TW3-Based Fully Automated Bone Age Assessment System Using Deep Neural Networks

Deep learning technology has rapidly evolved in recent years. Bone age assessment (BAA) is a typical object detection and classification problem that would benefit from deep learning. Convolutional neural networks (CNNs) and their variants are hence increasingly used for automating BAA, and they have shown promising results. In this paper, we propose a complete end-to-end BAA system to automate the entire process of the Tanner–Whitehouse 3 method, starting from localization of the epiphysis–metaphysis growth regions within 13 different bones and ending with estimation of the corresponding BA. Specific modifications to the CNNs and other stages are proposed to improve results. In addition, an annotated database of 3300 X-ray images is built to train and evaluate the system. The experimental results show that the average top-1 and top-2 prediction accuracies for skeletal bone maturity levels for 13 regions of interest are 79.6% and 97.2%, respectively. The mean absolute error and root mean squared error in age prediction are 0.46 years and 0.62 years, respectively, and accuracy within one year of the ground truth of 97.6% is achieved. The proposed system is shown to outperform a commercially available Greulich–Pyle-based system, demonstrating the potential for practical clinical use.