Autonomous artificial intelligence in pediatric radiology: the use and perception of BoneXpert for bone age assessment.

Background: The autonomous artificial intelligence (AI) system for bone age rating (BoneXpert) was designed to be used in clinical radiology practice as an AI-replace tool, replacing the radiologist completely.

Objective: The aim of this study was to investigate how the tool is used in clinical practice. Are radiologists more inclined to use BoneXpert to assist rather than replace themselves, and how much time is saved?

Materials And Methods: We sent a survey consisting of eight multiple-choice questions to 282 radiologists in departments in Europe already using the software.

Improving Automated Pediatric Bone Age Estimation Using Ensembles of Models from the 2017 RSNA Machine Learning Challenge.

Purpose: To investigate improvements in performance for automatic bone age estimation that can be gained through model ensembling.

Materials And Methods: A total of 48 submissions from the 2017 RSNA Pediatric Bone Age Machine Learning Challenge were used. Participants were provided with 12 611 pediatric hand radiographs with bone ages determined by a pediatric radiologist to develop models for bone age determination.

Metacarpal bone loss in patients with rheumatoid arthritis estimated by a new Digital X-ray Radiogrammetry method - initial results.

Background: The Digital X-ray Radiogrammetry (DXR) method measures the cortical bone thickness in the shafts of the metacarpals and has demonstrated its relevance in the assessment of hand bone loss caused by rheumatoid arthritis (RA). The aim of this study was to validate a novel approach of the DXR method in comparison with the original version considering patients with RA.

Method: The study includes 49 patients with verified RA.

Automated determination of bone age from hand X-rays at the end of puberty and its applicability for age estimation.

The BoneXpert method for automated determination of bone age from hand X-rays was introduced in 2009, covering the Greulich-Pyle bone age ranges up to 17 years for boys and 15 years for girls. This paper presents an extension of the method up to bone age 19 years for boys and 18 years for girls. The extension was developed based on images from the First Zurich Longitudinal Study of 231 healthy children born in 1954-1956 and followed with annual X-rays of both hands until adulthood.

A new implementation of digital X-ray radiogrammetry and reference curves of four indices of cortical bone for healthy European adults.

Unlabelled: Digital X-ray radiogrammetry performs measurements on a hand radiograph in digital form. We present an improved implementation of the method and provide reference curves for four indices for the amount of bone. We collected 1662 hand radiographs of healthy subjects of age 9-100 years.

Validation of adult height prediction based on automated bone age determination in the Paris Longitudinal Study of healthy children.

Background: An adult height prediction model based on automated determination of bone age was developed and validated in two studies from Zurich, Switzerland. Varied living conditions and genetic backgrounds might make the model less accurate.

Objective: To validate the adult height prediction model on children from another geographical location.

Automation of bone age reading and a new prediction model improve adult height prediction in children with short stature.

Aim: A new method (BX AHP) for adult height prediction (AHP), based on automated bone age (BoneXpert®, here called autBA) assessment, has been developed and validated. The aim of this study was to evaluate the performance of autBA and BX AHP in comparison with manual Greulich-Pyle bone age (manBA) and Bayley-Pinneau AHP (BP AHP) in children with untreated idiopathic short stature (ISS; including familial short stature and constitutional delay of growth and puberty).

Materials And Methods: We acquired the adult height of 190 patients (123 boys and 67 girls) with ISS and 448 (303 male and 135 female) X-rays of their left hand.

Automated determination of bone age in a modern chinese population.

Rationale and Objective. Large studies have previously been performed to set up a Chinese bone age reference, but it has been difficult to compare the maturation of Chinese children with populations elsewhere due to the potential variability between raters in different parts of the world. We re-analysed the radiographs from a large study of normal Chinese children using an automated bone age rating method to establish a Chinese bone age reference, and to compare the tempo of maturation in the Chinese with other populations.

Validation of automatic bone age rating in children with precocious and early puberty.

Background And Aims: Manual bone age (BA) rating in precocious puberty (PP) is associated with considerable rater variability. The aim was to evaluate a new method for automated Greulich and Pyle (GP) BA determination in children with PP.

Methods: Seven hundred forty-one archived X-rays from 13 boys and 103 girls with PP or early puberty of various etiologies (age range at time of X-ray, 0.

Standardization of the Tanner-Whitehouse bone age method in the context of automated image analysis.

Background/aims: The Tanner-Whitehouse (TW) method for bone age determination has been the basis for many population studies and it is used in many clinics. However, TW bone age raters can differ systematically from each other. The aim of the study was to present a new standard version of TW bone age rating implemented by the automated BoneXpert method and calibrated on the manual TW stage ratings of the First Zurich Longitudinal Study.

The use of bone age in clinical practice - part 2.

If height-limiting treatment is being considered for a child with tall stature, skeletal maturity is invaluable in the selection of appropriate patients for treatment, determining appropriate age of treatment commencement, monitoring progress of treatment, and determining the expected treatment effect on adult height. In precocious puberty, bone maturation can be usefully assessed at initial diagnosis and start of treatment and at regular intervals thereafter during treatment monitoring. Together with height, bone maturation is an essential parameter for long-term treatment monitoring in congenital adrenal hyperplasia.

The use of bone age in clinical practice - part 1.

This review examines the role of skeletal maturity ('bone age', BA) assessment in clinical practice. BA is mainly used in children with the following conditions: short stature (addressed in part 1 of this review), tall stature, early or late puberty, and congenital adrenal hyperplasia (all addressed in part 2). Various manual and automatic methods of BA assessment have been developed.

Validation and reference values of automated bone age determination for four ethnicities.

Rationale And Objectives: Bone age (BA) rating is associated with a considerable rater variability, which would be eliminated with an automated computerized method. The aim of the study was to validate the BoneXpert method, an automated determination of BA, in American children of four ethnicities.

Materials And Methods: The study is based on a publicly available database of hand x-rays of healthy children, established in a previous, National Institutes of Health-funded study.

Validation of bone age methods by their ability to predict adult height.

Aim: Several bone age (BA) methods are in use today. The aim of this study was to introduce a framework for assessing the validity of a BA method by its ability to predict adult height (H) and to apply it to manual ratings based on Greulich-Pyle (GP) and Tanner-Whitehouse 3 (TW) and to the fully automated BoneXpert method.

Material: The study used X-rays of 232 children from the First Zurich Longitudinal Study recorded close to each anniversary.

Automatic determination of left- and right-hand bone age in the First Zurich Longitudinal Study.

Background/aims: A more advanced bone age (BA) has been reported for the left hand relative to the right hand, while another study has found no such effect. The aim was to study the average difference of automated BoneXpert BA determination (left- vs. right-hand) for normal children, examine the precision of automatic BA and provide a BA reference for normal Caucasian children.

Validation of a new method for automated determination of bone age in Japanese children.

BoneXpert, an automated method for analysis of hand radiographs of children, has recently been developed and validated in European children. It determines Tanner-Whitehouse (TW) and Greulich Pyle (GP) bone ages (BA). The purpose of this work is to validate BoneXpert BA in Japanese children and determine the following two properties of the method: (1) The accuracy of the BA, i.

Prediction of adult height based on automated determination of bone age.

Context: Adult height prediction is a common procedure in pediatric endocrinology, but it is associated with a considerable variability and bias from the bone age rating.

Objective: A new method for adult height prediction is presented, based on automated bone age determination.

Method: The method predicts the fraction of height left to grow from age and BoneXpert bone age.

Clinical review: An automated method for determination of bone age.

Context: Bone age rating is associated with a considerable rater variability, which limits its usefulness in modern pediatric endocrinology. An automated computerized method would theoretically solve this problem but has been surprisingly difficult to establish.

Evidence Acquisition: We review the development of automated bone age assessment and describe how the conceptual understanding of bone age rating shifted from a rule-based theory to a more intuitive and experience-based approach.

Clinical application of automated Greulich-Pyle bone age determination in children with short stature.

Background: Bone age (BA) rating is time consuming and highly rater dependent.

Objective: To adjust the fully automated BoneXpert method to agree with the manual Greulich and Pyle BA (GP BA) ratings of five raters and to validate the accuracy for short children.

Materials And Methods: A total of 1,097 left hand radiographs from 188 children with short stature, including growth hormone deficiency (44%) and Turner syndrome (29%) were evaluated.

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

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.

The BoneXpert method for automated determination of skeletal maturity.

Bone age rating is associated with a considerable variability from the human interpretation, and this is the motivation for presenting a new method for automated determination of bone age (skeletal maturity). The method, called BoneXpert, reconstructs, from radiographs of the hand, the borders of 15 bones automatically and then computes "intrinsic" bone ages for each of 13 bones (radius, ulna, and 11 short bones). Finally, it transforms the intrinsic bone ages into Greulich Pyle (GP) or Tanner Whitehouse (TW) bone age.

Minimum Description Length shape and appearance models.

The Minimum Description Length (MDL) approach to shape modelling is reviewed. It solves the point correspondence problem of selecting points on shapes defined as curves so that the points correspond across a data set. An efficient numerical implementation is presented and made available as open source Matlab code.