Charting the growth through intelligence: A SWOC analysis on AI-assisted radiologic bone age estimation

Bone age estimation (BAE) is based on skeletal maturity and degenerative process of the skeleton. The clinical importance of BAE is in understanding the pediatric and growth-related disorders; whereas medicolegally it is important in determining criminal responsibility and establishing identification. Artificial Intelligence (AI) has been used in the field of the field of medicine and specifically in diagnostics using medical images. AI can greatly benefit the BAE techniques by decreasing the intra observer and inter observer variability as well as by reducing the analytical time. The AI techniques rely on object identification, feature extraction and segregation. Bone age assessment is the classical example where the concepts of AI such as object recognition and segregation can be used effectively. The paper describes various AI based algorithms developed for the purpose of radiologic BAE and the performances of the models. In the current paper we have also carried out qualitative analysis using Strength, Weakness, Opportunities and Challenges (SWOC) to examine critical factors that contribute to the application of AI in BAE. To best of our knowledge, the SWOC analysis is being carried out for the first time to assess the applicability of AI in BAE. Based on the SWOC analysis we have provided strategies for successful implementation of AI in BAE in forensic and medicolegal context.