Article2014

Are the new automated methods for bone age estimation advantageous over the manual approaches?

Vincenzo De Sanctis · Ashraf Tawfik Soliman · Salvatore Di Maio · Said M Bedair

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Forensic Anthropology and Bioarchaeology Studies Bone health and osteoporosis research Growth Hormone and Insulin-like Growth Factors

Abstract

Bone Age Assessment (BAA) is performed worldwide for the evaluation of endocrine, genetic and chronic diseases, to monitor response to medical therapy and to determine the growth potential of children and adolescents. It is also used for consultation in planning orthopedic procedures, for determination of chronological age for adopted children, youth sports participation and in forensic settings. The main clinical methods for skeletal bone age estimation are the Greulich and Pyle (GP) and the Tanner and Whitehouse (TW) methods. Seventy six per cent (76%) of radiologists or pediatricians usually use the method of GP, 20% that of TW and 4% other methods. The advantages of using the TW method, as opposed to the GP method, are that it overcomes the subjectivity problem and results are more reproducible. However, it is complex and time consuming; for this reason its usage is just about 20% on a world-wide scale. Moreover, there are some evidences that bone age assignments by different physicians can differ significantly. Computerized and Quantitative Ultrasound Technologies (QUS) for assessing skeletal maturity have been developed with the aim of reducing many of the inconsistencies associated with radiographic investigations. In spite of the fact that the volume of automated methods for BAA has increased, the majotity of them are still in an early phase of development. QUS is comparable to the GP based method, but there is not enough established data yet for the healthy population. The Authors wish to stimulate the attention on the accuracy, reliability and consistency of BAA and to initiate a debate on manual versus automated approaches to enhance our assessment for skeletal matutation in children and adolescents.

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References

1959RADIOGRAPHIC ATLAS OF SKELETAL DEVELOPMENT OF THE HAND AND WRIST 1976Assessment of Skeletal Maturity and Prediction of Adult Height (TW2 Method)2000Age estimation: The state of the art in relation to the specific demands of forensic practise 2009The BoneXpert Method for Automated Determination of Skeletal Maturity 2001Assessment of skeletal maturity and prediction of adult height:(TW3 Method)2000Effects of ethnicity on skeletal maturation: consequences for forensic age estimations 1999Bone age assessment: a large scale comparison of the Greulich and Pyle, and Tanner and Whitehouse (TW2) methods 1996Bone age in children of diverse ethnicity.

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2019Assessing the Bone Age of Children in an Automatic Manner Newborn to 18 Years Range 2019Potential Value of Conventional Ultrasound in Estimation of Bone Age in Patients from Birth to Near Adulthood 2020Automatic assessment of bone age in Taiwanese children: A comparison of the Greulich and Pyle method and the Tanner and Whitehouse 3 method 2018Evaluation of a Computer-Aided Diagnosis System for Automated Bone Age Assessment in Comparison to the Greulich-Pyle Atlas Method: A Multireader Study

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