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A method for measuring spinal curvature that provides a useful analog to the Cobb angle and is tolerant of degraded image quality is proposed. Conventional methods require a higher standard of discernibility for vertebra features and suffer high variability.Assumption is made that the natural representation of the spine for the purpose of scoliosis monitoring is that of a continuous curved contour rather than a series of discrete vertebral bodies with individual orientations. The angle that a tangent line to this contour makes with the vertical, expressed as a continuous function of height, is proposed as a metric for characterization of the curve. The Cobb angle can be approximated as the difference between the extrema of this function, and details of the function shape can provide additional markers for tracking curve variation and evolution. A method for deriving the angle function from coronal images of the spine is proposed, and both manual and automatic variants of the procedure are described.The method is applied to conventional coronal radiographs and to magnetic resonance (MR) coronal views derived from volumetric acquisitions of the spine. Included in the latter category is an image exhibiting poor discrimination of vertebra features due to motion artifacts. The method permits extraction of the curve and Cobb angles in all cases.Because the spine contour is discernible even in low quality images where vertebral endplates may be obscured or poorly contrasted from surrounding tissue, the approach offers improved reliability, applicability across imaging modalities, and, in the case of x-rays, the possibility of a reduced radiation dose. Moreover, since it relies on larger image features and exploits the continuity of the spine, the contour-based approach is expected to reduce the variability associated with Cobb angle measurement.

Contour and Angle-Function Based Scoliosis Monitoring: Relaxing the Requirement on Image Quality in the Measurement of Spinal Curvature