Abstract:
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Purpose: Radiological assessment of bone age is traditionally performed through visual comparison with existing reference images of normal children at different ages published in reference textbooks such as the Greulich and Pyle atlas published in 1950. The purpose of our project is to develop a digital index based on idealized hand Xray images that can be incorporated in a hand held computer and used for visual assessment of bone age for patients.
Methods and Materials: Due to the large variability in maturation of ossification in the normal population, we elected to generate a set of ideal images obtained by computer combinations of images from our normal reference data sets. Software for hand-held PDA devices was developed for easy navigation through the set of images and visual selection of the closest image to a given patient study. A formula based on our statistical analysis provides the standard deviation from normal based on the patient's chronological age. The accuracy of the program was compared to traditional interpretation using the Greulich and Pyle by two radiologists in a double blind reading of 200 normal Caucasian children (100 boys, 100 girls).
Results: Regardless of the radiologist or the method to assess skeletal maturity, strong correlations were present between chronological age and bone age (r > 0.9) with no statistical difference when the digital index was used. When divided in different age categories, and also when bone age was assessed on sub-regions of the hand such as the phalanges, the palm and the wrist, the digital system seemed to provide slightly more accurate and more consistent correlations, although these differences were not statistically significant. The users did praise the convenience and effectiveness of the portable Palm Index in clinical practice.
Conclusion: An idealized digital Palm Bone Age Index provides a convenient and effective alternative to conventional atlases for the assessment of skeletal maturity.
Questions about this event email: oratib@mednet.ucla.edu
Ratib MD, PhD, O,
Design and Validation of a Palm-based Bone Age Atlas. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3101845.html
