Software validation for Estimation of Bone Age through the Cervical Vertebrae

Currently, to establish a diagnosis and determine a treatment plan based on the

skeletal maturation, lateral radiograph of the head can be used, where it is observed

the morphological changes of the cervical vertebrae C2, C3 and C4. The aim of this

study is to validate a software (Easy Age) to assess skeletal maturation by cervical

vertebrae, demonstrating its applicability and reproducibility. For this, the sample

consisted of 500 lateral radiographs of patients of both genders, from 7 to 15 years of

age, who were examined by three evaluators, twice for the visual method and twice

with the software. To evaluate the inter- and intra-examiner agreement, it was

applied the test of Kappa, which showed a substantial level of agreement for visual

assessment of the cervical vertebrae, while for the evaluation of the cervical

vertebrae through the software, showed a level almost perfect agreement for all

evaluators. Friedman's test was applied to compare the ratings between 1st and 2nd

visual examination and between 1st and 2nd examination using the software, and

there were no significant differences. To validate the software it was performed a

comparison between results obtained by visual method and by software, with the

Spearman correlation test. Results showed a strong correlation, statistically

significant, between the measurements of visual examination and of the software

evaluation. It is concluded that the software is valid and improved applicability and

reproducibility of the method of estimating skeletal age.