Abstract
Purpose
Bone age assessment is not only an important means of assessing maturity of adolescents, but also plays an indispensable role in the fields of orthodontics, kinematics, pediatrics, forensic science, etc. Most studies, however, do not take into account the impact of background noise on the results of the assessment. In order to obtain accurate bone age, this paper presents an automatic assessment method, for bone age based on deep convolutional neural networks.
Method
Our method was divided into two phases. In the image segmentation stage, the segmentation network U-Net was used to acquire the mask image which was then compared with the original image to obtain the hand bone portion after removing the background interference. For the classification phase, in order to further improve the evaluation performance, an attention mechanism was added on the basis of Visual Geometry Group Network (VGGNet). Attention mechanisms can help the model invest more resources in important areas of the hand bone.
Result
The assessment model was tested on the RSNA2017 Pediatric Bone Age dataset. The results show that our adjusted model outperforms the VGGNet. The mean absolute error can reach 9.997 months, which outperforms other common methods for bone age assessment.
Conclusion
We explored the establishment of an automated bone age assessment method based on deep learning. This method can efficiently eliminate the influence of background interference on bone age evaluation, improve the accuracy of bone age evaluation, provide important reference value for bone age determination, and can aid in the prevention of adolescent growth and development diseases.
Similar content being viewed by others
References
Kaiyu X (2007) On the development of bone age research. J Beijing Sport Univ 2007(07):944–945, 958
Martin DD, Wit JM, Hochberg Z, Savendahl L, Van Rijn RR, Fricke O, Cameron N, Caliebe J, Hertel T, Kiepe D, Albertssonwikland K, Thodberg HH, Binder G, Ranke MB (2011) The use of bone age in clinical practice—part 1. Hormone Res Paediatr 76(1):1–9
Cheung KM, Cheung JP, Samartzis D, Mak KC, Wong YW, Cheung WY, Akbarnia BA, Luk KD (2012) Magnetically controlled growing rods for severe spinal curvature in young children: a prospective case series. Lancet 379(9830):1967–1974
Dominkus M, Krepler P, Schwameis E, Windhager R, Kotz R (2001) Growth prediction in extendable tumor prostheses in children. Clin Orthop Relat Res 390(390):212–220
Duthie RB (1959) The significance of growth in orthopaedic surgery. Clin Orthop Relat Res 14:7–19
Thompson GH, Akbarnia BA, Campbell RM (2007) Growing rod techniques in early-onset scoliosis. J Pediatr Orthop 27(3):354–361
Garn SM (1959) Radiographic atlas of skeletal development of the hand and wrist. Am J Hum Genet 11(3):282–283
Kim SY, Oh YJ, Shin JY, Rhie YJ, Lee KH (2008) Comparison of the Greulich–Pyle and Tanner Whitehouse (TW3) methods in bone age assessment. J Korean Soc Pediatr Endocrinol 13(1):50–55
Mansourvar M, Ismail MA, Herawan T, Gopal Raj R, Abdul Kareem S, Nasaruddin FH (2013) Automated bone age assessment: motivation, taxonomies, and challenges. Comput Math Methods Med 2013:391626. https://doi.org/10.1155/2013/391626
Michael DJ, Nelson AC (1989) HANDX: a model-based system for automatic segmentation of bones from digital hand radiographs. IEEE Trans Med Imaging 8(1):64
Frisch H, Riedl S, Waldhor T (1996) Computer aided estimation of skeletal age and comparison with bone age evaluations by the method of Greulich-Pyle and Tanner-Whitehouse. Pediatr Radiol 26(3):226–231
Pietka E, Gertych A, Pospiech S, Cao F, Huang HK, Gilsanz V (2001) Computer-assisted bone age assessment: image preprocessing and epiphyseal/metaphyseal ROI extraction. IEEE Trans Med Imaging 20(8):715–729
Mahmoodi S, Sharif BS, Chester EG, Owen JP, Lee RE (1997) Automated vision system for skeletal age assessment using knowledge based techniques. In: International conference on image processing
Mahmoodi S, Sharif BS, Chester EG, Owen JP, Lee RE (2000) Skeletal growth estimation using radiographic image processing and analysis. In: International conference of the IEEE engineering in medicine and biology society, vol 4, no 4, pp 292–297
Bocchi L, Ferrara F, Nicoletti I, Valli G (2003) An artificial neural network architecture for skeletal age assessment. In: International conference on image processing
Liang B, Zhai Y, Tong C, Zhao J, Li J, He X, Ma Q (2019) A deep automated skeletal bone age assessment model via region-based convolutional neural network. Future Gener Comput Syst 98:54–59
Alom MZ, Taha TM, Yakopcic C, Westberg S, Sidike P, Nasrin MS, Hasan M, Van Essen BC, Awwal AAS, Asari VK (2019) A state-of-the-art survey on deep learning theory and architectures. Electronics 8:292
Krizhevsky A, Sutskever I, Hinton GE (2012) ImageNet classification with deep convolutional neural networks. In: Neural information processing systems
Deng J, Dong W, Socher R, Li L, Li K, Feifei L (2009) ImageNet: a large-scale hierarchical image database. In: Computer vision and pattern recognition
Simonyan K, Zisserman A (2015) Very deep convolutional networks for large-scale image recognition. In: International conference on learning representations
Szegedy C, Liu W, Jia Y, Sermanet P, Reed S, Anguelov D, Erhan D, Vanhoucke V, Rabinovich A (2015) Going deeper with convolutions. In: Computer vision and pattern recognition
He K, Zhang X, Ren S, Sun J (2016) Deep residual learning for image recognition. In: Computer vision and pattern recognition
Payan A, Montana G (2015) Predicting Alzheimer’s disease: a neuroimaging study with 3D convolutional neural networks. arXiv Computer vision and pattern recognition
Gao X, Lin S, Wong TY (2015) Automatic feature learning to grade nuclear cataracts based on deep learning. IEEE Trans Biomed Eng 62(11):2693–2701
Christ PF, Ettlinger F, Kaissis G, Schlecht S, Grün F, Valentinitsch A, Ahmadi S-A, Braren R, Menze B (2017) SurvivalNet: predicting patient survival from diffusion weighted magnetic resonance images using cascaded fully convolutional and 3D convolutional neural networks. In: International symposium on biomedical imaging
Zheng H, Chen J, Yao X, Sangaiah AK, Jiang Y, Zhao C (2018) Clickbait convolutional neural network. Symmetry 10(5):138
Sajjad M, Khan S, Hussain T, Muhammad K, Sangaiah AK, Castiglione A, Esposito C, Baik SW (2019) CNN-based anti-spoofing two-tier multi-factor authentication system. Pattern Recognit Lett 126:123–131
Larson DB, Chen MC, Lungren MP, Halabi SS, Stence NV, Langlotz CP (2018) Performance of a deep-learning neural network model in assessing skeletal maturity on pediatric hand radiographs. Radiology 287(1):313
Lee H, Tajmir S, Lee J, Zissen M, Yeshiwas BA, Alkasab TK, Choy G, Do S (2017) Fully automated deep learning system for bone age assessment. J Digit Imaging 30(4):427–441
Spampinato C, Palazzo S, Giordano D, Aldinucci M, Leonardi R (2017) Deep learning for automated skeletal bone age assessment in X-ray images. Med Image Anal 36:41–51
Ronneberger O, Fischer P, Brox T (2015) U-Net: convolutional networks for biomedical image segmentation. In: Medical image computing and computer assisted intervention
RSNA Pediatric Bone Age Challenge (2017). http://rsnachallenges.cloudapp.net/competitions/4. Accessed 12 Dec 2017
Simu S, Lal S (2017) A study about evolutionary and non-evolutionary segmentation techniques on hand radiographs for bone age assessment. Biomed Signal Process Control 33:220–235
Fang B, Lu Y, Zhou Z, Li Z, Yan Y, Yang L, Jiao G, Li G (2019) Classification of genetically identical left and right irises using a convolutional neural network. Electronics 8(10):1109
Ponzio F, Urgese G, Ficarra E, Di Cataldo S (2019) Dealing with lack of training data for convolutional neural networks: the case of digital pathology. Electronics 8(3):256
Ioffe S, Szegedy C (2015) Batch normalization: accelerating deep network training by reducing internal covariate shift. arXiv preprint arXiv:1502.03167
Wang F, Jiang M, Qian C, Yang S, Li C, Zhang H, Wang X, Tang X (2017) Residual attention network for image classification. In: Computer vision and pattern recognition
Ma Z, Yin S (2018) Deep attention network for melanoma detection improved by color constancy. In: International conference on information technology in medicine and education
Kingma DP, Ba J (2014) Adam: a method for stochastic optimization. arXiv Learning
Abadi M, Agarwal A, Barham P, Brevdo E, Chen Z, Citro C, Corrado SG, Davis A, Dean J, Devin M, Ghemawat S, Goodfellow I, Harp A, Irving G, Isard M, Jia Y, Jozefowicz R, Kaiser L, Kudlur M, Levenberg J, Mane D, Monga R, Moore S, Murray GD, Olah C, Schuster M, Shlens J, Steiner B, Sutskever I, Talwar K, Tucker P, Vanhoucke V, Vasudevan KV, Viegas BF, Oriol Vinyals, Warden P, Wattenberg M, Wicke M, Yu Y, Zheng X (2015) TensorFlow: large-scale machine learning on heterogeneous distributed systems. arXiv Distributed, parallel, and cluster computing
Gilsanz V, Ratib O (2005) Hand bone age: a digital atlas of skeletal maturity. Springer, Berlin
Szegedy C, Vanhoucke V, Ioffe S, Shlens J, Wojna Z (2016) Rethinking the inception architecture for computer vision. In: Computer vision and pattern recognition
Szegedy C, Ioffe S, Vanhoucke V, Alemi AA (2016) Inception-v4, Inception-ResNet and the impact of residual connections on learning. In: National conference on artificial intelligence
Huang G, Liu Z, Der Maaten LV, Weinberger KQ (2017) Densely connected convolutional networks. In: Computer vision and pattern recognition
Acknowledgements
This work was supported by National Natural Science Foundations of China (No. 61971168) and Natural Science Foundation of Zhejiang Province (No. LY18F030009).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical approval
This article does not contain any studies with human participants performed by any of the authors.
Informed consent
This articles does not contain patient data.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Gao, Y., Zhu, T. & Xu, X. Bone age assessment based on deep convolution neural network incorporated with segmentation. Int J CARS 15, 1951–1962 (2020). https://doi.org/10.1007/s11548-020-02266-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11548-020-02266-0