Automated Cobb Angle Measurements for Scoliosis Diagnosis and Assessment: AI Applications and Accuracy Enhancement Through Image Processing Techniques

Introduction Scoliosis is characterized by an abnormal curvature of the spine in the coronal plane. Idiopathic scoliosis is the most prevalent type, though specific causes are sometimes identifiable. Genetic factors significantly influence adolescent idiopathic scoliosis (AIS), which is diagnosed through clinical and radiographic evaluations, primarily using the Cobb angle to measure curvature severity. The classification of scoliosis severity ranges from mild scoliosis, where sometimes the absence of pain is encountered, to moderate and severe, which is usually associated with lancinating pain. Early onset and high progression rates in idiopathic scoliosis are indicative of poorer prognoses. Methods The study analyzed 197 radiographic images from a private clinic database between December 2023 and April 2024. Inclusion criteria focused on anteroposterior images of the thorax and abdomen, excluding unclear and non-spinal images. Manual Cobb angle measurements were performed using RadiAnt DICOM Viewer 2020.2, followed by automated measurements using the Cobb Angle Calculator software. Discrepancies led to further image processing with enhanced color contrast for improved visualization. Data were analyzed using GraphPad InStat to assess error margins between manual and automated measurements. Results Initial results indicated discrepancies between manual and automated Cobb angle measurements. Enhanced image processing improved accuracy, demonstrating the efficacy of both manual and automated techniques in evaluating spinal deformities. Statistical analysis revealed significant error margins, prompting a refined approach for minimizing measurement errors. Discussion The study highlights the importance of accurate Cobb angle measurement in diagnosing and classifying scoliosis. Manual measurements, while reliable, are time-consuming and prone to human error. Automated methods, particularly those enhanced by machine learning algorithms, offer promising accuracy and efficiency. The integration of image processing techniques further enhances the reliability of scoliosis evaluation. Conclusion Accurate assessment of scoliosis through Cobb angle measurement is crucial for effective diagnosis and treatment planning. The study demonstrates that combining manual techniques with advanced automated methods and image processing significantly improves measurement accuracy. Such an approach is intended to support better clinical outcomes. Future research should focus on refining these technologies for broader clinical applications.