arXiv:2507.14093cs.CVcs.AI2025-07

AI自动测量脊柱侧弯角度,多中心验证效果接近专家水平。

Multi-Centre Validation of a Deep Learning Model for Scoliosis Assessment

  • 用深度学习模型自动分析全脊柱正位片,实现无需人工干预的侧弯角度测量。
  • 与两位放射科医生相比,平均误差仅3.9度,相关性达0.88以上。
  • 适合临床快速筛查和分诊,减轻医生负担,提升诊断一致性。

青少年脊柱侧弯患病率约2%至4%,治疗决策依赖精确的Cobb角测量。手动评估耗时且存在观察者间差异。本研究对来自十家医院的103张站立前后位全脊柱X光片进行了回顾性多中心评估,使用全自动深度学习软件Carebot AI Bones(Spine Measurement功能;Carebot s.r.o.)。两名骨科放射科医生独立测量作为参考标准。通过Bland-Altman分析、平均绝对误差(MAE)、均方根误差(RMSE)、皮尔逊相关系数及严重程度分级的组内一致性系数(Cohen kappa)评估AI与每位医生的一致性。与放射科医生1相比,AI的MAE为3.89度(RMSE 4.77度),偏倚0.70度,一致性界限为-8.59至+9.99度;与放射科医生2相比,MAE为3.90度(RMSE 5.68度),偏倚2.14度,一致性界限为-8.23至+12.50度。皮尔逊相关系数分别为0.906和0.880(医生间相关系数0.928),严重程度分级的Cohen kappa值分别为0.51和0.64(医生间kappa 0.59)。结果表明,该软件在多中心环境下可复现专家水平的Cobb角测量和分类分级,具备提升临床报告与分诊效率的应用潜力。

原文摘要 · Abstract (English)

Scoliosis affects roughly 2 to 4 percent of adolescents, and treatment decisions depend on precise Cobb angle measurement. Manual assessment is time consuming and subject to inter observer variation. We conducted a retrospective, multi centre evaluation of a fully automated deep learning software (Carebot AI Bones, Spine Measurement functionality; Carebot s.r.o.) on 103 standing anteroposterior whole spine radiographs collected from ten hospitals. Two musculoskeletal radiologists independently measured each study and served as reference readers. Agreement between the AI and each radiologist was assessed with Bland Altman analysis, mean absolute error (MAE), root mean squared error (RMSE), Pearson correlation coefficient, and Cohen kappa for four grade severity classification. Against Radiologist 1 the AI achieved an MAE of 3.89 degrees (RMSE 4.77 degrees) with a bias of 0.70 degrees and limits of agreement from minus 8.59 to plus 9.99 degrees. Against Radiologist 2 the AI achieved an MAE of 3.90 degrees (RMSE 5.68 degrees) with a bias of 2.14 degrees and limits from minus 8.23 to plus 12.50 degrees. Pearson correlations were r equals 0.906 and r equals 0.880 (inter reader r equals 0.928), while Cohen kappa for severity grading reached 0.51 and 0.64 (inter reader kappa 0.59). These results demonstrate that the proposed software reproduces expert level Cobb angle measurements and categorical grading across multiple centres, suggesting its utility for streamlining scoliosis reporting and triage in clinical workflows.

医学影像AI诊断脊柱侧弯深度学习

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