A Low Resource Skeleton Maturation Estimation System for Automatic Hand X-Ray Assessment in Pediatric Applications

Abstract

The assessment of differences between skeletal age and chronological age in childhood is often based on the comparison of the patient's left hand x-ray with a reference atlas, performed by a experienced professional. This procedure involves a manual image analysis, that can be subject to inter rater variability posing several problems for clinical applications. In this paper a new methodology for skeleton maturation estimation based on automatic hand X-ray assessment for pediatric applications on a low resource devices (e.g. mobile device) is proposed. The pipeline covers hand-area estimation and bone-area estimation to achieve maturation scores which are then indexed with references images, separately for male and female. The proposed approach is based on simple image processing functions always bearing in mind the application on a mobile context. The involved steps are thoroughly presented and all the used functions are explained. The performance of the system was then evaluated using the complete pipeline. The obtained results pointed to an average error rate of 15,38±3,31%, which is subject to improvements. In particular, contrast enhancement in some lower quality images still offers some challenges.