Validity and reliability of 3D automatic ultrasound imaging for measuring coronal and sagittal angles in idiopathic scoliosis

Patients with idiopathic scoliosis require regular radiation-less follow-up such as ultrasound. Automated labeling reduces traditional ultrasound manual labeling errors. We enrolled 80 patients with idiopathic scoliosis between February 2024 and June 2024. We evaluated both intra- and inter-operator reliability of the ultrasound curve angle (UCA) and ultrasound lamina angle (USLA) and compared three-dimensional ultrasound assessments with conventional X-ray imaging to evaluate the validity and reliability of ultrasound measurements (UCA and USLA) against established radiographic benchmarks, including Cobb angle, thoracic kyphosis, and lumbar lordosis. Reliability assessments were conducted using the intraclass correlation coefficient (ICC). The validity of the UCA and USLA measurements was rigorously analyzed by comparing them against established radiographic benchmarks using Pearson correlation coefficients and Bland-Altman plots. ICC analyses confirmed robust ultrasound measurement reliability. Validity evaluations revealed a pronounced linear correlation between the UCA and coronal Cobb angle. Bland-Altman plots showed a strong correlation between ultrasound and radiologic measurements in the coronal plane. Automated ultrasound represents a promising diagnostic tool for monitoring conservative treatments in the future.