Automatic Ultrasound Curve Angle Measurement via Affinity Clustering for Adolescent Idiopathic Scoliosis Evaluation

The current clinical gold standard for evaluating adolescent idiopathic scoliosis (AIS) is X-ray radiography, using Cobb angle measurement. However, the frequent monitoring of the AIS progression using X-rays poses a challenge due to the cumulative radiation exposure. Although 3D ultrasound has been validated as a reliable and radiation-free alternative for scoliosis assessment, the process of measuring spinal curvature is still carried out manually. Consequently, there is a considerable demand for a fully automatic system that can locate bony landmarks and perform angle measurements. To this end, we introduce an estimation model for automatic ultrasound curve angle (UCA) measurement. The model employs a dual-branch network to detect candidate landmarks and perform vertebra segmentation on ultrasound coronal images. An affinity clustering strategy is utilized within the vertebral segmentation area to illustrate the affinity relationship between candidate landmarks. Subsequently, we can efficiently perform line delineation from a clustered affinity map for UCA measurement. As our method is specifically designed for UCA calculation, this method outperforms other state-of-the-art methods for landmark and line detection tasks. The high correlation between the automatic UCA and Cobb angle (R$^2$=0.858) suggests that our proposed method can potentially replace manual UCA measurement in ultrasound scoliosis assessment.