Unsupervised local center of mass based scoliosis spinal segmentation and Cobb angle measurement

Scoliosis is a medical condition in which a person's spine has an abnormal curvature and Cobb angle is a measurement used to evaluate the severity of a spinal curvature. Presently, automatic Existing Cobb angle measurement techniques require huge dataset, time-consuming, and needs significant effort. So, it is important to develop an unsupervised method for the measurement of Cobb angle with good accuracy. In this work, an unsupervised local center of mass (LCM) technique is proposed to segment the spine region and further novel Cobb angle measurement method is proposed for accurate measurement. Validation of the proposed method was carried out on 2D X-ray images from the Saudi Arabian population. Segmentation results were compared with GMM-Based Hidden Markov Random Field (GMM-HMRF) segmentation method based on sensitivity, specificity, and dice score. Based on the findings, it can be observed that our proposed segmentation method provides an overall accuracy of 97.3% whereas GMM-HMRF has an accuracy of 89.19%. Also, the proposed method has a higher dice score of 0.54 compared to GMM-HMRF. To further evaluate the effectiveness of the approach in the Cobb angle measurement, the results were compared with Senior Scoliosis Surgeon at Multispecialty Hospital in Saudi Arabia. The findings indicated that the segmentation of the scoliotic spine was nearly flawless, and the Cobb angle measurements obtained through manual examination by the expert and the algorithm were nearly identical, with a discrepancy of only ± 3 degrees. Our proposed method can pave the way for accurate spinal segmentation and Cobb angle measurement among scoliosis patients by reducing observers' variability.