Scoliosis

Purpose	Quantify the presence and change of scoliosis measurements
Tag(s)
Panel	Pediatric
TOUCH-AI ID	18010001
Originator	Pediatric Panel
Panel Chair	Matt Hawkins
Panel Reviewers	Pediatric Panel
License	Creative Commons 4.0
Status	Published

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	RDE264
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	RDE265
Definition	Angle between the iliac crest to the horizontal
Data Type	Numeric
Value Set
Units	Degrees

Secondary Outputs

Risser Score

RadElement ID	RDE273
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	RDE266
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	RDE267
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	RDE268
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	RDE269
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	RDE270
Definition	Thoracic convexity
Data Type	Numeric
Value Set
Units	Degrees

Lumar Lordosis Angle

RadElement ID	RDE271
Definition	Anterior convexity of the lumbar spine in the midsagittal plane
Data Type	Numeric
Value Set
Units	Degrees

Scoliosis Type

RadElement ID	RDE272
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

Related Datasets

No known related public datasets at this time, please alert us if you know of any.