LIU Qixing, WANG Huogen, CIDAN Wangjiu, TUDAN Awang, YANG Meijie, PUQIONG Qiongda, YANG Xiao, PAN Hui, WANG Fengdan. Construction and Validation of A Deep Learning-based Bone Age Prediction Model for Children Living in Both Plain and Highland Regions[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(6): 1439-1446. DOI: 10.12290/xhyxzz.2023-0651
Citation: LIU Qixing, WANG Huogen, CIDAN Wangjiu, TUDAN Awang, YANG Meijie, PUQIONG Qiongda, YANG Xiao, PAN Hui, WANG Fengdan. Construction and Validation of A Deep Learning-based Bone Age Prediction Model for Children Living in Both Plain and Highland Regions[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(6): 1439-1446. DOI: 10.12290/xhyxzz.2023-0651

Construction and Validation of A Deep Learning-based Bone Age Prediction Model for Children Living in Both Plain and Highland Regions

Funds: 

Youth Fund of National Natural Science Foundation of China 82001900

National High Level Hospital Clinical Research Funding 2022-PUMCH-A-003

CAMS Innovation Fund for Medical Sciences 2021-I2M-1-051

More Information
  • Corresponding author:

    WANG Fengdan, E-mail: wangfengdan@pumch.cn

  • Received Date: December 25, 2023
  • Accepted Date: May 26, 2024
  • Available Online: October 11, 2024
  • Publish Date: October 11, 2024
  • Issue Publish Date: November 29, 2024
  • Objective 

    To construct and validate a deep learning-based bone age prediction model for children living in both plain and highland regions.

    Methods 

    A model named "ethnicity vision gender-bone age net (EVG-BANet)" was trained using three datasets, including the Radiology Society of North America (RSNA) dataset [training set(n=12 611), validation set (n=1425), test set (n=200)], the Radiological Hand Pose Estimation (RHPE) dataset[training set (n=5491), validation set (n=713), test set (n=79)], and a self-established dataset[training set (n=825), test set (n=351)], and it was validated using an external test set. Self-established dataset retrospectively recruited 1176 left-hand DR images of children from Peking Union Medical College Hospital (n=745, all were Han) and Tibet Autonomous Region People's Hospital (n=431, 114 were Han, 317 were Tibetan). External test set included images from People's Hospital of Nagqu (n=256, all were Tibetan). Mean absolute difference (MAD) and accuracy within 1 year were used as indicators.

    Results 

    EVG-BANet exhibited MAD of 0.34 and 0.52 years in RSNA and RHPE test sets, respectively. In the self-established test set, the model achieved MAD of 0.47 years (95% CI: 0.43-0.50) with accuracy within 1 year of 97.72% (95% CI: 95.56-99.01%). For the external test set, MAD was 0.53 years(95% CI: 0.48-0.58), with accuracy within 1 year of 89.45% (95% CI: 85.03-92.93).

    Conclusion 

    EVG-BANet demonstrated high accuracy in bone age prediction, and therefore can be applied in children living in both plain and highland.

  • [1]
    Creo A L, Schwenk W F 2nd. Bone age: a handy tool for pediatric providers[J]. Pediatrics, 2017, 140(6): e20171486. DOI: 10.1542/peds.2017-1486
    [2]
    Greulich W W, Pyle S I. Radiographic atlas of skeletal development of the hand and wrist[J]. Am J Med Sci, 1959, 238(3): 393.
    [3]
    Tanner J M, Healy M J R, Goldstein H N C. Assessment of skeletal maturity and 421 prediction of adult height(TW3 method)[M]. London: WB Saunders, 2001.
    [4]
    Escobar M, González C, Torres F, et al. Hand pose estimation for pediatric bone age assessment[C]//Medical Image Computing and Computer Assisted Intervention-MICCAI 2019. Cham: Springer, 2019: 531-539.
    [5]
    Larson D B, Chen M C, Lungren M P, et al. Performance of a deep-learning neural network model in assessing skeletal maturity on pediatric hand radiographs[J]. Radiology, 2018, 287(1): 313-322. DOI: 10.1148/radiol.2017170236
    [6]
    Ren X H, Li T T, Yang X J, et al. Regression convolutional neural network for automated pediatric bone age assessment from hand radiograph[J]. IEEE J Biomed Health Inform, 2019, 23(5): 2030-2038. DOI: 10.1109/JBHI.2018.2876916
    [7]
    Zhou X L, Wang E G, Lin Q, et al. Diagnostic performance of convolutional neural network-based Tanner-Whitehouse 3 bone age assessment system[J]. Quant Imaging Med Surg, 2020, 10(3): 657-667. DOI: 10.21037/qims.2020.02.20
    [8]
    Yang C, Dai W, Qin B, et al. A real-time automated bone age assessment system based on the RUS-CHN method[J]. Front Endocrinol(Lausanne), 2023, 14: 1073219. DOI: 10.3389/fendo.2023.1073219
    [9]
    文颖, 任旭华, 杨秀军, 等. 基于手腕部影像传统关注特征区域深度学习的人工智能骨龄评估[J]. 中华放射学杂志, 2019, 53(10): 895-899. DOI: 10.3760/cma.j.issn.1005-1201.2019.10.020

    Wen Y, Ren X H, Yang X J, et al. Artificial intelligence-based bone age assessment using deep learning of characteristic regions in digital hand radiograph[J]. Chin J Radiol, 2019, 53(10): 895-899. DOI: 10.3760/cma.j.issn.1005-1201.2019.10.020
    [10]
    宋娟, 宫平, 高畅, 等. 基于深度学习的儿童骨龄智能评估模型构建及初步临床验证[J]. 中华放射学杂志, 2019, 53(11): 974-978.

    Song J, Gong P, Gao C, et al. Construction and clinical preliminary validation of an automaticbone age assessment model based on deep learning[J]. Chin J Radiol, 2019, 53(11): 974-978.
    [11]
    Lee K C, Lee K H, Kang C H, et al. Clinical validation of a deep learning-based hybrid(Greulich-Pyle and modified Tanner-Whitehouse) method for bone age assessment[J]. Korean J Radiol, 2021, 22(12): 2017-2025. DOI: 10.3348/kjr.2020.1468
    [12]
    Xiao B, Wu H P, Wei Y C. Simple Baselines for Human Pose Estimation and Tracking[M/OL ]. [2023-12-20]. https://citations.springernature.com/item?doi=10.1007/978-3-030-01231-1_29.
    [13]
    Tajmir S H, Lee H, Shailam R, et al. Artificial intelligence-assisted interpretation of bone age radiographs improves accuracy and decreases variability[J]. Skeletal Radiol, 2019, 48(2): 275-283. DOI: 10.1007/s00256-018-3033-2
    [14]
    拉巴顿珠, 次旦旺久, 边巴次仁, 等. 人工智能骨龄系统提高西藏放射科医师骨龄判读的准确性[J]. 医学影像学杂志, 2023, 33(11): 2061-2065.

    Laba Dunzhu, Cidan Wangjiu, Bianba Ciren, et al. Artificial intelligence bone age system improves the accuracy of bone age interpretation by Tibetan radiologists[J]. J Med Imaging, 2023, 33(11): 2061-2065.
    [15]
    次旦旺久, 土旦阿旺, 杨美杰, 等. 海拔高度对儿童及青少年骨龄发育的影响[J]. 基础医学与临床, 2023, 43(4): 636-640.

    Cidan Wangjiu, Tudan Awang, Yang M J, et al. Influence of high altitude on bone age development of children and adolescents[J]. Basic Clin Med, 2023, 43(4): 636-640.
    [16]
    Halabi S S, Prevedello L M, Kalpathy-Cramer J, et al. The RSNA pediatric bone age machine learning challenge[J]. Radiology, 2019, 290(2): 498-503. DOI: 10.1148/radiol.2018180736
    [17]
    Wang F D, Cidanwangjiu, Gu X, et al. Performance of an artificial intelligence system for bone age assessment in Tibet[J]. Br J Radiol, 2021, 94(1120): 20201119. DOI: 10.1259/bjr.20201119
    [18]
    Wang F D, Gu X, Chen S, et al. Artificial intelligence system can achieve comparable results to experts for bone age assessment of Chinese children with abnormal growth and development[J]. PeerJ, 2020, 8: e8854. DOI: 10.7717/peerj.8854
    [19]
    Redmon J, Farhadi A. YOLOv3: an incremental improvement[DB/OL ]. (2018-04-08)[2023-12-20]. https://arxiv.org/abs/1804.02767.
    [20]
    Li Y H, Yao T, Pan Y W, et al. Contextual transformer networks for visual recognition[J]. IEEE Trans Pattern Anal Mach Intell, 2023, 45(2): 1489-1500. DOI: 10.1109/TPAMI.2022.3164083
    [21]
    Szegedy C, Vanhoucke V, Ioffe S, et al. Rethinking the inception architecture for computer vision[DB/OL ]. (2015-12-11)[2023-12-20]. https://arxiv.org/abs/1512.00567.
    [22]
    Li X, Jiang Y C, Liu Y L, et al. RAGCN: region aggregation graph convolutional network for bone age assessment from X-ray images[J]. IEEE Trans Instrum Meas, 2022, 71: 1-12.
    [23]
    Ji Y F, Chen H, Lin D, et al. PRSNet: part relation and selection network for bone age assessment[C]//Medical Image Computing and Computer Assisted Intervention-MICCAI 2019. Cham: Springer, 2019: 413-421.
    [24]
    Koitka S, Kim M S, Qu M, et al. Mimicking the radiologists' workflow: estimating pediatric hand bone age with stacked deep neural networks[J]. Med Image Anal, 2020, 64: 101743. DOI: 10.1016/j.media.2020.101743
    [25]
    Iglovikov V, Rakhlin A, Kalinin A, et al. Pediatric bone age assessment using deep convolutional neural networks[DB/OL ]. (2018-06-19)[ 2023-12-20]. https://arxiv.org/abs/1712.05053.
    [26]
    Wu E, Kong B, Wang X, et al. Residual attention based network for hand bone age assessment[C]//2019 IEEE 16th International Symposium on Biomedical Imaging(ISBI 2019). Piscataway, NJ: IEEE Press, 2019: 1158-1161.
    [27]
    Nguyen Q H, Nguyen B P, Nguyen M T, et al. Bone age assessment and sex determination using transfer learning[J]. Expert Syst Appl, 2022, 200: 116926. DOI: 10.1016/j.eswa.2022.116926
    [28]
    González C, Escobar M, Daza L, et al. SIMBA: specific identity markers for bone age assessment[C]//Medical Image Computing and Computer Assisted Intervention-MICCAI 2020. Cham: Springer, 2020: 753-763.
    [29]
    Zhang A F, Sayre J W, Vachon L, et al. Racial differences in growth patterns of children assessed on the basis of bone age[J]. Radiology, 2009, 250(1): 228-235. DOI: 10.1148/radiol.2493080468
    [30]
    Ontell F K, Ivanovic M, Ablin D S, et al. Bone age in children of diverse ethnicity[J]. AJR Am J Roentgenol, 1996, 167(6): 1395-1398. DOI: 10.2214/ajr.167.6.8956565
  • Related Articles

    [1]ZHANG Mingzi, SI Loubin, HUANG Jiuzuo, YU Nanze, ZHENG Jiaojie, CHEN Jie, WANG Xiaojun, LONG Xiao, XIONG Wei. Construction of Medical Quality Control Indicators System for Chinese Plastic and Aesthetic Major[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(6): 1318-1324. DOI: 10.12290/xhyxzz.2024-0052
    [2]ZHENG Jiaojie, ZHANG Mingzi, SI Loubin, CHEN Jie, WANG Xiaojun, LONG Xiao, XIONG Wei. Journey and Significance of Quality Control in Medical Safety for China's Plastic Surgery and Aesthetic Medicine Professions[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(6): 1233-1237. DOI: 10.12290/xhyxzz.024-0487
    [3]HU Xiaoyu, LYU Jingjing, CUI Yongchun. Impact of DRG Payment on Medical Resource Utilization and Quality of Care for Hospitalized Lung Cancer Patients[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(5): 1059-1068. DOI: 10.12290/xhyxzz.2024-0374
    [4]ZHANG Guojie, ZHOU jiong, TAN Xutong, MA Xiaojun, WANG Zhi, CHANG Qing. With CHS-DRG Grouping Payment Scheme Significantly Upgraded, How Should Medical Institutions Respond?[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(5): 999-1005. DOI: 10.12290/xhyxzz.2024-0636
    [5]ZHOU Jiong, WANG Shuchang, MA Xiaojun. Improving Medical Quality and Safety Through DRG Payment Model[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(5): 981-986. DOI: 10.12290/xhyxzz.2024-0479
    [6]ZHENG Jiaojie, ZHANG Mingzi, SI Loubin, CHEN Jie, WANG Xiaojun, LONG Xiao, XIONG Wei. The Journey and Significance of Quality Control in Medical Safety for China's Plastic Surgery and Aesthetic Medicine Professions[J]. Medical Journal of Peking Union Medical College Hospital. DOI: 10.12290/xhyxzz.2024-0487
    [7]Quality Control Center of Plastic and Aesthetic Major, Quality Control Center of Anesthesia Major. Operating Technical Specifications on Sedation/Analgesia/Anesthesia in Diagnosis and Treatment of Chinese Plastic and Aesthetic Major(2023)[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(6): 1189-1196. DOI: 10.12290/xhyxzz.2023-0472
    [8]YAN Jia, SHEN Le, JIANG Hong, HUANG Yuguang. A Survey of the Current Status of Anesthesiology for Plastic and Cosmetic Surgery in China[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(3): 440-448. DOI: 10.12290/xhyxzz.2022-0107
    [9]CHANG Guojing, YU Nanze, LONG Xiao, WANG Xiaojun. Medical Aesthetic Surgery and Related Complications[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(3): 377-382. DOI: 10.12290/xhyxzz.2022-0056
    [10]ZHANG Guo-jie, CHANG Qing, PAN Hui, ZHOU Jiong, CHEN Qian, SUN Fang-yan, CHAI Wen-zhao, XU Mei, WU Wen-ming. Establishment of Medical Service Protocols in Large Public Hospitals for the Prevention and Control of Coronavirus Disease 2019[J]. Medical Journal of Peking Union Medical College Hospital, 2021, 12(1): 1-4. DOI: 10.12290/xhyxzz.20200258

Catalog

    Article Metrics

    Article views (73) PDF downloads (11) Cited by()
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return
    x Close Forever Close