title: Intra- and Inter-rater Reliability of Coronal Curvature Measurement for Adolescent Idiopathic Scoliosis Using Ultrasonic Imaging Method-A Pilot Study.
abstract: METHODS
  Retrospective reliability study of the coronal curvature measurement on ultrasound (US) imaging in adolescent idiopathic scoliosis (AIS).
  
  
  OBJECTIVE
  To determine the intra- and inter-rater reliability and validity of the coronal curvature measurements obtained from US images.
  
  
  BACKGROUND
  Cobb angle measurements on radiographs are the usual method to diagnose and monitor the progression of scoliosis. Repeated ionizing radiation exposure is a frequent concern of patients and their families. Use of US imaging method to measure coronal curvature in children who have idiopathic scoliosis has not been clinically validated.
  
  
  METHODS
  The researchers scanned 26 subjects using a medical 3-dimensional US system. Spinal radiographs were obtained on the same day from the local scoliosis clinic. Three raters used the center of lamina method to measure the coronal curvature on the US images twice 1 week apart. The raters also measured the Cobb angle on the radiographs twice. Intra- and inter-rater reliability of the coronal curvature measurement from the US images was analyzed using intra-class correlation coefficients. The correlation coefficient of the US coronal curvature measurements was compared with the Cobb angles.
  
  
  RESULTS
  The intra-class correlation coefficient (2,1) values of intra- and inter-rater reliability on the US method were greater than 0.80. Standard error of measurement on both of the intra- and inter-rater US methods was less than 2.8°. The correlation coefficient between the US and radiographic methods ranged between 0.78 and 0.84 among 3 raters.
  
  
  CONCLUSIONS
  The US method illustrated substantial intra- and inter-rater reliability. The measurement difference between radiography and the US method was within the range of clinically acceptable error (5°). The US method may be considered a radiation-free alternative to assess children with scoliosis of mild to moderate severity.
authors.affiliation: Department of Surgery, University of Alberta, 8440 - 112 Street, Edmonton T6G 2B7, Canada.
authors.forename: Rui
authors.initials: R
authors.lastname: Zheng
authors.affiliation: Department of Surgery, University of Alberta, 8440 - 112 Street, Edmonton T6G 2B7, Canada.
authors.forename: Amanda C Y
authors.initials: AC
authors.lastname: Chan
authors.affiliation: Department of Biomedical Engineering, University of Alberta, 8308-114 Street, Edmonton, Canada T6G 2V2.
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.affiliation: Department of Surgery, University of Alberta, 8440 - 112 Street, Edmonton T6G 2B7, Canada; Glenrose Rehabilitation Hospital, Alberta Health Services, Glenrose Rehabilitation Research Centre, 10105 112 Avenue, Edmonton, Canada T5G 0H1.
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Hill
authors.affiliation: Department of Radiology and Diagnostic Imaging, University of Alberta, 8440-112 Street, Edmonton, Canada T6G 2B7.
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Le
authors.affiliation: Department of Surgery, University of Alberta, 8440 - 112 Street, Edmonton T6G 2B7, Canada.
authors.forename: Douglas
authors.initials: D
authors.lastname: Hedden
authors.affiliation: Department of Surgery, University of Alberta, 8440 - 112 Street, Edmonton T6G 2B7, Canada.
authors.forename: Marc
authors.initials: M
authors.lastname: Moreau
authors.affiliation: Department of Surgery, University of Alberta, 8440 - 112 Street, Edmonton T6G 2B7, Canada.
authors.forename: James
authors.initials: J
authors.lastname: Mahood
authors.affiliation: Department of Surgery, University of Alberta, 8440 - 112 Street, Edmonton T6G 2B7, Canada.
authors.forename: Sarah
authors.initials: S
authors.lastname: Southon
authors.affiliation: Department of Surgery, University of Alberta, 8440 - 112 Street, Edmonton T6G 2B7, Canada; Glenrose Rehabilitation Hospital, Alberta Health Services, Glenrose Rehabilitation Research Centre, 10105 112 Avenue, Edmonton, Canada T5G 0H1. Electronic address: elou@ualberta.ca.
authors.forename: Edmond
authors.initials: E
authors.lastname: Lou
keywords: AIS; COL method; Cobb angle; Coronal curvature; Ultrasound imaging