Estimation of pediatric skeletal age using geometric morphometrics and three-dimensional cranial size changes.

This paper presents a method for estimating the skeletal age of children based on the centroid size of their face and their basicranium, derived from the three-dimensional coordinates of anatomical landmarks. The sample consists of computed tomography scans of 127 children (54 boys, 73 girls) of mixed origin living in the area of Toulouse (France), ranging in age from a few days to 18 years. The purpose of the present investigation was, first, to increase the variety of age-related structures theoretically available for pediatric skeletal age estimation and, second, to devise a method that can be applicable from early postnatal age to the end of adolescence with a satisfactory accuracy independent of age and even a better accuracy with greater age. We examined the relationship between the chronological age and the centroid size, calculated by using geometric morphometric methods and a linear model. With the aid of cross-validations, the statistical analysis indicates that the centroid size of the facial skeleton can be used an age-related variable without any loss of accuracy with increased age, contrary to most of the methods of pediatric age estimation. The standard error was always lower or equal to 2.1 years (at the 95% confidence level) and decreased in our sub-sample of older children represented by a larger number of individuals.