Bone age assessment by content-based image retrieval and case-based reasoning

Skeletal maturity is assessed visually by comparing hand radiographs to a standardized reference image atlas. Most common are the methods by Greulich & Pyle and Tanner & Whitehouse. For computer-aided diagnosis (CAD), local image regions of interest (ROI) such as the epiphysis or the carpal areas are extracted and evaluated. Heuristic approaches trying to automatically extract, measure and classify bones and distances between bones suffer from the high variability of biological material and the differences in bone development resulting from age, gender and ethnic origin. Content-based image retrieval (CBIR) provides a robust solution without delineating and measuring bones. In this work, epiphyseal ROIs (eROIS) of a hand radiograph are compared to previous cases with known age, mimicking a human observer. Leaving-one-out experiments are conducted on 1,102 left hand radiographs and 15,428 metacarpal and phalangeal eROIs from the publicly available USC hand atlas. The similarity of the eROIs is assessed by a combination of cross-correlation, image distortion model, and Tamura texture features, yielding a mean error rate of 0.97 years and a variance of below 0.63 years. Furthermore, we introduce a publicly available online-demonstration system, where queries on the USC dataset as well as on uploaded radiographs are performed for instant CAD. In future, we plan to evaluate physician with CBIR-CAD against physician without CBIR-CAD rather than physician vs. CBIR-CAD.