Digital Hand Atlas in Assessment of Skeletal Development

描述(由申请人提供)： 骨龄评估是儿科患者经常进行的一种程序，以评估他们的生长发育。它在内分泌疾病的诊断和治疗、代谢和生长异常的诊断性评估、各种综合征的成熟减速、畸形和骨发育不良中是一个重要的过程。它也被用于规划整形外科手术的咨询。最常见的临床骨龄评估方法是通过左手腕关节X线片与Greulich和Parle在20世纪上半叶收集的数据在20世纪50年代开发的正常标准图谱的一小部分参考图集进行匹配。(Tanner-Whitehouse方法是第二种方法，需要对9个可能的发育阶段的20块骨骼进行广泛的测量和比较。它很繁琐，不适合临床环境，因此很少使用。)不幸的是，Greulich和Parle的参考X线片没有反映当今欧洲、非洲、西班牙裔或亚洲后裔的儿童和青少年的骨骼发育情况。美国日益增加的种族多样性，以及儿童营养和行为习惯的变化，表明有必要重新评估骨龄标准的使用。我们之前的努力证实并确认了继续研究的必要性。 这项应用是我们继续努力的第三阶段，目的是完成一个灵活、更相关的数字手绘地图集系统的开发，该系统利用人口统计学和技术方面的新趋势。数字地图集将是一大套标准的四个不同种族儿童的正常手和手腕图像。它由1,080张(已收集和阅读)+400张(待收集)参考图像和计算机提取的骨骼对象和定量特征组成，消除了过时的、受种族限制的Greulich-Pyle图谱的缺点，以及Tanner和Whitehouse评分方法的繁琐。这些图像是从平均分布的1到18岁的正常儿童，男性和女性，欧洲人，非洲人，西班牙人和亚洲人后裔中收集的。将实施一个基于网络的骨龄评估计算机辅助诊断系统，在网络下水道上提取与地图集相似的量化特征，然后与数字地图集数据库中的模式以及计算机生成的分数进行比较，以评估骨龄。 在这项研究结束时，我们将完成与基于网络的下水道完全集成的数字手部图谱，以进行可以随时随地进行的定量、一致和可靠的骨龄评估。用户界面将简单易用，并类似于目前的骨龄评估程序。这将带来两个直接的好处：改进的实时临床骨龄评估和一种研究工具的生产，该工具将允许对骨龄评估的传统黄金标准技术进行持续评估。这些优势与诊断的更高准确性和快速周转时间相结合，将获得儿科放射科医生和其他临床医生的接受。

DESCRIPTION (provided by applicant): Bone age assessment is a procedure frequently performed on pediatric patients to evaluate their growth. It is an important procedure in the diagnosis and management of endocrine disorders, diagnostic evaluation of metabolic and growth abnormalities, deceleration of maturation in a variety of syndromes, malformations, and bone dysplasias. It is also used for consultation in planning orthopedic procedures. The most common clinical method for bone age assessment is atlas matching by a left-hand wrist radiograph against a small reference set of atlas patterns of normal standards developed by Greulich and Pyle in the 1950s based on data collected in the first half of the 20th century. (The Tanner-Whitehouse method is a second method that requires extensive measurement and comparison of 20 bones against 9 possible stages of development. It is tedious and unsuitable for a clinical environment and thus, rarely used.) Unfortunately, the Greulich and Pyle reference radiographs do not reflect skeletal development in children and adolescents of today's European, African, Hispanic or Asian descent. Increasing racial diversity in the United States, as well as changing nutritional and behavioral habits of children, show a need for reevaluation of the use of skeletal age standards. Our preceding efforts have validated and confirmed the need for continued study. This application is the third phase of our continuing effort and intends to complete the development of a flexible, more relevant digital hand atlas system that exploits novel trends in both demography and technology. The digital atlas will be a large standard set of normal hand and wrist images of children of four diverse ethnic groups. It is comprised of 1,080 (already collected and read) + 400 (to be collected) reference images and computer-extracted bone objects and quantitative features, removes the disadvantages of the out-of-date, ethnically constrained Greulich-Pyle atlas and the tediousness of Tanner and Whitehouse scoring method. These images are collected from evenly distributed normal 1 to 18 years of age, male and female, European, African, Hispanic, and Asian descent. A Web-based computer-aided diagnostic system for bone age assessment will be implemented where quantitative features similar to those in the atlas are extracted on a Web sewer and then compared with patterns from the digital atlas database as well as computer generated scores to assess the bone age. By the end of this study, we will have completed a digital hand atlas fully integrated with a Web-based sewer for quantitative, consistent, and reliable bone age assessment that can be performed anywhere, anytime. The user interface will be simple to apply and resemble current bone age assessment procedures. Two immediate benefits will be realized: improved real-time clinical bone age assessment and the production of a research tool that will allow for ongoing evaluation of the traditional gold standard techniques for bone age assessment. These advantages combined with higher accuracy and fast turn around time in diagnosis would gain acceptance by both pediatric radiologists and other clinicians.