosis was 0.953 (P < 0.001). The sensitivity, specificity, positive predictive value, and negative predictive value of 3D-SSS for diagnosing scoliosis were 87.8%, 92.1%, 93.5%, and 85.3%, respectively. The intraobserver and interobserver ICCs for Cobb angles derived from 3D-SSS were 0.969 and 0.934, respectively, demonstrating excellent reproducibility. Conclusions The portable and radiation-free 3D-SSS accurately measured scoliosis and provided highly reproducible data. This system offers a novel method for clinicians to screen and monitor scoliosis in young patients.https://doi.org/10.1186/s12891-025-08415-3ScoliosisPortableRadiation-freeThree-dimensional spine sensing systemCobb angle
spellingShingle Hui Wang
Yunfeng Zhu
Qiyuan Bao
Yong Lu
Fuhua Yan
Lianjun Du
Le Qin
A novel portable and radiation-free method for assessing scoliosis: an accurate and reproducible study
BMC Musculoskeletal Disorders
Scoliosis
Portable
Radiation-free
Three-dimensional spine sensing system
Cobb angle
title A novel portable and radiation-free method for assessing scoliosis: an accurate and reproducible study
title_full A novel portable and radiation-free method for assessing scoliosis: an accurate and reproducible study
title_fullStr A novel portable and radiation-free method for assessing scoliosis: an accurate and reproducible study
title_full_unstemmed A novel portable and radiation-free method for assessing scoliosis: an accurate and reproducible study
title_short A novel portable and radiation-free method for assessing scoliosis: an accurate and reproducible study
title_sort novel portable and radiation free method for assessing scoliosis an accurate and reproducible study
topic Scoliosis
Portable
Radiation-free
Three-dimensional spine sensing system
Cobb angle
url https://doi.org/10.1186/s12891-025-08415-3
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