Validation of automatic bone age determination in children with congenital adrenal hyperplasia

Martin, David; Heil, Katharina; Heckmann, Conrad; Zierl, Angelika; Schaefer, Jürgen F.; Ranke, Michael B.; Binder, Gerhard

doi:10.1007/s00247-013-2744-8

Cited by 22 publications

(20 citation statements)

References 18 publications

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“…In other studies, more physicians (3 or 4) are usually involved [13,15]. However, the 2 attending radiologists in our study are the only 2 subspecialists for BA assessment in our department.…”

Section: Discussionmentioning

confidence: 40%

“…This result also supports the idea that BoneXpert might be used as an alternative to resident estimates. Compared with other researchers who even suggested that BoneXpert could be used without supervision from physicians [13,14,15], we consider our recommendation to supervise BoneXpert as prudent with a high degree of safety.…”

Section: Discussionmentioning

confidence: 99%

“…In other studies, deviations of 1.9 and 1.5 years have been selected as comparative standard years [13,14,15]. However, because BoneXpert data is based on European children, and our comparison was among different ethnicities, we choose a 1-year deviation as a stricter standard.…”

Section: Discussionmentioning

confidence: 99%

“…The accuracy of the BoneXpert method with regard to the manual method was defined as the root mean square (rms) deviation. As the rms deviation contains some bias, which indicates the difference between rms deviation and standard deviation, it is usually slightly larger than the standard deviation [15]. According to the Chinese rules regarding BA rating, the supervisor takes the main responsibility for the accuracy of the radiological report, so it is rational to use the determination of the attending radiologists according to the GP atlas as a relatively accurate reference BA.…”

Section: Methodsmentioning

confidence: 99%

“…One fully automated image analysis method, BoneXpert, has performed well in terms of estimating BA in normal children in some countries including China, even though BoneXpert was based on data of European children [7,8,9,10,11,12]. However, only few articles have discussed the clinical application of BoneXpert for children with discordant BA development [13,14,15,16,17,18]. …”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

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

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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.

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Section: Discussionmentioning

confidence: 40%