Scoliosis

Purpose

Quantify the presence and change of scoliosis measurements

Tag(s)

 

Panel

Pediatric 

TOUCH-AI ID

TAI-01180001

Originator

Pediatric Panel 

Panel Chair

Matt Hawkins

Panel Reviewers

Pediatric Panel 

License

Creative Commons 4.0 

Status Public Commenting 
                               

Clinical Implementation


Value Proposition

Scoliosis is a lateral curvature in the normally straight vertical line of the spine with mild roundness in the upper back and inward curvature of the spine. Detecting scoliosis is cumbersome and currently requires extensive manual human measurement to assess the spinal angle. An algorithm meeting this use case will make it easier to detect scoliosis, measure the curve, and flag any extreme spinal angles. Additionally, the algorithm may help detect and characterize rotary scoliosis. These automated measurements will improve consistency between operators and provide the radiologist with more time to focus on ancillary findings that could be missed by orthopedic surgeons.

Narrative(s)

A teenage female patient presents with suspected scoliosis of the back.

Workflow Description

An x-ray is taken and sent to PACS and the AI engine. The algorithm is triggered automatically by a scoliosis study. This scoliosis algorithm returns the patient’s Cobb angle and pelvic tilt as well as change over time, if priors exist. An algorithm that also produces the Risser score, the presence of triradiate cartilage, and vertebral body numbering is preferable. Additional data elements are suggested for a wider scope of populations.

Considerations for Dataset Development


Procedures(s): X-ray, Scoliosis Procedure, Total Spine

View(s): {Upright, supine, flexion, extension}

 

Sex at Birth: {Male, Female}

 

Age: All

 

Pelvic Tilt (degrees):  [0,180]

 

Weight-Bearing: {weight bearing, non-weight bearing}

 

Image Acquisition: {Image fusion (consider front-thoracic spine, lumbar spine, or cervical spine), Total spine exposure}

Technical Specifications


Inputs

DICOM Study

Procedure

XRAY, Scoliosis Procedure, Total Spine

Views

Upright, supine, flexion, extension

Data Type

DICOM

Modality

XRAY

Body Region

Spine

Anatomic Focus

Spinal Cord

Primary Outputs

Cobb Angle

RadElement ID

RDE265

Definition

Measure coronal plane deformity on anteroposterior plane radiographs in the classification of scoliosis.

Data Type

Numeric

Value Set

 

Units

Degrees

 

Pelvic Tilt

RadElement ID

RDE266

Definition

Angle between the iliac crest to the horizontal

Data Type

Numeric

Value Set

 

Units

Degrees

Secondary Outputs

Risser Score

RadElement ID

RDE274

Definition

Grade skeletal maturity based on the level of ossification and fusion of the iliac crest apophyses

Data Type

Categorical

Value Set

0–Stage 0: no ossification center at the level of iliac crest apophysis

1–Stage 1: apophysis along <25% of the iliac crest

2–Stage 2: apophysis along 25-50% of the iliac crest

3–Stage 3: apophysis along 50-75% of the iliac crest

4–Stage 4: apophysis along >75% of the iliac crest

5–Stage 5: complete ossification and fusion of the iliac crest apophysis

6–Indeterminate

Units

N/A

 

Triradiate Cartilage

RadElement ID

RDE267

Definition

Epiphyseal plate between the ilium, ischium, and pubis to form the acetabulum of the os coxae

Data Type

Categorical

Value Set

0–Open

1–Closed

2–Indeterminate

Units

N/A

 

Vertebral Body Numbering

RadElement ID

RDE268

Definition

Numbering order of the vertebrae of the human spinal column

Data Type

Matrix

Value Set

0–Non vertebrae pixel

{C1, C2, C3, C4,C5, C6, C7, Th1, Th2, Th3, Th4, Th5, Th6, Th7, Th8, Th9, Th10, Th11, Th12, Th13, L1, L2, L3, L4, L5, L6, Os sacrum, Coccyx}

Units

N/A

 

Pelvic Incidence

RadElement ID

RDE269

Definition

Angle of incidence is the algebraic sum of 2 complementary angles: pelvic tilt and sacral slope

Data Type

Numeric

Value Set

 

Units

Degrees

 

Sagittal Vertical Axis

RadElement ID

RDE270

Definition

Sagittal offset of a plumb line dropped from the C7 vertebral body from the posterosuperior corner of the sacral plate

Data Type

Numeric

Value Set

 

Units

mm

 

Thoracic Kyphosis Angle

RadElement ID

RDE271

Definition

Thoracic convexity

Data Type

Numeric

Value Set

 

Units

Degrees

 

Lumar Lordosis Angle

RadElement ID

RDE272

Definition

Anterior convexity of the lumbar spine in the midsagittal plane

Data Type

Numeric

Value Set

 

Units

Degrees

 

Scoliosis Type

RadElement ID

RDE273

Definition

Classify the scoliosis type, which is required information for ICD-10

Data Type

Categorical

Value Set

0–Unknown

1–Congenital

2–Infantile, idiopathic

3–Juvenile, idiopathic

4–Thoracogenic

5–Radiation related

6–Syndrome related

Units

N/A

Public Commenting


Use cases are meant to be a primary vehicle for distributing clinical information to the developer community. They pinpoint precise scenarios within radiology workflows where potential automation could add noticeable value and establish standards for interpreting and passing corresponding common data elements. Implementing effective standards requires the perspective from all stakeholders. So to that end, we encourage your feedback on use cases.

To submit comments, please email DSIUseCases@acr.org with the use case title(s) and relevant comments by January 1, 2019. If more convenient, you may also download this use case and comment directly on the PDF. Just attach the PDF copy on the email.