Skip to main content
Top

22-01-2024 | Artificial Intelligence | Original Article

Determination of growth and developmental stages in hand–wrist radiographs

Can fractal analysis in combination with artificial intelligence be used?

Authors: Asst. Prof. Merve Gonca, DDS, Asst. Prof. Mehmet Fatih Sert, PhD, Assoc. Prof. Dilara Nil Gunacar, DDS, Assoc. Prof. Taha Emre Kose, DDS PhD, Asst. Prof. Busra Beser, DDS

Published in: Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie

Login to get access

Abstract

Purpose

The goal of this work was to assess the classification of maturation stage using artificial intelligence (AI) classifiers.

Methods

Hand–wrist radiographs (HWRs) from 1067 individuals aged between 7 and 18 years were included. Fifteen regions of interest were selected for fractal dimension (FD) analysis. Five predictive models with different inputs were created (model 1: only FD; model 2: FD and Chapman sesamoid stage; model 3: FD, age, and sex; model 4: FD, Chapman sesamoid stage, age, and sex; model 5: Chapman sesamoid stage, age, and sex). The target diagnoses were accelerating growth velocity, very high growth velocity, and decreasing growth velocity. Four AI algorithms were applied: multilayer perceptron (MLP), support vector machine (SVM), gradient boosting machine (GBM) and C 5.0 decision tree classifier.

Results

All AI algorithms except for C 5.0 yielded similar overall predictive accuracies for the five models. In order from lowest to highest, the predictive accuracies of the models were as follows: model 1 < model 3 < model 2 < model 5 < model 4. The highest overall F1 score, which was used instead of accuracy especially for models with unbalanced data, was obtained for models 1, 2, and 3 based on SVM, for model 4 based on MLP, and for model 5 based on C 5.0. Adding Chapman sesamoid stage, chronologic age, and sex as additional inputs to the FD values significantly increased the F1 score.

Conclusion

Applying FD analysis to HWRs is not sufficient to predict maturation stage in growing patients but can be considered a growth rate prediction method if combined with the Chapman sesamoid stage, age, and sex.
Appendix
Available only for authorised users
Literature
2.
5.
go back to reference J. M. Tanner RHW, N. Cameron, W. A. Marshall, M. J. R. Healy. Assessment of Skeletal Maturity and Prediction of Adult Height (TW2 Method). Academic Pr; Subsequent edition (December 1, 1983); 1983. J. M. Tanner RHW, N. Cameron, W. A. Marshall, M. J. R. Healy. Assessment of Skeletal Maturity and Prediction of Adult Height (TW2 Method). Academic Pr; Subsequent edition (December 1, 1983); 1983.
6.
go back to reference Gilsanz V, Ratib O (2005) Hand bone age: a digital atlas of skeletal maturity. Springer Gilsanz V, Ratib O (2005) Hand bone age: a digital atlas of skeletal maturity. Springer
15.
go back to reference Raschka S (2015) Python machine learning. Packt Publ Ltd Raschka S (2015) Python machine learning. Packt Publ Ltd
18.
go back to reference Karatzoglou A, Meyer D, Hornik K (2006) Support Vector Machines in R. J Stat Soft 15(9):1–28CrossRef Karatzoglou A, Meyer D, Hornik K (2006) Support Vector Machines in R. J Stat Soft 15(9):1–28CrossRef
19.
go back to reference Vapnik V (1998) The support vector method of function estimation. Nonlinear modeling. Springer, pp 55–85 Vapnik V (1998) The support vector method of function estimation. Nonlinear modeling. Springer, pp 55–85
20.
go back to reference Grosan C, Abraham A (2011) Artificial neural networks. Intelligent Systems. Springer, pp 281–323 Grosan C, Abraham A (2011) Artificial neural networks. Intelligent Systems. Springer, pp 281–323
23.
go back to reference Thodberg HH, Kreiborg S, Juul A, Pedersen KD (2008) The BoneXpert method for automated determination of skeletal maturity. IEEE Trans Med Imaging 28(1):52–66CrossRef Thodberg HH, Kreiborg S, Juul A, Pedersen KD (2008) The BoneXpert method for automated determination of skeletal maturity. IEEE Trans Med Imaging 28(1):52–66CrossRef
27.
go back to reference Etemad L, Wu TH, Heiner P, Liu J, Lee S, Chao WL et al. Machine learning from clinical data sets of a contemporary decision for orthodontic tooth extraction. Orthod Craniofac Res. 2021;24 Suppl 2:193–200. https://doi.org/10.1111/ocr.12502. Etemad L, Wu TH, Heiner P, Liu J, Lee S, Chao WL et al. Machine learning from clinical data sets of a contemporary decision for orthodontic tooth extraction. Orthod Craniofac Res. 2021;24 Suppl 2:193–200. https://​doi.​org/​10.​1111/​ocr.​12502.
33.
go back to reference Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33(1):159–174CrossRefPubMed Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33(1):159–174CrossRefPubMed
35.
go back to reference Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1(8476):307–310CrossRefPubMed Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1(8476):307–310CrossRefPubMed
36.
go back to reference Maimon OZ, Rokach L (2014) Data mining with decision trees: theory and applications. World Sci Maimon OZ, Rokach L (2014) Data mining with decision trees: theory and applications. World Sci
39.
go back to reference Hunter CJ (1966) The correlation of facial growth with body height and skeletal maturation at adolescence. Angle Orthod 36(1):44–54PubMed Hunter CJ (1966) The correlation of facial growth with body height and skeletal maturation at adolescence. Angle Orthod 36(1):44–54PubMed
42.
go back to reference Uysal T, Ramoglu SI, Basciftci FA, Sari Z (2006) Chronologic age and skeletal maturation of the cervical vertebrae and hand-wrist: is there a relationship? Am J Orthod Dentofac Orthop 130(5):622–628CrossRef Uysal T, Ramoglu SI, Basciftci FA, Sari Z (2006) Chronologic age and skeletal maturation of the cervical vertebrae and hand-wrist: is there a relationship? Am J Orthod Dentofac Orthop 130(5):622–628CrossRef
47.
go back to reference Flores-Mir C, Nebbe B, Major PW (2004) Use of skeletal maturation based on hand-wrist radiographic analysis as a predictor of facial growth: A systematic review. Angle Orthod 74(1):118–124PubMed Flores-Mir C, Nebbe B, Major PW (2004) Use of skeletal maturation based on hand-wrist radiographic analysis as a predictor of facial growth: A systematic review. Angle Orthod 74(1):118–124PubMed
48.
go back to reference Mardiati E, Komara I, Halim H, Maskoen AM (2021) Determination of pubertal growth plot using hand-wrist and cervical vertebrae maturation indices, dental calcification, peak height velocity, and menarche. TODENTJ 15(1) Mardiati E, Komara I, Halim H, Maskoen AM (2021) Determination of pubertal growth plot using hand-wrist and cervical vertebrae maturation indices, dental calcification, peak height velocity, and menarche. TODENTJ 15(1)
52.
go back to reference Grolinger K, Hayes M, Higashino WA, L’Heureux A, Allison DS, Capretz MA (eds) (2014) world congress on. services, vol 2014. IEEE, IEEE Grolinger K, Hayes M, Higashino WA, L’Heureux A, Allison DS, Capretz MA (eds) (2014) world congress on. services, vol 2014. IEEE, IEEE
Metadata
Title
Determination of growth and developmental stages in hand–wrist radiographs
Can fractal analysis in combination with artificial intelligence be used?
Authors
Asst. Prof. Merve Gonca, DDS
Asst. Prof. Mehmet Fatih Sert, PhD
Assoc. Prof. Dilara Nil Gunacar, DDS
Assoc. Prof. Taha Emre Kose, DDS PhD
Asst. Prof. Busra Beser, DDS
Publication date
22-01-2024
Publisher
Springer Medizin
Published in
Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie
Print ISSN: 1434-5293
Electronic ISSN: 1615-6714
DOI
https://doi.org/10.1007/s00056-023-00510-1