Bone Age: A Handy Tool for Pediatric Providers

Creo, Ana; Schwenk, W.

doi:10.1542/peds.2017-1486

Cited by 106 publications

(105 citation statements)

References 101 publications

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“…BA advancement can be a marker of prolonged and/or excess exposure to postnatal androgens, and the individual's standard deviation (SD) for bone age (i.e., BA SD) an index of BA advancement as an average (mean) for their age and sex (28). A radiograph of the left hand was used to determine bone age (BA) using the Greulich-Pyle method (29) and read in a blinded fashion by a single pediatric endocrinologist (M.S.K.).…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Brain Differences in the Prefrontal Cortex, Amygdala, and Hippocampus in Youth with Congenital Adrenal Hyperplasia

Herting

Azad

Kim

et al. 2020

The Journal of Clinical Endocrinology &Amp; Metabolism

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Context Classical congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency results in hormone imbalances present both prenatally and postnatally that may impact the developing brain. Objective To characterize gray matter morphology in the prefrontal cortex and subregion volumes of the amygdala and hippocampus in youth with CAH as compared to controls. Design A cross-sectional study of 27 CAH youth (16 female; 12.6 ± 3.4 years) and 35 typically developing, healthy controls (20 female; 13.0 ± 2.8 years) with 3-T magnetic resonance imaging scans. Brain volumes of interest included bilateral prefrontal cortex and 9 amygdala and 6 hippocampal subregions. Between-subject effects of group (CAH vs. control) and sex, and their interaction (group-by-sex) on brain volumes, were studied while controlling for intracranial volume (ICV) and group differences in body mass index and bone age. Results Congenital adrenal hyperplasia youth had smaller ICV and increased cerebrospinal fluid volume compared to controls. In fully-adjusted models, CAH youth had smaller bilateral superior and caudal middle frontal volumes, and smaller left lateral orbitofrontal volumes compared to controls. Medial temporal lobe analyses revealed that the left hippocampus was smaller in fully-adjusted models. Congenital adrenal hyperplasia youth also had significantly smaller lateral nucleus of the amygdala and hippocampal subiculum and CA1 subregions. Conclusions This study replicates previous findings of smaller medial temporal lobe volumes in CAH patients and suggests that the lateral nucleus of the amygdala, as well as subiculum and subfield CA1 of the hippocampus, are particularly affected within the medial temporal lobes in CAH youth.

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Section: Accepted Manuscriptmentioning

confidence: 99%

Brain Differences in the Prefrontal Cortex, Amygdala, and Hippocampus in Youth with Congenital Adrenal Hyperplasia

Herting

Azad

Kim

et al. 2020

The Journal of Clinical Endocrinology &Amp; Metabolism

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“…Bone age (BA), which evaluates skeletal maturity from the radiographs of the left hand and wrist, is a crucial indicator for revealing the growth and development of children (Creo & Schwenk, 2017). Two methods are mainly used to assess BA: the Greulich and Pyle (GP) and (Greulich & Pyle, 1959;Tanner, 1962;Tanner et al, 1983;Tanner et al, 2001); of these, the GP atlas is generally accepted as a faster and simpler method and thus widely applied in clinical practice (De Sanctis et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

“…Two methods are mainly used to assess BA: the Greulich and Pyle (GP) and (Greulich & Pyle, 1959;Tanner, 1962;Tanner et al, 1983;Tanner et al, 2001); of these, the GP atlas is generally accepted as a faster and simpler method and thus widely applied in clinical practice (De Sanctis et al, 2014). However, manual assessment of BA completely depends on the reviewers' experience to determine BA (Creo & Schwenk, 2017;Mari, 2015), thereby causing significant intra-and inter-observer variations. Furthermore, constant time and effort are needed to train clinical reviewers; consequently, primary and rural hospitals face a daunting task to carry out this important examination.…”

Section: Introductionmentioning

confidence: 99%

Artificial intelligence system can achieve comparable results to experts for bone age assessment of Chinese children with abnormal growth and development

Wang

Chen

et al. 2020

PeerJ

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Objective Bone age (BA) is a crucial indicator for revealing the growth and development of children. This study tested the performance of a fully automated artificial intelligence (AI) system for BA assessment of Chinese children with abnormal growth and development. Materials and Methods A fully automated AI system based on the Greulich and Pyle (GP) method was developed for Chinese children by using 8,000 BA radiographs from five medical centers nationwide in China. Then, a total of 745 cases (360 boys and 385 girls) with abnormal growth and development from another tertiary medical center of north China were consecutively collected between January and October 2018 to test the system. The reference standard was defined as the result interpreted by two experienced reviewers (a radiologist with 10 years and an endocrinologist with 15 years of experience in BA reading) through consensus using the GP atlas. BA accuracy within 1 year, root mean square error (RMSE), mean absolute difference (MAD), and 95% limits of agreement according to the Bland-Altman plot were statistically calculated. Results For Chinese pediatric patients with abnormal growth and development, the accuracy of this new automated AI system within 1 year was 84.60% as compared to the reference standard, with the highest percentage of 89.45% in the 12- to 18-year group. The RMSE, MAD, and 95% limits of agreement of the AI system were 0.76 years, 0.58 years, and −1.547 to 1.428, respectively, according to the Bland-Altman plot. The largest difference between the AI and experts’ BA result was noted for patients of short stature with bone deformities, severe osteomalacia, or different rates of maturation of the carpals and phalanges. Conclusions The developed automated AI system could achieve comparable BA results to experienced reviewers for Chinese children with abnormal growth and development.

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Section: Introductionmentioning

confidence: 99%

“…Tanner-Whitehouse (TW3) (Greulich & Pyle, 1959;Tanner, 1962;Tanner et al, 1983;Tanner et al, 2001); of these, the GP atlas is generally accepted as a faster and simpler method and thus widely applied in clinical practice (De Sanctis et al, 2014). However, manual assessment of BA completely depends on the reviewers' experience to determine BA (Creo & Schwenk, 2017;Mari, 2015), thereby causing significant intra-and inter-observer variations. Furthermore, constant time and effort are needed to train clinical reviewers; consequently, primary and rural hospitals face a daunting task to carry out this important examination.…”

Section: Introductionmentioning

confidence: 99%

Peer Review #1 of "Artificial intelligence system can achieve comparable results to experts for bone age assessment of Chinese children with abnormal growth and development (v0.2)"

2020

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Bone age (BA) is a crucial indicator for revealing the growth and development of children. This study tested the performance of a fully automated artificial intelligence (AI) system for BA assessment of Chinese children with abnormal growth and development. Materials and methods. A fully automated AI system based on the Greulich and Pyle (GP) method was developed for Chinese children by using 8,000 BA radiographs from five medical centers nationwide in China. Then, a total of 745 cases (360 boys and 385 girls) with abnormal growth and development from another tertiary medical center of north China were consecutively collected between January and October 2018 to test the system. The reference standard was defined as the result interpreted by two experienced reviewers (a radiologist with 10 years and an endocrinologist with 15 years of experience in BA reading) through consensus using the GP atlas. BA accuracy within 1 year, root mean square error (RMSE), mean absolute difference (MAD), and 95% limits of agreement according to the Bland-Altman plot were statistically calculated. Results. For Chinese pediatric patients with abnormal growth and development, the accuracy of this new automated AI system within 1 year was 84.60% as compared to the reference standard, with the highest percentage of 89.45% in the 12-to 18-year group. The RMSE, MAD, and 95% limits of agreement of the AI system were 0.76 years, 0.58 years, and-1.547 to 1.428, respectively, according to the Bland-Altman plot. The largest difference between the AI and experts' BA result was noted for patients of short stature with bone deformities, severe osteomalacia, or different rates of maturation of the carpals and phalanges. Conclusions. The developed automated AI system could achieve comparable BA results to experienced reviewers for Chinese children with abnormal growth and development.

show abstract

Bone Age: A Handy Tool for Pediatric Providers

Cited by 106 publications

References 101 publications

Brain Differences in the Prefrontal Cortex, Amygdala, and Hippocampus in Youth with Congenital Adrenal Hyperplasia

Brain Differences in the Prefrontal Cortex, Amygdala, and Hippocampus in Youth with Congenital Adrenal Hyperplasia

Artificial intelligence system can achieve comparable results to experts for bone age assessment of Chinese children with abnormal growth and development

Peer Review #1 of "Artificial intelligence system can achieve comparable results to experts for bone age assessment of Chinese children with abnormal growth and development (v0.2)"

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