Diagnostic performance of convolutional neural network-based Tanner-Whitehouse 3 bone age assessment system.

Artificial intelligence (AI) Tanner-Whitehouse 3 method (TW3 method) bone age convolutional neural network (CNN)

Journal

Quantitative imaging in medicine and surgery
ISSN: 2223-4292
Titre abrégé: Quant Imaging Med Surg
Pays: China
ID NLM: 101577942

Informations de publication

Date de publication:
Mar 2020
Historique:
entrez: 10 4 2020
pubmed: 10 4 2020
medline: 10 4 2020
Statut: ppublish

Résumé

Bone age can reflect the true growth and development status of a child; thus, it plays a critical role in evaluating growth and endocrine disorders. This study established and validated an optimized Tanner-Whitehouse 3 artificial intelligence (TW3-AI) bone age assessment (BAA) system based on a convolutional neural network (CNN). A data set of 9,059 clinical radiographs of the left hand was obtained from the picture archives and communication systems (PACS) between January 2012 and December 2016. Among these, 8,005/9,059 (88%) samples were treated as the training set for model implementation, 804/9,059 (9%) samples as the validation set for parameters optimization, and the remaining 250/9,059 (3%) samples were used to verify the accuracy and reliability of the model compared to that of 4 experienced endocrinologists and 2 experienced radiologists. The overall variation of TW3-metacarpophalangeal, radius, ulna and short bones (RUS) and TW3-Carpal bone score, as well as each bone (13 RUS + 7 Carpal) between reviewers and the AI, were compared by Bland-Altman (BA) chart and Kappa test, respectively. Furthermore, the time consumption between the model and reviewers was also compared. The performance of TW3-AI model was highly consistent with the reviewers' overall estimation, and the root mean square (RMS) was 0.50 years. The accuracy of the BAA of the TW3-AI model was better than the estimate of the reviewers. Further analysis revealed that human interpretations of the male capitate, hamate, the first distal and fifth middle phalanx and female capitate, the trapezoid, and the third and fifth middle phalanx, were most inconsistent. The average image processing time was 1.5±0.2 s in the TW3-AI model, which was significantly shorter than manual interpretation. The diagnostic performance of CNN-based TW3 BAA was accurate and timesaving, and possesses better stability compared to diagnostics made by experienced experts.

Sections du résumé

BACKGROUND BACKGROUND
Bone age can reflect the true growth and development status of a child; thus, it plays a critical role in evaluating growth and endocrine disorders. This study established and validated an optimized Tanner-Whitehouse 3 artificial intelligence (TW3-AI) bone age assessment (BAA) system based on a convolutional neural network (CNN).
METHODS METHODS
A data set of 9,059 clinical radiographs of the left hand was obtained from the picture archives and communication systems (PACS) between January 2012 and December 2016. Among these, 8,005/9,059 (88%) samples were treated as the training set for model implementation, 804/9,059 (9%) samples as the validation set for parameters optimization, and the remaining 250/9,059 (3%) samples were used to verify the accuracy and reliability of the model compared to that of 4 experienced endocrinologists and 2 experienced radiologists. The overall variation of TW3-metacarpophalangeal, radius, ulna and short bones (RUS) and TW3-Carpal bone score, as well as each bone (13 RUS + 7 Carpal) between reviewers and the AI, were compared by Bland-Altman (BA) chart and Kappa test, respectively. Furthermore, the time consumption between the model and reviewers was also compared.
RESULTS RESULTS
The performance of TW3-AI model was highly consistent with the reviewers' overall estimation, and the root mean square (RMS) was 0.50 years. The accuracy of the BAA of the TW3-AI model was better than the estimate of the reviewers. Further analysis revealed that human interpretations of the male capitate, hamate, the first distal and fifth middle phalanx and female capitate, the trapezoid, and the third and fifth middle phalanx, were most inconsistent. The average image processing time was 1.5±0.2 s in the TW3-AI model, which was significantly shorter than manual interpretation.
CONCLUSIONS CONCLUSIONS
The diagnostic performance of CNN-based TW3 BAA was accurate and timesaving, and possesses better stability compared to diagnostics made by experienced experts.

Identifiants

pubmed: 32269926
doi: 10.21037/qims.2020.02.20
pii: qims-10-03-657
pmc: PMC7136746
doi:

Types de publication

Journal Article

Langues

eng

Pagination

657-667

Informations de copyright

2020 Quantitative Imaging in Medicine and Surgery. All rights reserved.

Déclaration de conflit d'intérêts

Conflicts of Interest: The authors have no conflicts of interest to declare.

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Auteurs

Xue-Lian Zhou (XL)

The Children's Hospital, Zhejiang University School of Medicine, Division of Endocrinology, National Clinical Research Center for Child Health, Hangzhou 310052, China.

Er-Gang Wang (EG)

Center for Genomics and Computational Biology, Duke University, Durham, NC, USA.
Department of Biomedical Engineering, Duke University, Durham, NC, USA.

Qiang Lin (Q)

Hangzhou YITU Healthcare Technology Co., Ltd, Hangzhou 310012, China.

Guan-Ping Dong (GP)

The Children's Hospital, Zhejiang University School of Medicine, Division of Endocrinology, National Clinical Research Center for Child Health, Hangzhou 310052, China.

Wei Wu (W)

The Children's Hospital, Zhejiang University School of Medicine, Division of Endocrinology, National Clinical Research Center for Child Health, Hangzhou 310052, China.

Ke Huang (K)

The Children's Hospital, Zhejiang University School of Medicine, Division of Endocrinology, National Clinical Research Center for Child Health, Hangzhou 310052, China.

Can Lai (C)

The Children's Hospital, Zhejiang University School of Medicine, Division of Radiology, National Clinical Research Center for Child Health, Hangzhou 310052, China.

Gang Yu (G)

The Children's Hospital, Zhejiang University School of Medicine, Division of Information Science, National Clinical Research Center for Child Health, Hangzhou 310052, China.

Hai-Chun Zhou (HC)

The Children's Hospital, Zhejiang University School of Medicine, Division of Radiology, National Clinical Research Center for Child Health, Hangzhou 310052, China.

Xiao-Hui Ma (XH)

The Children's Hospital, Zhejiang University School of Medicine, Division of Radiology, National Clinical Research Center for Child Health, Hangzhou 310052, China.

Xuan Jia (X)

The Children's Hospital, Zhejiang University School of Medicine, Division of Radiology, National Clinical Research Center for Child Health, Hangzhou 310052, China.

Lei Shi (L)

Hangzhou YITU Healthcare Technology Co., Ltd, Hangzhou 310012, China.

Yong-Sheng Zheng (YS)

Hangzhou YITU Healthcare Technology Co., Ltd, Hangzhou 310012, China.

Lan-Xuan Liu (LX)

Hangzhou YITU Healthcare Technology Co., Ltd, Hangzhou 310012, China.

Da Ha (D)

Hangzhou YITU Healthcare Technology Co., Ltd, Hangzhou 310012, China.

Hao Ni (H)

Hangzhou YITU Healthcare Technology Co., Ltd, Hangzhou 310012, China.

Jun Yang (J)

Hangzhou YITU Healthcare Technology Co., Ltd, Hangzhou 310012, China.

Jun-Fen Fu (JF)

The Children's Hospital, Zhejiang University School of Medicine, Division of Endocrinology, National Clinical Research Center for Child Health, Hangzhou 310052, China.

Classifications MeSH