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Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
A comparative study of three bone age assessment methods on Chinese preschool-aged children
Chengcheng Gao1, Qi Qian2, Yangsheng Li1
1Department of Radiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Insights
The Tanner-Whitehouse 3 (TW3) method is the most reliable for bone age assessment in Chinese preschoolers, though combining methods improves accuracy. This study compared GP, TW3, and RUS-CHN bone age assessment methods.
Area of Science:
- Pediatric endocrinology
- Radiology
- Growth and development
Background:
- Bone age assessment (BAA) is crucial in pediatric outpatient clinics.
- Comparing Greulich-Pyle (GP), Tanner-Whitehouse 3 (TW3), and China 05 RUS-CHN (RUS-CHN) methods is essential for accurate BAA.
- Preschool children's bone age (BA) and chronological age (CA) comparison is vital for growth monitoring.
Purpose of the Study:
- To determine the most reliable bone age assessment method for Chinese preschool children.
- To compare the accuracy of GP, TW3, and RUS-CHN methods in assessing BA against CA.
- To identify potential discrepancies in BAA among different methods.
Main Methods:
- Radiographs of 400 preschool children (207 females, 183 males, aged 3-6 years) from Zhejiang Province, China, were analyzed.
- Two pediatric radiologists assessed bone age using GP, TW3, and RUS-CHN methods.
- Statistical analysis included boxplots, Wilcoxon rank test, and Student's t-test to compare BA and CA differences (D).
Main Results:
- The TW3 method showed the median difference (D) between BA and CA closest to zero for both genders.
- TW3 and RUS-CHN methods tended to overestimate BA in both males and females.
- TW3 demonstrated the highest correct classification rate in males and comparable rates in females; RUS-CHN yielded the least consistent results.
Conclusions:
- The TW3 method is superior to GP and RUS-CHN for BAA in this cohort but not entirely reliable alone.
- Accurate bone age diagnosis in preschool children may require combining multiple assessment methods.
- Utilizing a single BAA method may lead to imprecise age diagnosis; combined approaches offer advantages.
Background:
Bone 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.
Methods:
The 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.
Results:
According 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.
Conclusion:
The 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.
