Comparative study of Gilsanz-Ratib digital atlas and Greulich-Pyle atlas for bone age estimation in a Chinese sample

Lin, Fangqin; Ji, Zhang; Zhu, Zhen; Wu, Yumeng

doi:10.3109/03014460.2014.977346

Cited by 13 publications

(8 citation statements)

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“…There have been many studies worldwide that have compared different methods of BA estimation. [ 9 10 11 24 25 26 ] Studies using correlation coefficients (which only measure the strength of association and not an agreement between methods) done by Kim et al ,[ 9 ] Lin et al ,[ 11 ] and Kim et al [ 10 ] showed no differences between various BA methods. Similarly, in our study, the correlation between all three methods of BA estimation was very strong.…”

Section: Discussionmentioning

confidence: 99%

“…To assess intrarater variation, the 30 radiographs were analyzed initially and then were reevaluated by the same four observers independently by the three methods after a 4-week interval. [ 11 ] If there were statistically significant inter-rater (disagreement among the four observers) and intra-rater differences, they were checked for clinical significance. If the differences were within the range of SDs given in each of the methods of BA assessment, it was considered as clinically not significant and if they were out of range, it was considered as clinically significant.…”

Section: Ethodologymentioning

confidence: 99%

“…[ 8 ] In addition, most of the studies done worldwide comparing different methods of BA estimation have used correlation analysis. [ 5 9 10 11 ] Correlation coefficients measure the strength of association between two variables and not the agreement between them. Also, the wider the range of values analyzed (in our study 2–16.5 years), the greater is the correlation obtained.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Bone Age Assessments by Gruelich-Pyle, Gilsanz-Ratib, and Tanner Whitehouse Methods in Healthy Indian Children

Shah

Khadilkar

Lohiya

et al. 2021

Indian Journal of Endocrinology and Metabolism

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Background: There are several methods of bone age (BA) assessment, which include Gruelich-Pyle (GP), Gilsanz-Ratib (GR), and Tanner Whitehouse-3 (TW-3) methods. Although GP atlas is the most widely used, there are concerns about its accuracy in children of different ethnicities, making the use of the TW-3 method an attractive option in Indian children. Objectives: 1) To assess the relationship of BA with chronological age (CA) as assessed by different methods (GP, GR, and TW-3) in healthy Indian children 2) To assess which of the three methods of BA assessment is more suitable in Indian children. Methodology: X-rays of 851 children (438 boys and 413 girls, aged 2–16.5 years) were analyzed by four independent observers using three different methods of BA estimation (GP, GR, and TW-3). Mean BAs were converted to Z -scores. For purpose of deciding which method of BA was most suitable in our cohort, a test of proportions and root mean square (RMS) deviations were computed. Results: Using the test of proportions, the TW-3 method was most suitable overall ( P < 0.05). TW-3 method was again most applicable in prepubertal boys ( P < 0.05), in prepubertal girls (although not significant, P > 0.1), and pubertal girls ( P < 0.05). However, in pubertal boys, the GR atlas method was most suitable ( P < 0.05). The same results were obtained when root mean square (RMS) deviations were computed. Interestingly, BA was underestimated in Indian boys irrespective of the method used. In Indian girls, however, the BA was underestimated till the pubertal growth spurt, after which there was rapid advancement of BA. Conclusions: Among the three methods (GP, GR, and TW-3), the BAs estimated by the TW-3 method were closest to CAs. Hence, it seems reasonable to recommend the use of the TW-3 method for BA estimation in the Indian population till an Indian standard bone age atlas is developed.

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Section: Discussionmentioning

confidence: 99%

Section: Ethodologymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of Bone Age Assessments by Gruelich-Pyle, Gilsanz-Ratib, and Tanner Whitehouse Methods in Healthy Indian Children

Shah

Khadilkar

Lohiya

et al. 2021

Indian Journal of Endocrinology and Metabolism

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“…The Greulich and Pyle (GP) radiographic atlas of the hand and wrist is one of the oldest and most commonly utilized atlas for this purpose worldwide [4, 5]. Gilsanz and Ratibin (GR) atlas also provides a bone age assessment scheme using detailed images of ossification centres in hand radiographs of healthy children and shows comparable accuracy to GP method [6]. Other methods such as Girdany and Golden (GG) method utilize a plain radiograph of various large joints of the body and determine skeletal age based upon the appearance of ossification centres around those joints [7].…”

Section: Introductionmentioning

confidence: 99%

Bone Age Practices in Infants and Older Children among Practicing Radiologists in Pakistan: Developing World Perspective

Mirza

Memon

Shah

et al. 2019

Cureus

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ObjectiveTo investigate which bone age assessment techniques are utilized by radiologists in Pakistan to determine skeletal age in three defined age groups: less than one year, one to three years and three to 18 years. We also assessed the perceived confidence in skeletal age assessments made by respondents using their chosen bone age assessment technique, within each defined age group.Materials and methodsA cross-sectional survey was conducted among 147 practicing radiologists in Pakistan. A pre-validated survey form was adopted from a similar study conducted amongst members of the Society for Pediatric Radiology. The survey collected demographic information, choice of bone age assessment technique in each age group and confidence of bone age assessments in each age group.ResultsThe hand-wrist method of Greulich and Pyle was used by 87.5% of respondents when assessing bone age in infants (less than one year), followed by Gilsanz-Ratib hand bone age method (7.3%). In children aged one to three years, Greulich and Pyle method was chosen by 85.7% of respondents, followed by Gilsanz-Ratib hand bone age method (6.1%) and the Hoerr, Pyle, Francis' Radiographic Atlas of Skeletal Development of the Foot and Ankle (3.1%). In children, older than three years, the Greulich and Pyle technique was used by 83.7% of respondents. This was followed by Gilsanz-Ratib hand bone age method (5.8%) and the Hoerr, Pyle, Francis' Radiographic Atlas of Skeletal Development of the Foot and Ankle (3.8%). 26.4% were “very confident” in bone age assessments conducted among infants. In children aged one to three years, 38.1% were “very confident”. In children, greater than three years, 48.6% were “very confident” in their chosen technique.ConclusionGreulich and Pyle is the dominant method for bone age assessments in all age groups, however, confidence in its application among infants and young children is low. It is recommended that clear recommendations be developed for bone age assessments in this age group alongside incorporation of indigenous standards of bone age assessments based on a representative sample of healthy native children.

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“…An additional potential limitation of G&P is its applicability to modern diverse populations since it is based upon a study of a more focused patient population in the 1930s [6]. More recently, alternative atlases to G&P also containing left hand radiographic standards have been developed [8–10]; however, there is overall a relative paucity of peer-reviewed data available on the clinical utility or accuracy of such alternatives [11, 12]. No previous study has compared the most recent of these alternative atlases— Skeletal Development of the Hand and Wrist: Digital Bone Age Companion (DBAC) (Oxford University Press, New York)—to G&P. DBAC [8] is a commercially available software application that accompanies a hardcopy bone age reference textbook based upon G&P. The precursors of the DBAC standards came from candidate clinical digital bone age images while referencing the G&P maturity indicators.…”

Section: Introductionmentioning

confidence: 99%

Skeletal development of the hand and wrist: digital bone age companion—a suitable alternative to the Greulich and Pyle atlas for bone age assessment?

et al. 2017

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PurposeTo assess reader performance and subjective workflow experience when reporting bone age studies with a digital bone age reference as compared to the Greulich and Pyle atlas (G&P). We hypothesized that pediatric radiologists would achieve equivalent results with each method while digital workflow would improve speed, experience, and reporting quality.Materials and methodsIRB approval was obtained for this HIPAA-compliant study. Two pediatric radiologists performed research interpretations of bone age studies randomized to either the digital (Digital Bone Age Companion, Oxford University Press) or G&P method, generating reports to mimic clinical workflow. Bone age standard selection, interpretation-reporting time, and user preferences were recorded. Reports were reviewed for typographical or speech recognition errors. Comparisons of agreement were conducted by way of Fisher’s exact tests. Interpretation-reporting times were analyzed on the natural logarithmic scale via a linear mixed model and transformed to the geometric mean. Subjective workflow experience was compared with an exact binomial test. Report errors were compared via a paired random permutation test.ResultsThere was no difference in bone age determination between atlases (p = 0.495). The interpretation-reporting time (p < 0.001) was significantly faster with the digital method. The faculty indicated preference for the digital atlas (p < 0.001). Signed reports had fewer errors with the digital atlas (p < 0.001).ConclusionsBone age study interpretations performed with the digital method were similar to those performed with the Greulich and Pyle atlas. The digital atlas saved time, improved workflow experience, and reduced reporting errors relative to the Greulich and Pyle atlas when integrated into electronic workflow.

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Comparative study of Gilsanz-Ratib digital atlas and Greulich-Pyle atlas for bone age estimation in a Chinese sample

Abstract: Both atlases can be used on most age groups. However, the GR atlas is not recommended in boys aged 10-13 years, while the GP atlas is not suitable for girls aged 0-3 years. Therefore, the use of the GP or GR atlas is practical, depending on the age of the child.

Cited by 13 publications

References 15 publications

Comparison of Bone Age Assessments by Gruelich-Pyle, Gilsanz-Ratib, and Tanner Whitehouse Methods in Healthy Indian Children

Comparison of Bone Age Assessments by Gruelich-Pyle, Gilsanz-Ratib, and Tanner Whitehouse Methods in Healthy Indian Children

Bone Age Practices in Infants and Older Children among Practicing Radiologists in Pakistan: Developing World Perspective

Skeletal development of the hand and wrist: digital bone age companion—a suitable alternative to the Greulich and Pyle atlas for bone age assessment?

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