computer-aided measurement system using image processing for measuring cobb angle in scoliosis

Background: one of the spine deformities is scoliosis, and cobb angle is generally used to assess it.objectives: in this study, a computer-aided measurement system (cams) was presented as a new repeatable and reproducible approach to assess the cobb angle in idiopathic scoliosis patients.methods: python libraries, including opencv and numpy were used for image processing and design of the software. to assess the repeatability and reproducibility of the cams, a series of 98 anterior-posterior radiographs from patients with idiopathic scoliosis were used. assessments were done by five independent observers. each radiograph was assessed by each observer three times with a minimum break of two weeks among assessment. the single measure intraclass correlation coefficient (icc), the mean absolute difference (mad), and the standard error measurement (sem) values were used for intra- and inter-observer reliability.results: the inter-observer analysis indicated that the iccs ranged from 0.94 - 0.99, and the mad between manual and cams were less than 3°. for intra-observer measurements, the combined sem between all observers for the manual and cams was 1.79° and 1.27°, respectively. an icc value of 0.97 with 95% confidence interval (ci) was excellent in cams for inter-observer reliability. the mad of cams was 2.18 ± 2.01 degrees.conclusions: the cams is an effective and reliable approach for assessing scoliotic curvature in the standing radiographs of thoraco-lumbar. moreover, cams can accelerate clinical visits, and its calculation results are reliable.