利用Tanner and Whitehouse方法且具使用者權限分級之雲端骨齡判讀服務系統研製

Abstract

In medical applications, bone age assessment is mainly used to measure children's bone development situations, which can not only provide an insight into whether a child is experiencing growth problems, but also be used to predict the adult height of the child. It makes a lot of help for the diagnosis of pediatric endocrinology. Currently the most popular method for bone age assessment used clinically is the Tanner and Whitehouse (TW3) method. TW3 scoring method examines 20 regions of the hand bone X-ray film against standard sketches of 8 or 9 different growth stages of each region respectively to get the maturity scores for each region. Finally, the bone age is determined by summing up all the scores and comparing to the age conversion table. In the past, when performing bone age assessment using TW3 method, the physicians or trained technicians/nurses would spend quite a bit of time in computing the scores and converting the scores to ages. Meanwhile sheets of papers for scoring were needed. Therefore, we propose a web-based bone age assessment system which is based on cloud network architecture and can provide the physicians or trained technicians/nurses with a quick and convenient way of performing TW3 assessment without paper. The system is implemented by using open resources such as PHP, MySQL and Javascript. It makes the TW3 scoring process become more convenient. And the user can use the system by connecting to the Internet at anytime and anywhere. The system also supports a user privilege classification framework. Therefore, different users can use different features and services from different privilege levels. Each user can have their owned data. Communications between users become more convenient by the provided mechanism of sharing assessment results and authorizing data. In TW3 scoring aspect, this system also improved the problem in previous versions of not being able to select the rating bone region directly. This version can select growth stage options directly by pointing to the bone region on the hand bone diagram, which make the scoring operation easier and more efficient. In addition it can also magnify whichever region the user wants to compare on the X-ray film and store the magnified picture. It can let the TW3 scoring be more automatic. Besides, our system also add a set of feature that can interpret the bone age fully automatically by using the area ratio of carpals. The main purpose in this system is to develop a user privilege classification that can be extended to all levels of hospitals. The concept of user hierarchy provides three privilege levels for hospital’s superiors, doctors and medical technicians/nurses. So different users have different privileges and can use features, including data and functions, corresponding to his/her privilege levels. With this mechanism, the proposed system not only achieves a hierarchical classification system of medical cloud, but also protects the personal medical records effectively.