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Chronological age assessment in young individuals using bone age assessment staging and nonradiological aspects : Machine learning multifactorial approach

Dallora, Ana Luiza ; Kvist, Ola ; Berglund, Johan Sanmartin LU ; Ruiz, Sandra Diaz ; Boldt, Martin ; Flodmark, Carl Erik LU and Anderberg, Peter LU (2020) In JMIR Medical Informatics 8(9).
Abstract

Background: Bone age assessment (BAA) is used in numerous pediatric clinical settings as well as in legal settings when entities need an estimate of chronological age (CA) when valid documents are lacking. The latter case presents itself as critical as the law is harsher for adults and granted rights along with imputability changes drastically if the individual is a minor. Traditional BAA methods have drawbacks such as exposure of minors to radiation, they do not consider factors that might affect the bone age, and they mostly focus on a single region. Given the critical scenarios in which BAA can affect the lives of young individuals, it is important to focus on the drawbacks of the traditional methods and investigate the potential of... (More)

Background: Bone age assessment (BAA) is used in numerous pediatric clinical settings as well as in legal settings when entities need an estimate of chronological age (CA) when valid documents are lacking. The latter case presents itself as critical as the law is harsher for adults and granted rights along with imputability changes drastically if the individual is a minor. Traditional BAA methods have drawbacks such as exposure of minors to radiation, they do not consider factors that might affect the bone age, and they mostly focus on a single region. Given the critical scenarios in which BAA can affect the lives of young individuals, it is important to focus on the drawbacks of the traditional methods and investigate the potential of estimating CA through BAA. Objective: This study aims to investigate CA estimation through BAA in young individuals aged 14-21 years with machine learning methods, addressing the drawbacks of research using magnetic resonance imaging (MRI), assessment of multiple regions of interest, and other factors that may affect the bone age. Methods: MRI examinations of the radius, distal tibia, proximal tibia, distal femur, and calcaneus were performed on 465 men and 473 women (aged 14-21 years). Measures of weight and height were taken from the subjects, and a questionnaire was given for additional information (self-assessed Tanner Scale, physical activity level, parents' origin, and type of residence during upbringing). Two pediatric radiologists independently assessed the MRI images to evaluate their stage of bone development (blinded to age, gender, and each other). All the gathered information was used in training machine learning models for CA estimation and minor versus adult classification (threshold of 18 years). Different machine learning methods were investigated. Results: The minor versus adult classification produced accuracies of 0.90 and 0.84 for male and female subjects, respectively, with high recalls for the classification of minors. The CA estimation for the 8 age groups (aged 14-21 years) achieved mean absolute errors of 0.95 years and 1.24 years for male and female subjects, respectively. However, for the latter, a lower error occurred only for the ages of 14 and 15 years. Conclusions: This study investigates CA estimation through BAA using machine learning methods in 2 ways: minor versus adult classification and CA estimation in 8 age groups (aged 14-21 years), while addressing the drawbacks in the research on BAA. The first achieved good results; however, for the second case, the BAA was not precise enough for the classification.

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; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Bone age, Calcaneus, Chronological age assessment, Distal femur, Distal tibia, Machine learning, Magnetic resonance imaging, Proximal tibia, Radius, Skeletal maturity
in
JMIR Medical Informatics
volume
8
issue
9
article number
e18846
publisher
JMIR Publications Inc.
external identifiers
  • scopus:85097465282
  • pmid:32955457
ISSN
2291-9694
DOI
10.2196/18846
language
English
LU publication?
yes
id
1bec4d62-bf0a-4e54-bd05-bd09824e2370
date added to LUP
2020-12-22 11:01:31
date last changed
2022-09-10 00:21:45
@article{1bec4d62-bf0a-4e54-bd05-bd09824e2370,
  abstract     = {{<p>Background: Bone age assessment (BAA) is used in numerous pediatric clinical settings as well as in legal settings when entities need an estimate of chronological age (CA) when valid documents are lacking. The latter case presents itself as critical as the law is harsher for adults and granted rights along with imputability changes drastically if the individual is a minor. Traditional BAA methods have drawbacks such as exposure of minors to radiation, they do not consider factors that might affect the bone age, and they mostly focus on a single region. Given the critical scenarios in which BAA can affect the lives of young individuals, it is important to focus on the drawbacks of the traditional methods and investigate the potential of estimating CA through BAA. Objective: This study aims to investigate CA estimation through BAA in young individuals aged 14-21 years with machine learning methods, addressing the drawbacks of research using magnetic resonance imaging (MRI), assessment of multiple regions of interest, and other factors that may affect the bone age. Methods: MRI examinations of the radius, distal tibia, proximal tibia, distal femur, and calcaneus were performed on 465 men and 473 women (aged 14-21 years). Measures of weight and height were taken from the subjects, and a questionnaire was given for additional information (self-assessed Tanner Scale, physical activity level, parents' origin, and type of residence during upbringing). Two pediatric radiologists independently assessed the MRI images to evaluate their stage of bone development (blinded to age, gender, and each other). All the gathered information was used in training machine learning models for CA estimation and minor versus adult classification (threshold of 18 years). Different machine learning methods were investigated. Results: The minor versus adult classification produced accuracies of 0.90 and 0.84 for male and female subjects, respectively, with high recalls for the classification of minors. The CA estimation for the 8 age groups (aged 14-21 years) achieved mean absolute errors of 0.95 years and 1.24 years for male and female subjects, respectively. However, for the latter, a lower error occurred only for the ages of 14 and 15 years. Conclusions: This study investigates CA estimation through BAA using machine learning methods in 2 ways: minor versus adult classification and CA estimation in 8 age groups (aged 14-21 years), while addressing the drawbacks in the research on BAA. The first achieved good results; however, for the second case, the BAA was not precise enough for the classification. </p>}},
  author       = {{Dallora, Ana Luiza and Kvist, Ola and Berglund, Johan Sanmartin and Ruiz, Sandra Diaz and Boldt, Martin and Flodmark, Carl Erik and Anderberg, Peter}},
  issn         = {{2291-9694}},
  keywords     = {{Bone age; Calcaneus; Chronological age assessment; Distal femur; Distal tibia; Machine learning; Magnetic resonance imaging; Proximal tibia; Radius; Skeletal maturity}},
  language     = {{eng}},
  number       = {{9}},
  publisher    = {{JMIR Publications Inc.}},
  series       = {{JMIR Medical Informatics}},
  title        = {{Chronological age assessment in young individuals using bone age assessment staging and nonradiological aspects : Machine learning multifactorial approach}},
  url          = {{http://dx.doi.org/10.2196/18846}},
  doi          = {{10.2196/18846}},
  volume       = {{8}},
  year         = {{2020}},
}