Clinical classification of scoliosis patients using machine learning and markerless 3D surface trunk data
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ORIGINAL ARTICLE
Clinical classification of scoliosis patients using machine learning and markerless 3D surface trunk data Stephan Rothstock 1
&
Hans-Rudolf Weiss 2 & Daniel Krueger 1 & Lothar Paul 1
Received: 7 April 2020 / Accepted: 29 August 2020 # International Federation for Medical and Biological Engineering 2020
Abstract Markerless 3D surface topography for scoliosis diagnosis and brace treatment can avoid repeated radiation known from standard X-ray analysis and possible side effects. Combined with the method of torso asymmetry analysis, curve severity and progression can be evaluated with high reliability. In the current study, a machine learning approach was utilised to classify scoliosis patients based on their trunk surface asymmetry pattern. Frontal X-ray and 3D scanning analysis with a clinical classification based on Cobb angle and spinal curve pattern were performed with 50 patients. Similar as in a previous study, each patient’s trunk 3D reconstruction was used for an elastic registration of a reference surface mesh with fixed number of vertices. Subsequently, an asymmetry distance map between original and reflected torso was calculated. A fully connected neural network was then utilised to classify patients regarding their Cobb angle (mild, moderate, severe) and an Augmented Lehnert-Schroth (ALS) classification based on their full torso asymmetry distance map. The results reveal a classification success rate of 90% (SE: 80%, SP: 100%) regarding the curve severity (mild vs moderate-severe) and 50–72% regarding the ALS group. Identifying patient curve severity and treatment group was reasonably possible allowing for a decision support during diagnosis and treatment planning. Keywords Scoliosis . 3D surface scan . Asymmetry distance map . Machine learning . Classification
1 Introduction A total of 2–4% of the population are affected by adolescent idiopathic scoliosis (AIS) making it one of the most common three-dimensional spine diseases [29]. Not only natural progression but also treatment requires frequent follow-up investigations [28]. There are several options for conservative treatment of scoliosis which predominantly affects female patients. Brace therapy, for example following the Chêneau principle, has become one of them [24, 40, 42, 43]. Despite certain limitations, radiographic assessment of the spine is still the ‘gold’ standard to measure the Cobb angle [2] between the * Stephan Rothstock [email protected] Hans-Rudolf Weiss [email protected] 1
Society for the Advancement of Applied Computer Science Berlin, GFaI Gesellschaft zur Förderung angewandter Informatik e. V., Volmerstraße 3, D-12489 Berlin, Germany
2
KOOB ScoliTechGmbH & Co KG, Haarbergweg 2, D-55546 Neu Bamberg, Germany
two most tilted vertebrae of each curve. Nevertheless, scoliosis is a three-dimensional deformity, while the Cobb angle measurement is in the frontal plane only. Especially for younger patients, repeated X-ray examinations might be related to adverse effects [3, 19, 26, 30, 31, 33]. Structured l
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