Automatic detection of scoliotic curves in posteroanterior radiographs

Spinal deformities are diagnosed using posteroanterior (PA) radiographs. Automatic detection of the spine on conventional radiographs would be of interest to quantify curve severity, would help reduce observer variability and would allow large-scale retrospective studies on radiographic databases. The goal of this paper is to present a new method for automatic detection of spinal curves from a PA radiograph. A region of interest (ROI) is first extracted according to the 2-D shape variability of the spine obtained from a set of PA radiographs of scoliotic patients. This region includes 17 bounding boxes delimiting each vertebral level from T1 to L5. An adaptive filter combining shock with complex diffusion is used to individually restore the image of each vertebral level. Then, texture descriptors of small block elements are computed and submitted for training to support vector machines (SVM). Vertebral body's locations are thereby inferred for a particular vertebral level. The classifications of block elements for all 17 SVMs are identified in the image and a voting system is introduced to cumulate correctly predicted blocks. A spline curve is then fitted through the centers of the predicted vertebral regions and compared to a manual identification using a Student t-test. A clinical validation is performed using 100 radiographs of scoliotic patients (not used for training) and the detected spinal curve is found to be statistically similar (p < 0.05) in 93% of cases to the manually identified curve.