International journal of Digital Signal and Image Processing (IJDSIP)Vol. 1, No.

1(September 2013)

39

Estimation of Skeletal Maturity by Tanner and Whitehouse Method

V.Karthikeyan1, V.J.Vijayalakshmi2, P.Jeyakumar3
1

Department of ECE, SVS College of Engineering, Coimbatore, India

Karthick77keyan@gmail.com

Department of EEE, Sri Krishna College of Egg & Tech., Coimbatore, India
Vijik810@gmail.com
3

Department of ECE Karpagam University, Coimbatore, India

Jeyak522@gmail.com

Abstract
The proposed paper present the development procedure for segmenting wrist bones commencing left hand wrist radiographs, which might exist more worn in estimating the skinny adulthood or bone age. Bone Age evaluation is a process used in the organization and analysis of endocrine disorders. It as well serves as a suggestion of the therapeutic consequence of behavior. It is of a great deal consequence in pediatric medicine in the finding of hormonal development or yet genetic disorders. The input radiographs are first preprocessed to remove noise using a Gaussian filter and then grayscale converted. Edge detection is done using canny edge detector. For Carpal Region of Interest analysis, bone removal is approved out by integrating anatomical information of the hand and trigonometric concepts; while a Tanner and Whitehouse method -phase task is achieved by combining the inclined vector flow Snakes and the imitative distinction of Gaussian filter. For Metaphyses Region of Interest study, image-processing methods and geometrical characteristic investigation, based on the dissimilarity of Gaussian, are proposed. The Region of Interest can be further used in feature extraction and classification to estimate the bone age. The Iterative Dichotomiser 3 classifier is used to classify the bones. The structure is validated by means of a statistics set of 50 images, 25 boys and 25 girls, and the results are discussed.

Keywords: Bone Age Assessment (BAA), Tanner and Whitehouse method (TW),
Region of Interest (ROI), Iterative Dichotomiser 3 (ID3) classifier

1. INTRODUCTION
Bone age assessment using a hand radiograph is a significant medical instrument in the region of pediatrics, particularly in relation to endocrinological problems and expansion disorders. A particular analysis of skinny age informs the clinician of the relative adulthood of a patient at a exacting time in his or her time and integrated with additional clinical finding, divides the usual from the relatively advanced or retarded [1]. The bone age of kids is in fact influenced by sexual category, contest, diet category, livelihood environments and communal resources, etc. Based on a radiological assessment of skinny growth of the left-hand wrist, bone age is assessed
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and compared by means of the chronological age. A difference is Tanner and Whitehouse. These Tanner and Whitehouse o values point out abnormalities in skeletal growth. The process is frequently used in the organization and diagnosis of endocrine disorders and too serves as a sign of the therapeutic result of action. It indicates whether the expansion of a patient is accelerating or falling, based on which the enduring can be treated with increase hormones. Bone Age evaluation is commonly used due to its effortlessness, least emission contact, and the ease of use of numerous Classification centers for assessment of adulthood.

2.

BACKGROUND OF BONE AGE ASSESMENT

The major clinical methods for skinny bone age opinion are the Greulich & Pyle (GP) technique and the Tanner & Whitehouse (TW) method. GP is an atlas matching method at the same time as Tanner and Whitehouse is a score assigning method [2]. Greulich & Pyle method is faster and easier to use than the Tanner and Whitehouse method. Bull et.al. Performed a large scale comparison of the GP and Tanner and Whitehouse method and concluded that Tanner and Whitehouse method is more reproducible of the Tanner and Whitehouse o and potentially more accurate [3].

Fig. 1 Bones of hand and wrist for Bone Age Assessment

In GP system, a left-hand wrist radiograph is compared by means of a sequence of radiographs grouped in the atlas according to age and gender. Tanner and Whitehouse system uses a thorough study of every persons bone (shown in Fig. 1), conveying it to single of eight classes reflecting its developmental stage. This leads to the account of every bone in terms of scores. The amount of all scores assess the bone age. Fig. 2 shows the advance of the phalanx bone into stages (A, B, C, D, I) as: Phase A absent Phase B single place of calcium Phase C center is dissimilar in look Phase D Most width is partially or more the Width of metaphysis Phase E Edge of the epiphysis is hollow

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International journal of Digital Signal and Image Processing (IJDSIP)Vol. 1, No. 1(September 2013)

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Phase F epiphysis is as broad as metaphysis Phase G epiphysis caps the metaphysis Phase H synthesis of epiphysis and metaphysis has begun Phase I epiphyseal synthesis concluded.

By adding the scores of every Region of Interests, and largely adulthood gain is obtained. This score is connected with the bone age in a different way for males and females [4].

3.

SYSTEM DESIGN

3.1 Image Preprocessing

Image preprocessing is performed in Tanner and Whitehouse o steps: Image smoothing and Grayscale conversion. Image smoothing is done to reduce the noise within the image or to create a fewer pixilated image. Most smoothing methods are based on low pass filters. In our system, we encompass to diminish noise through by means of a Gaussian filter. Gaussian filter reduces the amount of upper frequencies comparative to the lower frequencies, but at the rate of additional calculation time. But the speeding up of smoothing is achieved by splitting 2D Gaussian G(x,y) into Tanner and Whitehouse o 1D Gaussians G(x)G(y) and carrying out filtering in 1D, primary row by row and subsequently column by column. Grayscale alteration is completed as follows. Colors in the image are converted to a shade of gray by manipulative the effectual brightness or luminance of the color and by means of this to make a shade of gray that matches the preferred brightness.

3.2 Edge Detection

Edge takes place wherever near is a discontinuity in the strength task or an extremely vertical concentration gradient in the image. Using this statement, if one get the copied of the concentration value transversely the image and locate points where the derivative is highest, then the edge might be located [5]. We contain the use of canny edge detector to sense the edges. The Canny operator performs a 2D spatial gradient dimension on an image. Typically it is used to locate the estimated complete gradient magnitude at every point in an input grayscale image. The Canny edge detector uses a couple of 3 x 3 convolution masks, one estimating the gradient in the x-direction (columns) and the other estimating the gradient in the y-direction (rows). A complication mask is usually a great deal lesser than the real image. As an effect, the mask is slide above the image, manipulating a square of pixels at a time.
-1 -2 -1 0 0 0 +1 +2 +1 +1 0 -1 +2 0 -2 +1 0 -1

Gx Fig.2 3 x 3 convolution masks

Gy

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3.3

Epiphyses Metaphyses Region of Interest Extraction

To extract the features needed for stage assignment to each Epiphyses Metaphyses Region Of Interest, we improve the quality of the threshold image by filling the holes and by better defining the contours of the previous thresholded image with a segmentation algorithm, based on the approach proposed by Pappas and Jayant [7], which uses Gibbs arbitrary fields for a priori likelihood modeling mutual with a Gaussian model for the conditional probabilities. Since human bones have shapes that are often not convex, the aforementioned method allows us a more accurate analysis of the bones extracted, thus avoiding the use of approximation due to the convex hulls as in [8]. To describe each convex hull for each EMROI detected we extract the features shown in fig. 6 that are compared with the same features extracted from the TW2 stage classification model. The final result is the classification stage of all the extracted EMROIs and a final stage computed as the mean of all the stages.

Fig. 3 Feature vectors for each Epiphyses Metaphyses Region of Interest.

To describe each detected Epiphyses Metaphyses Region of Interest, we extract and measure some geometrical features (Fig. 2), inspired by [9], that are compared with the same features extracted from the Tanner and Whitehouse 2-stage classification model. According to this comparison, a Tanner and Whitehouse 2 stage is assigned to the considered bone. The final result is the Tanner and Whitehouse 2-score assignment for the valuation of the skeletal bone age. More in detail, we store for each stage and for each bone a vector of features (Fig. 2) Fstagebone [d meta, dist _ m _1, dnv1, dnv5, dhepi, area1... area6] (1)

If numeral of predicting attributes is unfilled, subsequently go back the solitary node tree Root, with label equal to the majority frequent value of the aim characteristic in the examples. If not start where dmeta is the width of the metaphysis, dnv1, dnv5 are the heights of different lines that divide the epiphysis width in six equal parts, and area1, and area6 are the areas of the six identified parts. Finally, dhepi is the distance between Tanner and Whitehouse & metaphysis and the diaphysis. The stage assignment, after the Epiphyses Metaphyses Region of Interest analysis,
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International journal of Digital Signal and Image Processing (IJDSIP)Vol. 1, No. 1(September 2013)

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is done by simply calculating the minimum Euclidean distance between Tanner and Whitehouse and the extracted features of the bone under analysis and all the Fbone stage stored as reference.

3.4 Carpal Region of Interest Extraction

The first step in Carpal Region of Interest analysis is the extraction of the carpal bones from the entire hand, performed by a suitable application of the wedge functions. The top-right point of the Carpal Region of Interest is found by detecting the soft tissue junction is Tanner and Whitehouse Then second finger and the thumb. Starting from this point, it is easy to find the other point. In order to better identify the single bones, a Derivative Difference of Gaussian filter has been applied. The principle of this anisotropic filter is to smooth out noise locally by diffusion while at the same time preventing diffusion across object details. This filter allows us to better differentiate carpal bones from the background in performing effective dynamic thresholding. Afterward, the single carpal bones are extracted by using a method that is able to identify the image edges and to fill the closed ones. More in detail, the image contours are detected through a canny edge detector followed by a fifth-order filter. Finally, a filling algorithm is applied to the extracted Carpal Region of Interest Region of Interest.

(a)

(b)

Fig. 4 - (a) Original Carpal ROI (b) Enhanced ROI by applying DrDoG.

(a)

(b)

(c)

Fig. 5 (a) Output of DrDoG filter, (b) Bone contour detection after canny edge detection, (c) Correctly regions extracted

The first step in the CROI analysis is the extraction of these bones from the entire hand that has been performed by a suitable application of the wedge functions. Once the carpal regions have been extracted, it is necessary to enhance them in order to facilitate the bone extraction. In order to better differentiate carpal bones from the background and obtain a performing and dynamic thresholding, we have used an anisotropic diffusion filter based on the derivative difference between two Gaussian functions (DrDoG) that is different than the one used in the EMROI processing. The principle is to smooth out noise locally by diffusion while at the same time preventing diffusion across object boundaries. This filter allows us to suppress the noise and at
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the same time to preserve image edges and details as shown in fig. 4 a & 4 b. Afterwards, to identify the contours we use a threshold through a canny edge detector followed by a fifth order filter, see fig.5a,5b &5c .

3.5 Overview of Iterative Dichotomiser 3 classifier

ID3 builds a result tree from a permanent set of examples. The resultant tree is used to categorize prospect samples. The instance has more than a few attributes and belongs to a class (like yes or no). The leaf nodes of the resultant tree hold the class forename while a non-leaf node is a conclusion node. The decision node is a characteristic test with every division (to another decision tree) being a probable value of the trait. Iterative Dichotomiser 3(ID 3) uses in sequence gain to assist it make a decision which feature goes into a result node.

4.

RESULTS AND DISCUSSION

The system for classifying wrist bones from left hand wrist radiographs was tested with 50 left hand wrist images (25 males and 25 females). The quality of the segmentation was influenced by the image quality. For radiographs over exposed to radiation, further preprocessing was required, to achieve good results. The use of image pre-processing techniques such as image smoothing and gray scale conversion improved the quality of the digitized radiograph. The noise caused due to radiation and other external factors were eliminated. Canny edge detector identified the boundary of the bones or Region of Interests. Then, Tanner and Whitehouse 2 method was applied to assess the bone age from the radiograph. The classification was regarded as accurate if the sum of over selected and under selected pixels were less than 25. The classification process was accurate by 0.96 for males and 0.98 for females. From the preprocessed bones, the selected Region of Interest can be used for feature extraction and thereafter in bone age estimation.

5.

CONCLUSION

Iterative Dichotomiser 3 classifier was used to classify bones from left hand wrist radiograph images, which can be further used for skeletal bone age assessment. The input image was first pre-processed to remove noise and was grayscale converted to improve image quality. Canny edge detector was used for edge detection and the threshold and Derivative Difference of Gaussian was used for feature extraction. The system was tested with 50 left hand wrist images (25 males and 25 females). The accuracy of the classification was influenced by the resultant image. For radiographs over exposed to radiation, further preprocessing was required. Future work would regard combining the Iterative Dichotomiser 3 classifier and the PSO algorithm to produce a better optimization for the bones.

REFERENCES
[1] [2] [3] Vicente Gilsanz, and Osman Ratib, Hand Bone Age A Digital Atlas of Skeletal Maturity, Springer-Verlag, 2005. Concetto Spampinato, Skeletal Bone Age Assessment, University of Catania, Viale Andrea Doria, 6 95125, 1995. R.K.Bull, P.D.Edwards, P.M.Kemp, S.Fry, I.A.Hughes, Bone Age Assessment: a large scale comparison of the Greulich and Pyle, and Tanner and Whitehouse (TANNER AND WHITEHOUSE 2) methods, Arch. Dis. Child, vol.81, pp. 172-173, 1999.

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International journal of Digital Signal and Image Processing (IJDSIP)Vol. 1, No. 1(September 2013)

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[4] [5] [6] [7] [8]

[9]

J.M.Tanner, R.H.Whitehouse, Assessment of Skeletal Maturity and Prediction of Adult Height (TANNER AND WHITEHOUSE 2 method), Academic Press, 1975. M.C.Cooper, The tractability of segmentation and scene analysis, International Journal of Computer Vision, vol.30, pp.27-42, 1998. Rafael C.Gonzalez, Richard E. Woods, Digital Image Processing, Third Edition, Pearson, 2009. T. Pappas and N. Jayant, An adaptive clustering algorithm for image segmentation, in Proc. ICCV, 1988, pp. 310315. D. Giordano, C. Spampinato, G. Scarciofalo, and R. Leonardi, Automatic skeletal bone age assessment by integrating EPIPHYSES METAPHYSES REGION OF INTEREST and CARPAL REGION OF INTEREST processing, in Proc. Int. Workshop MeMeA, May 2009, pp. 141145. E. Pietka, S. Kurkowska, G. Arkadiusz, and F. Cao, Integration of computer assisted bone age assessment with clinical PACS, Comput. Med. Imaging Graph., vol. 27, no. 2/3, pp. 217228, Mar./Jun. 2003.

Authors

Prof.V.Karthikeyan has received his Bachelors Degree in Electronics and Communication Engineering from PGP college of Engineering and Technology in 2003, Namakkal, India, He received Masters Degree in Applied Electronics from KSR college of Technology, Erode in 2006 He is currently working as Assistant Professor in SVS College of Engineering and Technology, Coimbatore. She has about 8 years of Teaching Experience

Prof.V.J.Vijayalakshmi has completed her Bachelors Degree in Electrical & Electronics Engineering from Sri Ramakrishna Engineering College, Coimbatore, India. She finished her Masters Degree in Power Systems Engineering from Anna University of Technology, Coimbatore, She is currently working as Assistant Professor in Sri Krishna College Of Engineering and Technology, Coimbatore She has about 5 years of teaching Experience.

Mr P.Jeyakumar Currently pursuing his Bachelors Degree in Electronics Engineering in Karpagam University, Coimbatore, Tamil Nadu, India.

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