The application of automated volume scanner in bone age assessment

Radiograph of hand and wrist has been widely used in children's bone age assessment (BAA). However, ionizing radiation may be harmful for children in the future. Therefore, alternative methods have been attempted for the evaluation of children's bone age. Here, we reported an automated volume scanner (AVS) in assessing the biological age of children in comparison with X-ray radiograph as the gold standard.

Total 22 children (13 male and 9 female) with short stature or precocious puberty were enrolled into this study. Their chronological age ranged from 4 to 14 years old. The children's left hand-wrist was scanned with the AVS by putting them into a water sink containing tape water. Coronal images of the left hand-wrist were reconstructed and compared with X-ray images.

The number of patients whose hand-wrist bones (except for the first metacarpal sesamoid bone and the secondary ossification center of the first metacarpal bone) identified by AVS image was not significantly different from that by X-ray image. In addition, the total number of observed bones in each patient were not significantly different between the two methods. The concordance rate (percentage of patients whose hand-wrist bone presented in both AVS image and X-ray image) was high and the inter-observer variance of BA was small.

The AVS method was highly correlated with the standard radiograph for children's bone age assessment with small inter-observer variability. This novel AVS method could be an alternative method in clinical practice for bone age assessment with higher safety and reliability.