{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T11:11:31Z","timestamp":1778065891385,"version":"3.51.4"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004377","name":"The Hong Kong Polytechnic University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004377","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Spine J"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Although optical (OPI) and ultrasonic imaging (USI) have each been independently investigated as non-invasive alternatives to radiography (Xray) in scoliosis assessment, no study has yet directly compared their clinical performance. This study aimed to evaluate the clinical agreement and validity of OPI and USI, using Xray as the reference standard.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Radiographic Cobb angle served as the gold standard for clinical evaluation of two non-invasive methods. The OPI-angle was derived from spine models fitted to digitised surface data based on structured-light, while USI-angle was measured from images acquired using an ultrasonic system. All scans were performed in the same upright posture. For analysis, 14 participants with suspected scoliosis completed all three assessments (Xray, OPI, USI) for direct three-way comparison. Additionally, 29 participants underwent Xray and OPI, and 25 underwent Xray and USI, enabling respective pairwise comparisons with the radiographic Cobb angle. The correlation, agreement, and measurement error were evaluated, with subgroup analyses based on spinal region, curve severity, and apical vertebral rotation (AVR) level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Both non-invasive methods showed strong correlations with the radiographic Cobb angle (OPI:\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.873, 95% CI: 0.734\u20130.938; USI:\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.902, 95% CI: 0.791\u20130.953), with mean absolute differences (MADs) of 4.3\u00b0 and 4.2\u00b0, respectively. The correlation between OPI- and USI-angles was\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.795 (95% CI: 0.590\u20130.898). Subgroup analyses revealed stronger correlations in the thoracic compared to the lumbar region for both methods. USI-angle showed a smaller MAD in mild than in moderate curves (4.3\u00b0 vs. 7.1\u00b0). Optimal performance for both methods was observed at 5\u201310\u00b0 AVR (OPI: MAD\u2009=\u20093.9\u00b0,\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.846; USI: MAD\u2009=\u20095.2\u00b0,\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.835).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Both OPI and USI demonstrated strong agreement with radiographic measurements in scoliosis assessment, supporting their potential as useful non-invasive tools for clinical screening and monitoring applications. Additional validation with larger sample sizes, different severities, and various body mass index levels is required to further improve their clinical efficacy and applicability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00586-026-09985-z","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T10:16:58Z","timestamp":1778062618000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical relevance among optical, ultrasonic, and radiographic imaging in scoliosis assessment"],"prefix":"10.1007","author":[{"given":"Yiying","family":"Zou","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Bertsch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mirko","family":"Kaiser","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William R.","family":"Taylor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanja","family":"Lukovic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Man Sang","family":"Wong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sasa","family":"Cukovic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,5,6]]},"reference":[{"key":"9985_CR1","doi-asserted-by":"crossref","unstructured":"Negrini S et al (2018) 2016 SOSORT guidelines: Orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis Spinal Disorders, 13(1):3","DOI":"10.1186\/s13013-017-0145-8"},{"key":"9985_CR2","doi-asserted-by":"crossref","unstructured":"Weinstein SL (2019) The Natural History of Adolescent Idiopathic Scoliosis. J Pediatr Orthop, 39(Issue 6, Supplement 1 Suppl 1): pp. S44-S46","DOI":"10.1097\/BPO.0000000000001350"},{"key":"9985_CR3","doi-asserted-by":"publisher","first-page":"3123","DOI":"10.1007\/s00586-020-06573-7","volume":"29","author":"F-J Luan","year":"2020","unstructured":"Luan F-J et al (2020) Cancer and mortality risks of patients with scoliosis from radiation exposure: a systematic review and meta-analysis. Eur Spine J 29:3123\u20133134","journal-title":"Eur Spine J"},{"issue":"1","key":"9985_CR4","doi-asserted-by":"publisher","first-page":"899","DOI":"10.1186\/s12891-025-09034-8","volume":"26","author":"M Bertsch","year":"2025","unstructured":"Bertsch M et al (2025) Exploring radiation-free scoliosis monitoring: systematic review and meta-analysis of non-ionizing methods. BMC Musculoskelet Disord 26(1):899","journal-title":"BMC Musculoskelet Disord"},{"issue":"4","key":"9985_CR5","doi-asserted-by":"publisher","first-page":"832","DOI":"10.1016\/j.jbmt.2016.02.004","volume":"20","author":"RM Aroeira","year":"2016","unstructured":"Aroeira RM et al (2016) Non-invasive methods of computer vision in the posture evaluation of adolescent idiopathic scoliosis. J Bodyw Mov Ther 20(4):832\u2013843","journal-title":"J Bodyw Mov Ther"},{"key":"9985_CR6","doi-asserted-by":"crossref","unstructured":"Mehta B et al (2023) Non-Invasive Assessment of Back Surface Topography: Technologies, Techniques and Clinical Utility. Sens (Basel), 23(20):8485","DOI":"10.3390\/s23208485"},{"issue":"2","key":"9985_CR7","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1016\/j.jspd.2015.08.008","volume":"4","author":"P Knott","year":"2016","unstructured":"Knott P et al (2016) Multicenter Comparison of 3D Spinal Measurements Using Surface Topography With Those From Conventional Radiography. Spine Deform 4(2):98\u2013103","journal-title":"Spine Deform"},{"issue":"2","key":"9985_CR8","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1097\/BRS.0000000000001679","volume":"42","author":"A Tabard-Fougere","year":"2017","unstructured":"Tabard-Fougere A et al (2017) Validity and Reliability of Spine Rasterstereography in Patients With Adolescent Idiopathic Scoliosis. Spine (Phila Pa 1976) 42(2):98\u2013105","journal-title":"Spine (Phila Pa 1976)"},{"key":"9985_CR9","doi-asserted-by":"crossref","unstructured":"Chan V, Perlas A (2011) Basics of ultrasound imaging. Atlas of ultrasound-guided procedures in interventional pain management, pp. 13\u201319","DOI":"10.1007\/978-1-4419-1681-5_2"},{"issue":"4","key":"9985_CR10","doi-asserted-by":"publisher","first-page":"717","DOI":"10.1007\/s00586-019-06280-y","volume":"29","author":"HD Wu","year":"2020","unstructured":"Wu HD, Liu W, Wong MS (2020) Reliability and validity of lateral curvature assessments using clinical ultrasound for the patients with scoliosis: a systematic review. Eur Spine J 29(4):717\u2013725","journal-title":"Eur Spine J"},{"key":"9985_CR11","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1186\/s13013-016-0074-y","volume":"11","author":"YP Zheng","year":"2016","unstructured":"Zheng YP et al (2016) A reliability and validity study for Scolioscan: A radiation-free scoliosis assessment system using 3D ultrasound imaging. Scoliosis Spinal Disord 11:13","journal-title":"Scoliosis Spinal Disord"},{"issue":"6","key":"9985_CR12","doi-asserted-by":"publisher","first-page":"e0198792","DOI":"10.1371\/journal.pone.0198792","volume":"13","author":"R Zheng","year":"2018","unstructured":"Zheng R et al (2018) Factors influencing spinal curvature measurements on ultrasound images for children with adolescent idiopathic scoliosis (AIS). PLoS ONE 13(6):e0198792","journal-title":"PLoS ONE"},{"key":"9985_CR13","doi-asserted-by":"crossref","unstructured":"Lai KK et al (2021) Validation of Scolioscan Air-Portable Radiation-Free Three-Dimensional Ultrasound Imaging Assessment System for Scoliosis. Sens (Basel), 21(8):2858","DOI":"10.3390\/s21082858"},{"issue":"11","key":"9985_CR14","doi-asserted-by":"publisher","first-page":"2360","DOI":"10.1007\/s00586-013-2693-9","volume":"22","author":"S Langensiepen","year":"2013","unstructured":"Langensiepen S et al (2013) Measuring procedures to determine the Cobb angle in idiopathic scoliosis: a systematic review. Eur Spine J 22(11):2360\u20132371","journal-title":"Eur Spine J"},{"key":"9985_CR15","unstructured":"Bertsch M (2025) Reading the back, revealing the spine: Optical surface imaging and machine learning for radiation-free scoliosis monitoring. Doctoral thesis, ETH Zurich"},{"key":"9985_CR16","unstructured":"Bertsch M et al (2026) Inferring spinal curvature from back surface topography: a data-driven approach to scoliosis assessment. Comput Biol Med, (under review). pp. 1633612"},{"key":"9985_CR17","doi-asserted-by":"publisher","first-page":"p110735","DOI":"10.1016\/j.compbiomed.2025.110735","volume":"196Pt A","author":"S Cukovic","year":"2025","unstructured":"Cukovic S et al (2025) Advancing 3D idiopathic scoliosis assessment through optical scans and web-based integration - Validation of the ScolioSIM system. Comput Biol Med 196Pt A:p110735","journal-title":"Comput Biol Med"},{"issue":"6","key":"9985_CR18","doi-asserted-by":"publisher","first-page":"979","DOI":"10.1016\/j.spinee.2017.10.012","volume":"18","author":"RC Brink","year":"2018","unstructured":"Brink RC et al (2018) A reliability and validity study for different coronal angles using ultrasound imaging in adolescent idiopathic scoliosis. Spine J 18(6):979\u2013985","journal-title":"Spine J"},{"issue":"1","key":"9985_CR19","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1007\/BF00298416","volume":"4","author":"H-R Weiss","year":"1995","unstructured":"Weiss H-R (1995) Measurement of vertebral rotation: Perdriolle versus Raimondi. Eur Spine J 4(1):34\u201338","journal-title":"Eur Spine J"},{"issue":"5","key":"9985_CR20","doi-asserted-by":"publisher","first-page":"1763","DOI":"10.1213\/ANE.0000000000002864","volume":"126","author":"P Schober","year":"2018","unstructured":"Schober P, Boer C, Schwarte LA (2018) Correlation Coefficients: Appropriate Use and Interpretation. Anesth Analg 126(5):1763\u20131768","journal-title":"Anesth Analg"},{"issue":"18","key":"9985_CR21","doi-asserted-by":"publisher","first-page":"2068","DOI":"10.1097\/01.brs.0000178819.90239.d0","volume":"30","author":"BS Richards","year":"2005","unstructured":"Richards BS et al (2005) Standardization of criteria for adolescent idiopathic scoliosis brace studies: SRS committee on bracing and nonoperative management. Spine 30(18):2068\u20132075","journal-title":"Spine"},{"key":"9985_CR22","doi-asserted-by":"crossref","unstructured":"Trzcinska S, Kuszewski M, Koszela K (2022) Analysis of Posture Parameters in Patients with Idiopathic Scoliosis with the Use of 3D Ultrasound Diagnostics-Preliminary Results. Int J Environ Res Public Health, 19(8):4750","DOI":"10.3390\/ijerph19084750"},{"issue":"13","key":"9985_CR23","doi-asserted-by":"publisher","first-page":"E781","DOI":"10.1097\/BRS.0000000000001971","volume":"42","author":"A Hong","year":"2017","unstructured":"Hong A et al (2017) Surface Topography Classification Trees for Assessing Severity and Monitoring Progression in Adolescent Idiopathic Scoliosis. Spine (Phila Pa 1976) 42(13):E781\u2013E787","journal-title":"Spine (Phila Pa 1976)"},{"issue":"6","key":"9985_CR24","doi-asserted-by":"publisher","first-page":"633","DOI":"10.1097\/PXR.0000000000000275","volume":"47","author":"B Hassan Beygi","year":"2023","unstructured":"Hassan Beygi B et al (2023) A feasibility study of application of purpose-design frame and 3-D clinical ultrasound in assessment and design of spinal orthoses for adolescent idiopathic scoliosis. Prosthet Orthot Int 47(6):633\u2013639","journal-title":"Prosthet Orthot Int"},{"issue":"9","key":"9985_CR25","doi-asserted-by":"publisher","first-page":"771","DOI":"10.1093\/pch\/12.9.771","volume":"12","author":"JA Janicki","year":"2007","unstructured":"Janicki JA, Alman B (2007) Scoliosis: Review of diagnosis and treatment. Paediatr Child Health 12(9):771\u2013776","journal-title":"Paediatr Child Health"},{"issue":"11","key":"9985_CR26","doi-asserted-by":"publisher","first-page":"2866","DOI":"10.1016\/j.ultrasmedbio.2019.07.006","volume":"45","author":"YS Wong","year":"2019","unstructured":"Wong YS et al (2019) Is Radiation-Free Ultrasound Accurate for Quantitative Assessment of Spinal Deformity in Idiopathic Scoliosis (IS): A Detailed Analysis With EOS Radiography on 952 Patients. Ultrasound Med Biol 45(11):2866\u20132877","journal-title":"Ultrasound Med Biol"},{"issue":"23","key":"9985_CR27","doi-asserted-by":"publisher","first-page":"1645","DOI":"10.1097\/BRS.0000000000004990","volume":"49","author":"A Gardner","year":"2024","unstructured":"Gardner A, Berryman F, Pynsent P (2024) How Accurate Are Anatomical Surface Topography Parameters in Indicating the Presence of a Scoliosis? Spine (Phila Pa 1976) 49(23):1645\u20131651","journal-title":"Spine (Phila Pa 1976)"},{"issue":"4","key":"9985_CR28","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1016\/j.jos.2018.03.005","volume":"23","author":"H Kuroki","year":"2018","unstructured":"Kuroki H et al (2018) School scoliosis screening by Moire topography - Overview for 33 years in Miyazaki Japan. J Orthop Sci 23(4):609\u2013613","journal-title":"J Orthop Sci"},{"issue":"1","key":"9985_CR29","doi-asserted-by":"publisher","first-page":"14273","DOI":"10.1038\/s41598-023-41267-2","volume":"13","author":"Q Zheng","year":"2023","unstructured":"Zheng Q et al (2023) A feasibility study of applying two-dimensional photogrammetry for screening and monitoring of patients with adolescent idiopathic scoliosis in clinical practice. Sci Rep 13(1):14273","journal-title":"Sci Rep"}],"container-title":["European Spine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00586-026-09985-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00586-026-09985-z","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00586-026-09985-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T10:17:07Z","timestamp":1778062627000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00586-026-09985-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,6]]},"references-count":29,"alternative-id":["9985"],"URL":"https:\/\/doi.org\/10.1007\/s00586-026-09985-z","relation":{},"ISSN":["0940-6719","1432-0932"],"issn-type":[{"value":"0940-6719","type":"print"},{"value":"1432-0932","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,6]]},"assertion":[{"value":"11 February 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 March 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 April 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 May 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}