Effect of Knowledge of Chronologic Age on the Variability of Pediatric Bone Age Determined Using the Greulich and Pyle Standards

Berst, Matthew J.; Dolan, Lori A.; Bogdanowicz, Marta; Stevens, Max A.; Chow, Shirley; Brandser, Eric A.

doi:10.2214/ajr.176.2.1760507

Cited by 75 publications

(39 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Figure 3 supports this hypothesis. Such an effect was also reported by Berst et al [13], but our study displayed a more dramatic effect. This finding is a problem in a PACS-based environment, where in daily clinical routine it is virtually impossible to blind radiologists to the CA.…”

Section: Discussionsupporting

confidence: 91%

Automatic determination of Greulich and Pyle bone age in healthy Dutch children

Rijn

Lequin

Thodberg³

2009

Pediatr Radiol

View full text Add to dashboard Cite

Background Bone age (BA) assessment is a routine procedure in paediatric radiology, for which the Greulich and Pyle (GP) atlas is mostly used. There is rater variability, but the advent of automatic BA determination eliminates this. Objective To validate the BoneXpert method for automatic determination of skeletal maturity of healthy children against manual GP BA ratings. Materials and methods Two observers determined GP BA with knowledge of the chronological age (CA). A total of 226 boys with a BA of 3-17 years and 179 girls with a BA of 3-15 years were included in the study. BoneXpert's estimate of GP BA was calibrated to agree on average with the manual ratings based on several studies, including the present study. Results Seven subjects showed a deviation between manual and automatic BA in excess of 1.9 years. They were rerated blindly by two raters. After correcting these seven ratings, the root mean square error between manual and automatic rating in the 405 subjects was 0.71 years (range 0.66-0.76 years, 95% CI). BoneXpert's GP BA is on average 0.28 and 0.20 years behind the CA for boys and girls, respectively. Conclusion BoneXpert is a robust method for automatic determination of BA.

show abstract

Section: Discussionsupporting

confidence: 91%

Automatic determination of Greulich and Pyle bone age in healthy Dutch children

Rijn

Lequin

Thodberg³

2009

Pediatr Radiol

View full text Add to dashboard Cite

show abstract

“…These limitations and the difficulty of interpreting X-rays of an almost ossified hand raise doubts about the reliability of the method, when it is used to predict reaching legal adult age. Despite these limitations in accordance with previous studies [10,11,14,[23][24][25][26][27], our results showed that the GPM is a reproducible and repeatable method. This means that although it closely depends on the judgment of the person interpreting it, there is a high level of agreement between different readers in assessment of skeletal age.…”

Section: Discussionsupporting

confidence: 91%

Applicability of Greulich and Pyle method for age assessment in forensic practice on an Italian sample

et al. 2011

View full text Add to dashboard Cite

show abstract

“…The 4 residents wrote 482 reports according to the GP atlas (4 residents estimated 110, 112, 120 and 140 cases, respectively). The clinical information and chronological age were available to the 4 residents as part of their routine work [4]. To evaluate interobserver variance, we selected 50 radiographs for all 4 residents and the 2 attending radiologists to determine the BA in a blinded manner.…”

Section: Methodsmentioning

confidence: 99%

“…Although using the GP atlas is faster than the Tanner-Whitehouse method [2,3], BA estimation is still time-consuming as radiologists must carefully match left-hand films of children who are suspected to have abnormal maturation with standard plates from the GP atlases. Additionally, rater variability is the main shortcoming of this method that cannot be avoided [4]. As a solution to this problem, automated systems have been developed [5,6].…”

Section: Introductionmentioning

confidence: 99%

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

Zhang

Lin²,

Ding³

2016

Horm Res Paediatr

View full text Add to dashboard Cite

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.

show abstract

Effect of Knowledge of Chronologic Age on the Variability of Pediatric Bone Age Determined Using the Greulich and Pyle Standards

Cited by 75 publications

References 25 publications

Automatic determination of Greulich and Pyle bone age in healthy Dutch children

Automatic determination of Greulich and Pyle bone age in healthy Dutch children

Applicability of Greulich and Pyle method for age assessment in forensic practice on an Italian sample

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

Contact Info

Product

Resources

About