Spinopelvic measurements of sagittal balance with deep learning: systematic review and critical evaluation

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

Purpose: To summarize and critically evaluate the existing studies for spinopelvic measurements of sagittal balance that are based on deep learning (DL). Methods: Three databases (PubMed, WoS and Scopus) were queried for records using keywords related to DL and measurement of sagittal balance. After screening the resulting 529 records that were augmented with specific web search, 34 studies published between 2017 and 2022 were included in the final review, and evaluated from the perspective of the observed sagittal spinopelvic parameters, properties of spine image datasets, applied DL methodology and resulting measurement performance. Results: Studies reported DL measurement of up to 18 different spinopelvic parameters, but the actual number depended on the image field of view. Image datasets were composed of lateral lumbar spine and whole spine X-rays, biplanar whole spine X-rays and lumbar spine magnetic resonance cross sections, and were increasing in size or enriched by augmentation techniques. Spinopelvic parameter measurement was approached either by landmark detection or structure segmentation, and U-Net was the most frequently applied DL architecture. The latest DL methods achieved excellent performance in terms of mean absolute error against reference manual measurements (~ 2° or ~ 1 mm). Conclusion: Although the application of relatively complex DL architectures resulted in an improved measurement accuracy of sagittal spinopelvic parameters, future methods should focus on multi-institution and multi-observer analyses as well as uncertainty estimation and error handling implementations for integration into the clinical workflow. Further advances will enhance the predictive analytics of DL methods for spinopelvic parameter measurement. Level of Evidence I: Diagnostic: individual cross-sectional studies with the consistently applied reference standard and blinding.

OriginalsprogEngelsk
TidsskriftEuropean Spine Journal
Vol/bind31
Sider (fra-til)2031–2045
ISSN0940-6719
DOI
StatusUdgivet - 2022

Bibliografisk note

Funding Information:
This work has been supported by the Slovenian Research Agency under grant P2-0232. The funding sources did not influence this investigation or affect the outcomes and results.

Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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