[Bone age - alternatives for skeletal maturity assessment for the EOS scanner]

Area of Science:

• Radiology
• Pediatric Imaging
• Skeletal Development

Background:

• Standard hand and wrist bone age assessments are incompatible with EOS scanner patient positioning.
• Alternative methods are needed for accurate bone age determination with EOS imaging.

Purpose of the Study:

• To evaluate the feasibility and reliability of five alternative bone age assessment methods using EOS scans.
• To identify the most suitable method for routine clinical use.

Main Methods:

• Five methods (Hassel-Farman cervical vertebra, Risser 'plus' iliac crest, Oxford hip, O'Connor knee, Nicholson calcaneus) were applied to EOS scans of 114 children (2-21 years).
• Intraclass correlation coefficients assessed reliability; Spearman correlation assessed agreement with chronological age.

Main Results:

• All five methods showed significant correlation with chronological age (r>0.829).
• Excellent intra- and interobserver reliability was observed for most methods, with the knee method rated as 'good'.
• The Hassel-Farman (cervical) and Nicholson (calcaneus) methods were fastest, though calcanei were unassessable in 14% of cases.

Conclusions:

• Bone age assessment is feasible with all five evaluated methods on EOS scans.
• The Hassel-Farman cervical vertebra method is highlighted as a fast, reliable, and user-friendly option for pediatric bone age assessment.