A comparative study of three bone age assessment methods on Chinese preschool-aged children

• Main Authors: Chengcheng Gao (Author), Qi Qian (Author), Yangsheng Li (Author), Xiaowei Xing (Author), Xiao He (Author), Min Lin (Author), Zhongxiang Ding (Author)
• Format: Book
• Published: Frontiers Media S.A., 2022-08-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2296-2360; 10.3389/fped.2022.976565
• Keywords: bone age assessment; preschool children; Greulich-Pyle (GP); Tanner-Whitehouse 3 (TW3); China 05 RUS-CHN; Pediatrics; RJ1-570
• Source: Frontiers in Pediatrics, Vol 10 (2022)

BackgroundBone age assessment (BAA) is an essential tool utilized in outpatient pediatric clinics. Three major BAA methods, Greulich-Pyle (GP), Tanner-Whitehouse 3 (TW3), and China 05 RUS-CHN (RUS-CHN), were applied to comprehensively compare bone age (BA) and chronological age (CA) in a Chinese sample of preschool children. This study was designed to determine the most reliable method.MethodsThe BAA sample consisted of 207 females and 183 males aged 3-6 years from the Zhejiang Province in China. The radiographs were estimated according to the GP, TW3, and RUS-CHN methods by two pediatric radiologists. The data was analyzed statistically using boxplots, the Wilcoxon rank test, and Student's t-test to explore the difference (D) between BA and CA.ResultsAccording to the distributions of D, the boxplots showed that the median D of the TW3 method was close to zero for both male and female subjects. The TW3 and RUS-CHN methods overestimated the age of both genders. The TW3 method had the highest correct classification rate for males but a similar rate for females. The GP method did not show any significant difference between the BA and CA when applied to 3-year-old males and 4-year-old females while the TW3 method showed similar results when applied to 6-year-old females. The RUS-CHN method showed the least consistent results among the three methods.ConclusionThe TW3 method was superior to the GP and RUS-CHN methods but not reliable on its own. It should be noted that a precise age diagnosis for preschool children cannot be easily made if only one of the methods is utilized. Therefore, it is advantageous to combine multiple methods when assessing bone age.