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Purpose <p>Scoliosis affects up to 5% of the population, and early detection is crucial to prevent progression and surgical intervention. X-ray imaging remains the standard for scoliosis assessment, but repeated exposure to ionizing radiation increases cancer risks, particularly in pediatric patients. This study evaluates bone-enhanced 3D ultrasound (BEUS) as a non-ionizing alternative for scoliosis measurement.</p> Methods <p>We conducted a comparative analysis of X-ray and BEUS measurements in 34 pediatric patients. Each participant underwent same-day spinal imaging with both modalities. Scoliosis angles were measured independently by two observers using anatomical landmarks visible in both imaging modalities. Statistical tests assessed agreement between X-ray and BEUS, inter-observer variability, and potential biases.</p> Results <p>Minimal inter-observer variability was found (intraclass correlation coefficient = 0.98). 93% of BEUS measurements fell within a clinically acceptable ± 5° range of X-ray values. Regression analysis identified age and scoliosis severity as significant predictors of measurement differences (<i>p</i> &lt; 0.05). In particular, error increased with scoliosis severity, with curvatures above 40° showing significant deviation.</p> Conclusion <p>BEUS is a promising alternative for scoliosis assessment, demonstrating strong reliability for mild to moderate cases while eliminating radiation exposure. BEUS holds potential for routine scoliosis monitoring, reducing reliance on X-rays and minimizing radiation risk in pediatric patients.</p>

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Bone-enhanced 3D ultrasound: a non-ionizing alternative for pediatric scoliosis assessment

  • 期刊论文

  • 发表日期：

    2025年6月7日

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  • Tamas Ungi,
  • Catherine O. Wu,
  • Sarah J. D. Dance,
  • Charles Lawall,
  • Charles Nagel,
  • Gregg Khodorov,
  • Robert W. Ford,
  • Kevin Cleary,
  • Gabor Fichtinger,
  • Matthew E. Oetgen,
  • Daniel P. Borschneck

摘要

Purpose

Scoliosis affects up to 5% of the population, and early detection is crucial to prevent progression and surgical intervention. X-ray imaging remains the standard for scoliosis assessment, but repeated exposure to ionizing radiation increases cancer risks, particularly in pediatric patients. This study evaluates bone-enhanced 3D ultrasound (BEUS) as a non-ionizing alternative for scoliosis measurement.

Methods

We conducted a comparative analysis of X-ray and BEUS measurements in 34 pediatric patients. Each participant underwent same-day spinal imaging with both modalities. Scoliosis angles were measured independently by two observers using anatomical landmarks visible in both imaging modalities. Statistical tests assessed agreement between X-ray and BEUS, inter-observer variability, and potential biases.

Results

Minimal inter-observer variability was found (intraclass correlation coefficient = 0.98). 93% of BEUS measurements fell within a clinically acceptable ± 5° range of X-ray values. Regression analysis identified age and scoliosis severity as significant predictors of measurement differences (p < 0.05). In particular, error increased with scoliosis severity, with curvatures above 40° showing significant deviation.

Conclusion

BEUS is a promising alternative for scoliosis assessment, demonstrating strong reliability for mild to moderate cases while eliminating radiation exposure. BEUS holds potential for routine scoliosis monitoring, reducing reliance on X-rays and minimizing radiation risk in pediatric patients.