OBJECTIVES To automatically measure the Cobb angle and diagnose scoliosis on chest X-rays, a computer-aided method was proposed and the reliability and accuracy were evaluated. METHODS Two Mask R-CNN models as the core of a computer-aided method were used to separately detect and segment the spine and all vertebral bodies on chest X-rays, and the Cobb angle of the spinal curve was measured from the output of the Mask R-CNN models. To evaluate the reliability and accuracy of the computer-aided method, the Cobb angles on 248 chest X-rays from lung cancer screening were measured automatically using a computer-aided method, and two experienced radiologists used a manual method to separately measure Cobb angles on the aforementioned chest X-rays. RESULTS For manual measurement of the Cobb angle on chest X-rays, the intraclass correlation coefficients (ICC) of intra- and inter-observer reliability analysis was 0.941 and 0.887, respectively, and the mean absolute differences were < 3.5°. The ICC between the computer-aided and manual methods for Cobb angle measurement was 0.854, and the mean absolute difference was 3.32°. These results indicated that the computer-aided method had good reliability for Cobb angle measurement on chest X-rays. Using the mean value of Cobb angles in manual measurements > 10° as a reference standard for scoliosis, the computer-aided method achieved a high level of sensitivity (89.59%) and a relatively low level of specificity (70.37%) for diagnosing scoliosis on chest X-rays. CONCLUSION The computer-aided method has potential for automatic Cobb angle measurement and scoliosis diagnosis on chest X-rays. These slides can be retrieved under Electronic Supplementary Material.

中文翻译：

---

计算机辅助测量胸部X射线Cobb角的方法的评估。

目的为了自动测量Cobb角并诊断胸部X光片上的脊柱侧弯，提出了一种计算机辅助方法，并对其可靠性和准确性进行了评估。方法采用两个Mask R-CNN模型作为计算机辅助方法的核心，分别在胸部X射线上检测和分割脊柱和所有椎体，并从X射线的输出测量脊髓曲线的Cobb角。遮罩R-CNN模型。为了评估该计算机辅助方法的可靠性和准确性，使用计算机辅助方法自动测量了来自肺癌筛查的248例胸部X射线的Cobb角，两名经验丰富的放射科医生使用手动方法分别测量了Cobb角。上面提到的胸部X光片。结果对于在胸部X射线上手动测量Cobb角，观察者内和观察者间可靠性分析的类内相关系数（ICC）分别为0.941和0.887，平均绝对差<3.5°。用计算机辅助方法和人工方法进行Cobb角测量的ICC为0.854，平均绝对差为3.32°。这些结果表明，计算机辅助方法对胸部X射线Cobb角测量具有良好的可靠性。使用人工测量> 10°的Cobb角平均值作为脊柱侧弯的参考标准，计算机辅助方法在诊断脊柱侧弯时获得了较高的灵敏度（89.59％）和相对较低的特异性（70.37％）。胸部X光片。结论该计算机辅助方法具有对胸部X射线自动Cobb角测量和脊柱侧凸诊断的潜力。