Aims and objectives
Ossification of the posterior longitudinal ligament (OPLL) of the cervical spine is one of the most common causes of cervical myelopathy in Eastern Asia including Korea and Japan (1).
Cervical radiography is usually performed as an initial diagnostic test for the assessment of symptoms from OPLL.
On the conventional lateral radiography,
OPLL appears as continuous or segmental ossifications posterior to the vertebral bodies along the course of the posterior longitudinal ligament (PLL).
However,
many instances of cervical OPLL can be missed on lateral plain radiographs...
Methods and materials
We retrospectively collected 1199 lateral cervical radiographs from 444 patients who underwent cervical spine CT between March 2008 and October 2017.
The training set consisted of 699 radiographs from 166 patients diagnosed with OPLL on CT.
The validation data set was composed of 150 radiographs from 38 patients with cervical OPLL and other 150 radiographs from 40 patients without OPLL.
For the test data set,
we used 100 lateral cervical radiographs from 100 patients with cervical OPLL (male-to-female patient ratio,
68:32; mean age 59.4 ±...
Results
As for the segmentation performance,
the mean precision,
recall,
intersection-over-union,
and Dice score were 0.66,
0.62,
0.45,
and 0.60,
respectively.
In the vertebral-level analysis,
the diagnostic performance of the model was a sensitivity of 81.7% and specificity 91.3%.
In the patient-level analysis,
AUC was 0.840 with a sensitivity of 98.7% and specificity 69.3%,
respectively.
When the vertebral level subgroup analysis was performed,
the highest sensitivity of 92.9% was obtained at the C2 level,
and the lowest sensitivity of 59.3% was observed at the C7 level.Representative...
Conclusion
In this preliminary study,
deep neural network based approach showed the potential to be used for the diagnosis of OPLL on cervical radiographs.
Personal information
Hee-Dong Chae,
MD
Department of Radiology,
Seoul National University College of
Medicine,
Seoul National University Hospital,
101,
Daehak-Ro,
Jongno-Gu,
Seoul 110-744,
Korea
Phone: +82220724055
Fax: +8227436385
e-mail:
[email protected]
References
1.
Wu JC,
Chen YC,
Huang WC.
Ossification of the Posterior Longitudinal Ligament in Cervical Spine: Prevalence,
Management,
and Prognosis.
Neurospine.
2018;15(1):33-41.
2.
Kang MS,
Lee JW,
Zhang HY,
Cho YE,
Park YM.
Diagnosis of Cervical OPLL in Lateral Radiograph and MRI: Is it Reliable? Korean J Spine.
2012;9(3):205-8.
3.
Chang H,
Kong CG,
Won HY,
Kim JH,
Park JB.
Inter- and intra-observer variability of a cervical OPLL classification using reconstructed CT images.
Clin Orthop Surg.
2010;2(1):8-12.
4.
Hosny A,
Parmar C,
Quackenbush J,
Schwartz...