title: New severity indices for quantifying single-suture metopic craniosynostosis.
abstract: OBJECTIVE
  To describe novel severity indices with which to quantify severity of trigonocephaly malformation in children diagnosed with isolated metopic synostosis.
  
  
  METHODS
  Computed tomographic scans of the cranium were obtained from 38 infants diagnosed with isolated metopic synostosis and 53 age-matched control patients. Volumetric reformations of the cranium were used to trace two-dimensional planes defined by the cranium-base plane and well-defined brain landmarks. For each patient, novel trigonocephaly severity indices (TSI) were computed from outline cranium shapes on each of these planes. The metopic severity index based on measurements of interlandmark distances was also computed and a receiver operating characteristic analysis used to compare the accuracy of classification based on TSIs versus that based on the metopic severity index.
  
  
  RESULTS
  The proposed TSIs are a sensitive measure of trigonocephaly malformation that can provide a classification accuracy of 96% with a specificity of 95%, in contrast with 82% of the metopic severity index at the same specificity level.
  
  
  CONCLUSIONS
  We completed exploratory analysis of outline-based severity measurements computed from computed tomographic image planes of the cranium. These TSIs enable quantitative analysis of cranium features in isolated metopic synostosis that may not be accurately detected by analytic tools derived from a sparse set of traditional interlandmark and semilandmark distances.
authors.affiliation: Department of Computer Science, Center for Mathematical Investigations, Guanajuato, Mexico.
authors.forename: Salvador
authors.initials: S
authors.lastname: Ruiz-Correa
authors.forename: Jacqueline R
authors.initials: JR
authors.lastname: Starr
authors.forename: H Jill
authors.initials: HJ
authors.lastname: Lin
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Kapp-Simon
authors.forename: Raymond W
authors.initials: RW
authors.lastname: Sze
authors.forename: Richard G
authors.initials: RG
authors.lastname: Ellenbogen
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Speltz
authors.forename: Michael L
authors.initials: ML
authors.lastname: Cunningham
mesh_terms: D002675:Child, Preschool; D003393:Cranial Sutures / Q000002:abnormalities* / Q000473:pathology*; D003398:Craniosynostoses / Q000473:pathology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012886:Skull / Q000002:abnormalities / Q000473:pathology
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