• Journal of the Korean Society of Radiology
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• v.9 no.6
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• pp.349-356
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• 2015

The study is to recognize the interactions with bone ages by measuring the length between the end of the bone and the growth plate on selected highest weight of regions of seven for bone maturity in TW3 method. The experiment is subjected on seventy-two children (36 males, 36 females) who have examined the growth plate test from March, 2014 to March, 2015 and implemented a regression analysis by measuring the length between the end of the bone and the growth plate in Hand AP image of the children. In result, each bone age has produced a mean value and a standard deviation corresponding to the specific range and as bone age increases the length between the end of the bone and the growth plate decreased. In addition, female children showed lower mean value in comparison to male and also the measurement of the length between the end of the bone and the growth plate and its bone age are shown to be statistically valid(p<0.001) according to the results of regression analysis using its result value. Therefore, the probability of prediction on the bone age read off through the applied TW3 method and regression equation in the Hand AP image of the children.

• The Journal of Pediatrics of Korean Medicine
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• v.37 no.2
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• pp.1-11
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• 2023

Objectives We aimed to compare the bone age (BA) estimation by a deep learning-based program and by a specialist in pediatrics of Korean medicine using the Tanner-Whitehouse 3 (TW3) technique for the cases of children who visited a Korean medicine hospital for growth, and to report the effect of Korean medicine treatment. Methods For three children who visited the Korean medicine hospital for growth, BA estimation by the deep learning program and by the specialist in pediatrics of Korean medicine using the TW3 technique was compared, and the time required for estimation was investigated. The change of height, BA, and predicted adult height (PAH) using deep learning program after Korean medicine treatment was observed. Results BA estimation of the left hand bone X-ray by the specialist using the TW3 technique showed a difference of -0.03 to +0.15 years from the estimation by the deep learning program. The mean estimation time was 5 minutes and 49 seconds per one for the specialist and 48 seconds for the deep learning program. During the treatment period, the height percentile and PAH estimated by deep learning program were increased after Korean medicine treatment compared to baseline while acceleration of BA was suppressed compared to chronological age. Conclusions BA estimation using the deep learning program and the TW3 technique showed a difference of less than 0.15 years, and in three cases of patients with growth as the chief complaint, Korean medicine treatment increased height percentile and PAH without accelerating BA maturation.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2015.05a
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• pp.391-394
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• 2015

They evaluate the bone age using the GP-BP (Greulich-Pyle and Bayley-Pinneau) and TW3 (Tanner-Whitehouse 3) in clinical. The skeletal maturity in Hand AP is evaluated by clinical experience of physicians and this is qualitative evaluation not same in every physicians. In order to devise and evaluate new methods not using TW3 method in this situation. The study was conducted with 70 (Male 35, Female 35) children who visited Yangsan P Hospital from March 2014 to March 2015. The study measured the length of growth plate and distal proximal phalanx and conducted regression analysis for statistical significance test of bone age length difference. The study found average and standard deviation corresponding to certain ranges each bone age. The more bone age increase, the more the length of growth plate and distal proximal phalanx decreased. The girls have less average rather than the boys because bone grows fast. The girls have first period age of 12 to 14, it appears length variation significantly. The study conducted regression analysis and this has statistical significance.

• The Journal of Pediatrics of Korean Medicine
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• v.22 no.2
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• pp.155-170
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• 2008

Objectives : The purpose of this study was to have better data and to make efficient clinical reviews about children's growth based on two methods; X-ray of hand, and ultrasound of calcaneus. Methods : The study was composed of 100 patients(50 of boys and 50 of girls) who visited in department of pediatrics, O O university oriental hospital considering growth and their development. Bone age was measured by the TW3 method's RUS score in simple X-ray image of hand and bone density through ultrasonic image of calcaneus. To predict children's estimated height, their parent's height, bone age, and present height's percentile was measured. Results and Conclusions : 1. The bone age results from X-ray image of hand and ultrasonic image of calcaneus were correlated. Younger children have older bone age from hand's X-ray than the one from calcaneus's ultrasound. Older children have older bone age from calcaneus's ultrasound than one from hand's X-ray. 2. Predicted adult height by bone age(BH) of hand's X-ray and BH of calcaneus's ultrasound were correlated, but predicted adult height by inheritance(IH) was not correlated with others. 3. Bone age and predicted adult height were correlated with age, height, weight, BMI, and especially with age and height. 4. Measuring bone age by X-ray image of hand and ultrasonic image of calcaneus was simple and effective way of estimating children's growth and development.

• Advances in nano research
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• v.12 no.2
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• pp.197-212
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• 2022

The purpose of this study is to develop an automatic software system for bone age evaluation and to evaluate its accuracy in testing and feasibility in clinical practice. 20394 left-hand radiographs of healthy children (2-18 years old) were collected from China Skeletal Development Survey data of 1998 and China Skeletal Development Survey data of 2005. Three experienced radiologists and China-05 standard maker jointly evaluate the stages of bone development and the reference bone age was determined by consensus. 1020 from 20394 radiographs were picked randomly as test set and the remaining 19374 radiographs as training set and validation set. Accuracy of the automatic software system for bone age assessment is evaluated in test set and two clinical test sets. Compared with the reference standard, the automatic software system based on RUS-CHN for bone age assessment has a 0.04 years old mean difference, ±0.40 years old in 95% confidence interval by single reading, a 85.6% percentage agreement of ratings, a 93.7% bone age accuracy rate, 0.17 years old of MAD, 0.29 years old of RMS; Compared with the reference standard, the automatic software system based on TW3-C RUS has a 0.04 years old mean difference, a ±0.38 years old in 95% confidence interval by single reading, a 90.9% percentage agreement of ratings, a 93.2% bone age accuracy rate, a 0.16 years of MAD, and a 0.28 years of RMS. Automatic software system, AI-China-05 showed reliably accuracy in bone age estimation and steady determination in different clinical test sets.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.22 no.10
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• pp.1314-1319
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• 2018

The current TW3 - based maximum height prediction technique used in KMAA(Korean Medical Academy of Auxology) is manual and subjective, and it requires a lot of time and effort in the medical treatment, while the interest in the child's growth is very high. In addition, the technique of classifying images using deep learning, especially convolutional neural networks, is used in many fields at a more accurate level than the human eyes, also there is no exception in the medical field. In this paper, we introduce a TW3 algorithm using deep learning, that uses the convolutional neural network to predict the growth level of the left hand bone, to predict the maximum height of child and youth in order to increase the reliability of predictions and improve the convenience of the doctor.

• Imaging Science in Dentistry
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• v.50 no.3
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• pp.237-243
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• 2020

Purpose: The aim of this study was to evaluate the clinical efficacy of a Tanner-Whitehouse 3 (TW3)-based fully automated bone age assessment system on hand-wrist radiographs of Korean children and adolescents. Materials and Methods: Hand-wrist radiographs of 80 subjects (40 boys and 40 girls, 7-15 years of age) were collected. The clinical efficacy was evaluated by comparing the bone ages that were determined using the system with those from the reference standard produced by 2 oral and maxillofacial radiologists. Comparisons were conducted using the paired t-test and simple regression analysis. Results: The bone ages estimated with this bone age assessment system were not significantly different from those obtained with the reference standard (P>0.05) and satisfied the equivalence criterion of 0.6 years within the 95% confidence interval (-0.07 to 0.22), demonstrating excellent performance of the system. Similarly, in the comparisons of gender subgroups, no significant difference in bone age between the values produced by the system and the reference standard was observed (P>0.05 for both boys and girls). The determination coefficients obtained via regression analysis were 0.962, 0.945, and 0.952 for boys, girls, and overall, respectively (P=0.000); hence, the radiologist-determined bone ages and the system-determined bone ages were strongly correlated. Conclusion: This TW3-based system can be effectively used for bone age assessment based on hand-wrist radiographs of Korean children and adolescents.

• The Journal of Pediatrics of Korean Medicine
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• v.31 no.4
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• pp.31-38
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• 2017

Objectives The purpose of this study was to find out the clinically reliable relationships between the Risser sign and chronological age, bone age, menarche, and adult height prediction (AHP) and to evidence the reliability of the Risser sign. Methods This study had been carried out with 50 children who had their growth checked in an oriental medical hospital from January 2015 to February 2017. We investigated Risser sign in AP X-rays with iliac crest, bone age, AHP for all 50 children and the timing of menarche from the 22 girls in the study subjects. We also investigated a correlation between the Risser stage and the other indicators to analyze statistical data. Results The mean chronological ages of Risser 1, 2, 3 and 4 were 11.2, 12.6, 14.4, and 15.5 years respectively for the boys and 10.8, 12.2, 13.8 and 14.8 years respectively for the girls. The mean bone ages of Risser 1, 2, 3 and 4 were 12.3, 13.6, 15.7 and 16.5 years respectively for the boys and 11.7, 13.8, 14.3 and 14.9 years respectively for the girls. We analyzed 22 girls' Risser stages in accordance with the duration from menarche. The result showed that in the first six months after menarche, all girls were in Risser 1 and 2; in the next six months, the girls were in Risser 2 on average; in the next 12 months, all girls were in Risser 3 and 4; after more than two years from menarche, all girls were in Risser 4. The mean remaining growth height of Risser 1, 2, 3 and 4 were 27.8, 17.3, 4.4 and 1.0 cm respectively for the boys and 14.5, 5.1, 3.1 and 1.1 cm respectively for the girls. The Risser stage was correlated strongly with chronological age (Spearman's rho=0.707 (boy), 0.841 (girl)), bone age (Spearman's rho=0.869 (boy), 0.875 (girl)), duration from menarche (Spearman's rho=0.909) and remaining growth height (Spearman's rho=-0.784 (boy), -0.878 (girl)). Conclusions This study showed that the Risser sign can be useful in assessing skeletal maturity and predicting remaining growth height based on the Risser stage and the other growth indicators.

• Clinical and Experimental Pediatrics
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• v.52 no.3
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• pp.351-355
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• 2009

Purpose : This study compared bone ages measured by the Greulich-Pyle (GP) and Tanner-Whitehouse 3 (TW3) methods and investigated the differences in predicted adult heights measured by Bayley-Pinneau (BP) and TW3 methods. Methods : Bone ages were assessed from left-wrist radiographs by two investigators, one for each GP and TW3 methods in 85 normal children, 30 precocious puberty girls, and 30 constitutional growth delay boys. The differences between the measured predicted adult heights using the BP and TW3 methods were compared in each group. Results : The bone age measured by the TW3 method was less than that by the GP method in normal children. The predicted adult heights measured by the two methods showed no significant difference in normal boys, while the predicted adult height measured by the TW3 method was higher than that by the BP method for normal girls ($156.4{\pm}4.7$ cm vs. $158.9{\pm}3.8$ cm, P<0.01) and for precocious puberty girls ($156.3{\pm}4.0$ cm vs. $159.3{\pm}4.2$ cm, P<0.01). In contrast, the predicted adult height was higher from the BP method than from the TW3 method in constitutional growth delay boys ($173.3{\pm}4.4$ cm vs. $169.7{\pm}3.2$ cm, P<0.01). Conclusion : There were significant differences in predicted adult heights between the BP and TW3 method in normal girls, precocious puberty girls, or constitutional growth delay boys. In precocious puberty and constitutional growth delay, the BP method might be preferred to predict adult height, but further studies on final adult height are needed.

• Journal of the Korean Applied Science and Technology
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• v.38 no.1
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• pp.318-331
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• 2021

This study was conducted on the assumption that bone age would be more effective when it comes to physique and physical fitness assessment for adolescents, and the purpose of this study was to identify the differences in physique and physical fitness for students in their adolescence through bone age and chronological age in order to contribute to the well-balanced physique and physical fitness development in adolescents and the health improvement in students. Total 874 adolescents(483 males, 391 females) aged 11~16 were selected as subjects out of the total population of 1100 adolescents aged 6~16 based on the PAPS(Physical Activity Promotion System) and age standards of the TW3 method; and skeletal maturation, which symbolize the indicators of biological maturation, were evaluated by using the TW3(Tanner-Whitehouse 3) method after hand-wrist radiographs, and birth date was used for chronological age. A stadiometer and InBody 270 (Biospace, Korea) were used to measure 2 components in physique. A total of 7 components in physical fitness, which included muscular strength, muscular endurance, flexibility, power, cardiovascular endurance, balance, agility, were measured as well. A independent samples t-test was conducted for data processing using SPSS 25.0, and the significance level was set at p< .05. The study results are as follows. First, bone age and chronological age used for physique comparison in males aged 11 and 12, height and weight showed significant difference; in males aged 13, weight showed signicant difference. Weight and height in females aged 11, and height in females aged 12 showed significant difference. Second, bone age and chronological age used for physical fitness comparison in males aged 11, muscular strength, power, flexibility, cardiovascular endurance showed significant difference; in males aged 12, muscular strength. power, cardiovascular endurance; in males aged 13, flexibility showed significant difference. Muscular strength, power, flexibility, muscular endurance, cardiovascular endurance in females aged 11, and flexibility in females aged 14 showed significant difference. As a result, this study concluded that in a period of rapid skeletal growth, evaluating physique and physical fitness based on bone age is more accurate than evaluating based on chronological age.