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Lopatin O, Barszcz M, Bolechała F, Woźniak K. Analysis of various radiological age-assessment methods in children, adolescents and young adults regarding the differences between the sexes and sides of the body - A comparative review. Leg Med (Tokyo) 2023; 65:102329. [PMID: 37832470 DOI: 10.1016/j.legalmed.2023.102329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 07/17/2023] [Accepted: 09/27/2023] [Indexed: 10/15/2023]
Abstract
A total of 76 articles published within the last twenty years, indexed in the PubMed and ResearchGate databases, were reviewed in order to compare medical imaging-based methods of age estimation of children, adolescents and young adults. The evaluated studies were analyzed for any statistically significant differences between the sexes and sides of the body, sample sizes, and population age. Irrespective of the evaluation method, there were some studies that showed a statistically significant differences in ossification stages between the male and female groups. Most of the studies whose authors conducted a statistical analysis demonstrated no significant differences between the left and right side of the body.
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Affiliation(s)
- Oleksiy Lopatin
- Chair and Department of Forensic Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Marta Barszcz
- Chair and Department of Forensic Medicine, Jagiellonian University Medical College, Krakow, Poland; Doctoral School of Medical and Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Filip Bolechała
- Chair and Department of Forensic Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Krzysztof Woźniak
- Chair and Department of Forensic Medicine, Jagiellonian University Medical College, Krakow, Poland.
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Lopatin O, Barszcz M, Bolechala F, Wozniak KJ. The fusion of ossification centers - A comparative review of radiographic and other imaging modalities of age assessment in living groups of children, adolescents, and young adults. Leg Med (Tokyo) 2023; 61:102185. [PMID: 36521210 DOI: 10.1016/j.legalmed.2022.102185] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 12/04/2022] [Indexed: 12/13/2022]
Abstract
A total of 227 articles published within the last twenty years, indexed in the PUBMED and Researchgate databases, were reviewed for the purpose of comparing medical imaging-based methods of age estimation. The evaluated studies were analyzed in terms of the assessed parts of the body, age, and epiphyseal fusion ages in children, adolescents, and young adults. Our analysis showed that an overwhelming majority of studies had been based on computed tomography and magnetic resonance imaging. A comparison of the studies showed that, irrespective of the imaging modality and the nationality of study population cohorts, the rates of development and the ages at which the process of ossification begins and ends show certain trends.
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Affiliation(s)
- Oleksiy Lopatin
- Department of Forensic Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Marta Barszcz
- Department of Forensic Medicine, Jagiellonian University Medical College, Krakow, Poland; Doctoral School of Medical and Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Filip Bolechala
- Department of Forensic Medicine, Jagiellonian University Medical College, Krakow, Poland
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Rüeger E, Hutmacher N, Eichelberger P, Löcherbach C, Albrecht S, Romann M. Ultrasound Imaging-Based Methods for Assessing Biological Maturity during Adolescence and Possible Application in Youth Sport: A Scoping Review. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121985. [PMID: 36553428 PMCID: PMC9776568 DOI: 10.3390/children9121985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022]
Abstract
Bone maturity is an indicator for estimating the biological maturity of an individual. During adolescence, individuals show heterogeneous growth rates, and thus, differences in biological maturity should be considered in talent identification and development. Radiography of the left hand and wrist is considered the gold standard of biological maturity estimation. The use of ultrasound imaging (US) may be advantageous; however, its validity and reliability are under discussion. The aims of this scoping review are (1) to summarize the different methods for estimating biological maturity by US imaging in adolescents, (2) to obtain an overview of the level of validity and reliability of the methods, and (3) to point out the practicability and usefulness of ultrasound imaging in the field of youth sports. The search included articles published up to November 2022. The inclusion criteria stipulated that participants had to fall within the age range of 8 to 23 years and be free of bone disease and fractures in the region of interest. Nine body regions were investigated, while the hand and wrist were most commonly analyzed. US assessment methods were usually based on the estimation of a bone maturity stage, rather than a decimal bone age. Furthermore, 70% of the assessments were evaluated as applicable, 10% expressed restraint about implementation, and 20% were evaluated as not applicable. When tested, inter- and intra-rater reliability was high to excellent. Despite the absence of ionization, low costs, fast assessment, and accessibility, none of the US assessments could be referred to as a gold standard. If further development succeeds, its application has the potential to incorporate biological age into selection processes. This would allow for more equal opportunities in talent selection and thus make talent development fairer and more efficient.
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Affiliation(s)
- Eva Rüeger
- Department of Elite Sport, Swiss Federal Institute of Sport Magglingen, 2532 Magglingen, Switzerland
| | - Nicole Hutmacher
- School of Health Professions, Physiotherapy, Bern University of Applied Science, 3012 Bern, Switzerland
| | - Patric Eichelberger
- School of Health Professions, Physiotherapy, Bern University of Applied Science, 3012 Bern, Switzerland
| | - Claus Löcherbach
- Swiss Olympic Medical Center, Swiss Federal Institute of Sport Magglingen, 2532 Magglingen, Switzerland
| | - Silvia Albrecht
- Swiss Olympic Medical Center, Swiss Federal Institute of Sport Magglingen, 2532 Magglingen, Switzerland
| | - Michael Romann
- Department of Elite Sport, Swiss Federal Institute of Sport Magglingen, 2532 Magglingen, Switzerland
- Correspondence: ; Tel.: +41-58-467-62-96
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Caggiano M, Scelza G, Amato A, Orefice R, Belli S, Pagano S, Valenti C, Martina S. Estimating the 18-Year Threshold with Third Molars Radiographs in the Southern Italy Population: Accuracy and Reproducibility of Demirjian Method. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191610454. [PMID: 36012087 PMCID: PMC9408143 DOI: 10.3390/ijerph191610454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/10/2022] [Accepted: 08/16/2022] [Indexed: 05/13/2023]
Abstract
The estimation of the age of the majority of living subjects is widely required nowadays due to the presence of unidentifiable individuals, without documents and general information, involved in migration or legal procedures. Dental age estimation (DAE) is a valid method for investigating the age of subjects. The aim of this study was to evaluate the accuracy of the Demirjian method in a limited age group (16-24 years) in differentiating between older and younger than 18 years. From an initial sample of 17,594 radiographs, 460 were selected meeting the inclusion criteria. Two dentists provided the age estimate according to the Demirjian method, with a simplified approach based on the development of the third molars. The presence of a developmental stage of H for at least one third molar allowed to establish the major age if the other third molars, inferior or superior, have reached a stage equal or superior to F, with an accuracy of 90.2% and a predictive positive value of 91.6%. Thirty-three patients showed the development of at least one third molar (Stage H) before the age of 18 years while six patients showed the development of all four third molars with root completion (stage H) before the age of 18 years. When all third molars reached stage H an individual was over 18 years old in 97.4% of cases. In presence of one third molar on stage H and a stage equal or superior to F for the other third molars the probability of being of major age was 91.6%.
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Affiliation(s)
- Mario Caggiano
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Allende, 84081 Baronissi, Italy
| | - Giuseppe Scelza
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Allende, 84081 Baronissi, Italy
| | - Alessandra Amato
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Allende, 84081 Baronissi, Italy
| | - Raffaele Orefice
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Allende, 84081 Baronissi, Italy
| | - Simona Belli
- ASL Napoli 1 Centro, Strada Comunale del Principe, 13/a, 80145 Napoli, Italy
| | - Stefano Pagano
- Odontostomatological University Centre, Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy
- Correspondence:
| | - Chiara Valenti
- Odontostomatological University Centre, Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy
| | - Stefano Martina
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Allende, 84081 Baronissi, Italy
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Classification of Distal Growth Plate Ossification States of the Radius Bone Using a Dedicated Ultrasound Device and Machine Learning Techniques for Bone Age Assessments. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12073361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
X-ray imaging, based on ionizing radiation, can be used to determine bone age by examining distal growth plate fusion in the ulna and radius bones. Legal age determination approaches based on ultrasound signals exist but are unsuitable to reliably determine bone age. We present a low-cost, mobile system that uses one-dimensional ultrasound radio frequency signals to obtain a robust binary classifier enabling the determination of bone age from data of girls and women aged 9 to 24 years. These data were acquired as part of a clinical study conducted with 148 subjects. Our system detects the presence or absence of the epiphyseal plate by moving ultrasound array transducers along the forearm, measuring reflection and transmission signals. Even though classical digital signal processing methods did not achieve a robust classifier, we achieved an F1 score of approximately 87% for binary classification of completed bone growth with machine learning approaches, such as the gradient boosting machine method CatBoost. We demonstrate that our ultrasound system can classify the fusion of the distal growth plate of the radius bone and the completion of bone growth with high accuracy. We propose a non-ionizing alternative to established X-ray imaging methods for this purpose.
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