Value of Magnetic Resonance Imaging for Skeletal Bone Age Assessment in Healthy Male Children.

BACKGROUND: Skeletal bone age assessment for medical reasons is usually performed by conventional x-ray with use of ionizing radiation. Few pilot studies have shown the possible use of magnetic resonance imaging (MRI). PURPOSE: To comprehensively evaluate feasibility and value of MRI for skeletal bone age (SBA) assessment in healthy male children. MATERIALS AND METHODS: In this prospective cross-sectional study, 63 male soccer athletes with mean age of 12.35 ± 1.1 years were examined. All participants underwent 3.0 Tesla MRI with coronal T1-weighted turbo spin echo (TSE), coronal proton density (PD)-weighted turbo spin echo (TSE), and T1-weighted three-dimensional (3D) volume interpolated breath-hold examination (VIBE) sequence. Subsequently, SBA was assessed by 3 independent blinded radiologists with different levels of experience using the common Greulich-Pyle (GP) atlas and the Tanner-Whitehouse (TW2) method. RESULTS: In a mean total acquisition time of 5:04 ± 0:47 min, MR image quality was sufficient in all cases. MRI appraisal was significantly faster ( P < 0.0001) by GP with mean duration of 1:22 ± 0:08 min vs. 7:39 ± 0:28 min by TW. SBA assessment by GP resulted in mean age of 12.8 ± 1.2 years, by TW 13.0 ± 1.4 years. Interrater reliabilities were excellent for both GP (ICC = 0.912 (95% confidence interval [CI] = 0.868-0.944) and TW (ICC = 0.988 (95% CI = 0.980-0.992) and showed statistical significance ( P < 0.001). Subdivided, for GP, ICCs were 0.822 (95% CI = 0.680-0.907) and 0.843 (95% CI = 0.713-0.919) in Under 12 and Under 14 group. For TW, ICCs were 0.978 (95% CI = 0.958-0.989) in Under 12 and 0.979 (95% CI = 0.961-0.989) in Under 14 group. CONCLUSION: MRI is a clinically feasible, rapidly evaluable method to assess skeletal bone age of healthy male children. Using the Greulich-Pyle (GP) atlas or the Tanner-Whitehouse (TW2) method, reliable results are obtained independent of the radiologist's experience level.

Disagreement between talent scouts: Implications for improved talent assessment in youth football.

Reliable talent identification and selection (TID) processes are prerequisites to accurately select young athletes with the most potential for talent development programmes. Knowledge about the agreement between scouts who play a key role in the initial TID in football is lacking. Therefore, the aim of the present study was to evaluate the agreement within four groups of a total of n = 83 talent scouts during rank assessment of under-11 male youth football players (n = 24, age = 11.0 ± 0.3 years) and to describe scouts' underlying approach to assess talent. Krippendorff's α estimates indicated disagreement of scouts' rankings within all groups of scouts (αA = 0.09, αB = 0.03, αC = 0.05, αD = 0.02). Scouts reported relying mainly on their overall impression when forming their final prediction about a player. Reportings of a consistent, structured approach were less prevalent. Taken together, results indicated that different approaches to TID may be associated with disagreement on selection decisions. In order to overcome disagreement in TID, football organisations are encouraged to establish a more structured process. Future research on the elaboration and benefit of ranking guidelines incorporating decomposed and independently evaluated sub-predictors is recommended to improve the reliability of TID.

Maturity-related developmental inequalities in age-group swimming: The testing of 'Mat-CAPs' for their removal.

OBJECTIVES: To (1) examine the association between maturity timing and performance-based selection levels in (N=708) Australian male 100-m Freestyle swimmers (12-17 years); (2) identify the relationship between maturation status and 100-m Freestyle performance; and (3) determine whether Maturation-based Corrective Adjustment Procedures (Mat-CAPs) could remove maturation-related differences in swimming performance. METHODS: In Part 1, maturity timing category distributions ('Early', 'Early Normative', 'Late Normative' and 'Late') for 'All', 'Top 50%' and '25%' of raw swimming times were examined within and across age-groups. In Part 2, multiple regression analyses quantified the relationship between maturity offset (YPHV) and swimming performance. In Part 3, sample-based maturity timing category distributions were examined based on raw and correctively adjusted swim times for 12-17 year old age-groups. RESULTS: Based on raw swim times, a high prevalence of 'Early-maturing' swimmers, with large effect sizes was identified (e.g., 14 years 'All' - χ2 (3, 151=111.98, p<0.001; 'Early' v 'Late' OR=82.0 95%CI=4.77, 1409.9); while a complete absence of 'Late-maturers' was apparent in the sample (N=708). When maturity categories were re-defined based on sample mean±standard deviation, and when using the expected curvilinear trendline identified in Part 2, Mat-CAPs mitigated maturity timing biases across all age-groups and selection levels, and removed the Freestyle performance advantage afforded by advanced maturity timing and status. CONCLUSIONS: Removing the influence of maturation-related developmental differences could help improve youth swimmer participation experiences and improve the accuracy of identifying genuinely skilled age-group swimmers.

Assessment of skeletal age on the basis of DXA-derived hand scans in elite youth soccer.

Physical performance is highly dependent on maturity. Therefore, consideration of maturity is recommended in the talent identification process. To date, skeletal age (SA) is assessed using X-ray scans. However, X-rays are associated with a 10-fold higher radiation compared to dual-energy X-ray absorptiometry (DXA). The aim of the study was to validate SA assessments in male soccer players with the DXA technique. Paired X-ray and DXA scans of the left hand of 63 Swiss U-15 national soccer players were performed. SA assessments were performed twice by two blinded raters using Tanner and Whitehouse' reference technique. Intrarater and interrater reliability as well as agreement between both techniques were tested. Intrarater and interrater reliabilities were excellent. Bland-Altman plots showed that SA assessments between X-ray and DXA differed by -0.2 years and 95% limits of agreement were ±0.6 years. Therefore, DXA offered a replicable method for assessing SA and maturity in youth soccer players.