Near Adult Heights and Predictions of Prospective Adult Heights using Automated and Conventional Greulich-Pyle Bone Age Determinations in children with chronic endocrine diseases

Abstract

Calculation of prospective adult heights (PAH) is associated with considerable bone age interrater variability. Therefore, the new PAH method based on automated bone age (BA) determination (BoneXpert™) was compared to the conventional PAH method by Bayley- Pinneau (BP) based on BA determination according to Greulich and Pyle (GP) and to observed near adult heights. Heights and near adult heights were measured in 82 patients (48 females) with chronic endocrinopathies at age of 10.45 ± 2.12 years and at time of transition to adult care (17.98 ± 3.02 years). Further, BA were assessed according to conventional GP - by three experts- and by BoneXpert™. PAH were calculated using conventional BP tables and BoneXpert™. The conventional and the automated BA determinations revealed a mean difference of 0.25 ± 0.72 years (p = 0.0027). The automated PAH by BoneXpert™ were 156.96 ± 0.86 cm in females and 171.75 ± 1.6 cm in males compared to 153.95 ± 1.12 cm in females and 169.31 ± 1.6 cm in males by conventional BP, respectively, and in comparison to near adult heights 156.38 ± 5.84 cm in females and 168.94 ± 8.18 cm in males, respectively. Conclusion: BA ratings and adult height predictions by BoneXpert™ in children with chronic endocrinopathies abolish rater dependent variability and enhance reproducibility of estimates thereby refining care in growth disorders. Conventional methods may outperform automated analyses in specific cases.