BoneAgeTW2: Automated Skeletal Maturation Assessment via the Tanner-Whitehouse 2 Method, Deep Learning, and Clinical Report Generation with Distribution Curves

Pediatric bone age prediction is a crucial task in clinical practice that can help diagnose endocrine disorders and provide insight into a child's growth and development. However, conventional bone age prediction methods are often labor-intensive and require specialized radiological expertise. This paper presents a Deep Learning (DL)-based approach to pediatric bone age prediction using EfficientNet with Additive Attention, a state-of-the-art neural network architecture for image classification and regression tasks. The method utilizes over 12,000 X-ray images from the RSNA bone age dataset. It involves image preprocessing, transforming them into three-channel images, and training a Convolutional Neural Network (CNN) to automatically learn the features of hand bone images. This approach provides a more effective and accurate solution for predicting bone age, which is critical in diagnosing pediatric endocrine diseases. This work uses two variations of the EfficientNet model (B0 and B4), where EfficientNetB4 is also finetuned with the Additive Attention mechanism. These three models predict the age for the original age, and their comparison is shown in curves. The predicted ages depict that in most cases, EfficientNetB4 and EfficientNetB4 with Additive Attention (EN-AA) successfully predicted the bone ages more accurately regarding the original age, and their performance was better than the EfficientNetB0. Specific performance metrics are provided to underscore this improvement. Learning curves for training and validation loss confirm effective learning without overfitting or underfitting, further validating our approach's efficacy in pediatric endocrine disease diagnosis.

Measuring the angle between bone structures is a routine task in medical image analysis and provides a key quantitative parameter for diagnosis and treatment planning. Automated methods can reduce time and cost while improving reproducibility. In this work, we address automatic bone pose estimation using a learning-based point candidate proposal followed by a line model to extract axis parameters. Since conventional line models such as least squares are sensitive to outliers, we incorporate false-positive reduction strategies and robust fitting techniques, such as RANSAC and Hough transforms, to improve robustness. We evaluate our method on three clinically relevant paediatric angle estimation tasks: fracture fragment assessment in radiographs and ultrasound and developmental dysplasia of the hip evaluation in ultrasound using the Graf method. Our approach achieves mean errors of $4.1^\circ$, $5.4^\circ$, and $5.51^\circ$, respectively, not only remaining within the expected clinical observer variability, but also significantly outperforming landmark-based methods. Our code and annotations for fracture angle assessment in radiographs are publicly available on GitHub.

Age estimation from finger vein images has been widely considered impractical due to severe demographic biases in public datasets and physiological confounding factors like gender. To overcome these limitations, we propose MAGE-Vein, a novel multi-instance, multi-task learning framework. Our approach extracts robust structural aging signs by employing a hybrid feature-level fusion of three fingers, effectively suppressing local imaging noise. Furthermore, simultaneous optimization of gender classification conditions the network to effectively eliminate gender-specific vascular variations. Evaluated on a demographically balanced dataset of 402 subjects, MAGE-Vein achieves a mean absolute error of 6.12 years and a correlation of 0.880. Our results not only overturn the conventional consensus regarding the limitations of the finger vein modality but also demonstrate that previous estimation failures were primarily artifacts of biased public datasets. Our code is available at https://github.com/gsisaoki/MAGE-Vein.