Ensemble learning of deep CNN models and two stage level prediction of Cobb angle on surface topography in adolescents with idiopathic scoliosis

This study employs Convolutional Neural Networks (CNNs) as feature extractors with appended regression layers for the non-invasive prediction of Cobb Angle (CA) from Surface Topography (ST) scans in adolescents with Idiopathic Scoliosis (AIS). The aim is to minimize radiation exposure during critical growth periods by offering a reliable, non-invasive assessment tool. The efficacy of various CNN-based feature extractors-DenseNet121, EfficientNetB0, ResNet18, SqueezeNet, and a modified U-Net-was evaluated on a dataset of 654 ST scans using a regression analysis framework for accurate CA prediction. The dataset comprised 590 training and 64 testing scans. Performance was evaluated using Mean Absolute Error (MAE), Root Mean Square Error (RMSE), and accuracy in classifying scoliosis severity (mild, moderate, severe) based on CA measurements. The EfficientNetB0 feature extractor outperformed other models, demonstrating strong performance on the training set (R = 0.96, R2 = 0.93) and achieving an MAE of 6.13 degrees and RMSE of 7.5 degrees on the test set. In terms of scoliosis severity classification, it achieved high precision (84.62%) and specificity (95.65% for mild cases and 82.98% for severe cases), highlighting its clinical applicability in AIS management. The regression-based approach using the EfficientNetB0 as a feature extractor presents a significant advancement for accurately determining CA from ST scans, offering a promising tool for improving scoliosis severity categorization and management in adolescents.