Automatic Determination of the Greulich-Pyle Bone Age as an Alternative Approach for Chinese Children with Discordant Bone Age

Abstract

Background: Automated bone age (BA) rating using BoneXpert is being adopted worldwide. This study investigated whether manual matching of hand radiographs could be replaced by BoneXpert for BA ratings of Chinese children with delayed or advanced BA. Methods: 482 left-hand radiographs from 482 children (aged 2-16 years) with discordant BA were evaluated by BoneXpert and manually by 4 radiology residents using the Greulich and Pyle atlas. Radiographs whose BoneXpert BA deviated by >1 year from manual assessment were rerated by 2 attending radiologists in a blinded manner. Results: Among all 482 radiographs, 46 (9.5%) radiographs were rerated and no radiographs were rejected. Differences between BoneXpert and manual rating of 28 (5.8%) cases were >1 year. The manual BAs of the 28 radiographs were all >10 years and greater than the BoneXpert BAs. The root mean square deviation between the residents and BoneXpert was 0.56 for these children (95% CI 0.53-0.61). Conclusion: BoneXpert agreed with manual BA rating in 94.2% of the images. Therefore, BoneXpert could be used as an alternative for the radiology residents to make an initial BA estimation. Modification of BoneXpert should provide greater accuracy for the estimation of BA in children aged >10 years with discordant BA.

[Retracted] Role of Medical IoT‐Based Bone Age Determination in the Diagnosis and Clinical Treatment of Dwarfism Disease Monitoring

“…It can occur at any stage of the child's growth. Idiopathic dwarfism: idiopathic dwarfism [ 10 ] is a temporarily unspecified cause of dwarfism and is one of the most common types of dwarfism. This type of dwarfism is usually due to the mother's own disease at the time of pregnancy, such as maternal gestational hypertension and maternal smoking and drug use, which can cause intrauterine growth retardation.…”

“…Idiopathic dwarfism: idiopathic dwarfism [ 10 ] is a temporarily unspecified cause of dwarfism and is one of the most common types of dwarfism.…”

Applicability of two commonly used bone age assessment methods to twenty-first century UK children

“…Rather, we aimed to correlate G&P and TW3 against known CA of a healthy modern population and found that G&P remains reliable (consistent with the results of a recent systematic review) [48]. The question of accuracy of BoneXpert has already been answered in primary research studies [49–51], whereas as far as we are aware, the assessment of the applicability of the standards themselves has not been previously performed using objective software and only a few have considered socioeconomic status [12, 14, 52–54]. Contrary to our results, these studies have shown delayed bone age in children of low socioeconomic status—it is possible that the degree of deprivation in the children from these studies was greater than in ours.…”

Correlación en la determinación de la edad ósea radiológica mediante el método de Greulich y Pyle versus la evaluación automatizada utilizando el software BoneXpert

“…Several methods have been used to assess radiological bone age over time, the main problem is the inter-and intra-rater reliability (7)(8)(9)(10)(11)(12)(13)(14) . The most commonly used methods are the Greulich and Pyle atlas (GP) and the Tanner-Whitehouse method (TW), both performed through the assessment of left hand x-rays.…”