21 March 2007 Is Greulich and Pyle atlas still a good reference for bone age assessment?
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Abstract
The most commonly used method for bone age assessment in clinical practice is the book atlas matching method developed by Greulich and Pyle in the 1950s. Due to changes in both population diversity and nutrition in the United States, this atlas may no longer be a good reference. An updated data set becomes crucial to improve the bone age assessment process. Therefore, a digital hand atlas was built with 1,100 children hand images, along with patient information and radiologists' readings, of normal Caucasian (CAU), African American (BLK), Hispanic (HIS), and Asian (ASI) males (M) and females (F) with ages ranging from 0 - 18 years. This data was collected from Childrens' Hospital Los Angeles. A computer-aided-diagnosis (CAD) method has been developed based on features extracted from phalangeal regions of interest (ROIs) and carpal bone ROIs from this digital hand atlas. Using the data collected along with the Greulich and Pyle Atlas-based readings and CAD results, this paper addresses this question: "Do different ethnicities and gender have different bone growth patterns?" To help with data analysis, a novel web-based visualization tool was developed to demonstrate bone growth diversity amongst differing gender and ethnic groups using data collected from the Digital Atlas. The application effectively demonstrates a discrepancy of bone growth pattern amongst different populations based on race and gender. It also has the capability of helping a radiologist determine the normality of skeletal development of a particular patient by visualizing his or her chronological age, radiologist reading, and CAD assessed bone age relative to the accuracy of the P&G method.
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Aifeng Zhang, Aifeng Zhang, Sinchai Tsao, Sinchai Tsao, James W. Sayre, James W. Sayre, Arkadiusz Gertych, Arkadiusz Gertych, Brent J. Liu, Brent J. Liu, H. K. Huang, H. K. Huang, } "Is Greulich and Pyle atlas still a good reference for bone age assessment?", Proc. SPIE 6516, Medical Imaging 2007: PACS and Imaging Informatics, 65161H (21 March 2007); doi: 10.1117/12.710057; https://doi.org/10.1117/12.710057
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