Digital Hand Atlas in Assessment of Skeletal Development

描述（由申请人提供）： 骨龄评估是一种经常对儿科患者进行的程序，以评估他们的生长情况。它是内分泌疾病诊断和治疗、代谢和生长异常诊断评估、各种综合征、畸形和骨发育不良成熟减慢的重要程序。它也用于规划骨科手术的咨询。骨龄评估最常见的临床方法是通过左手手腕X线片与Greulich和Pyle在20世纪50年代根据世纪上半叶收集的数据开发的正常标准的小参考集图谱模式进行图谱匹配。(The Tanner-Whitehouse方法是第二种方法，需要广泛测量和比较20块骨骼与9个可能的发育阶段。它是乏味的，不适合临床环境，因此很少使用。不幸的是，Greulich和Pyle的参考X光片不能反映当今欧洲、非洲、西班牙或亚洲血统的儿童和青少年的骨骼发育。美国种族多样性的增加，以及儿童营养和行为习惯的改变，表明有必要重新评估骨龄标准的使用。我们之前的努力已经证实并确认了继续研究的必要性。 该应用程序是我们持续努力的第三阶段，旨在完成一个灵活的，更相关的数字手图集系统，利用人口和技术的新趋势的发展。数字图谱将是一个大型的标准集，包括四个不同种族的儿童的正常手和手腕图像。它由1，080（已收集和阅读）+400（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图谱的缺点以及坦纳和怀特豪斯评分方法的繁琐。这些图像是从均匀分布的1至18岁正常人、男性和女性、欧洲人、非洲人、西班牙裔和亚裔中收集的。一个基于网络的计算机辅助骨龄评估诊断系统将被实施，其中的定量特征类似于那些在地图集上提取的网络下水道，然后与模式从数字地图集数据库以及计算机生成的分数进行比较，以评估骨龄。 到本研究结束时，我们将完成一个数字手图谱完全集成了基于Web的下水道定量，一致，可靠的骨龄评估，可以随时随地进行。用户界面将易于应用，并类似于当前的骨龄评估程序。两个直接的好处将实现：改进实时临床骨龄评估和生产的研究工具，将允许进行持续评价的传统黄金标准技术的骨龄评估。这些优点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认可。

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.