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01.12.2013 | Original Article

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

verfasst von: David D. Martin, Katharina Heil, Conrad Heckmann, Angelika Zierl, Jürgen Schaefer, Michael B. Ranke, Gerhard Binder

Erschienen in: Pediatric Radiology | Ausgabe 12/2013

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Abstract

Background

Determination of bone age is routinely used for following up substitution therapy in congenital adrenal hyperplasia (CAH) but today is a procedure with significant subjectivity.

Objective

The aim was to test the performance of automatic bone age rating by the BoneXpert software package in all radiographs of children with CAH seen at our clinic from 1975 to 2006.

Materials and methods

Eight hundred and ninety-two left-hand radiographs from 100 children aged 0 to 17 years were presented to a human rater and BoneXpert for bone age rating. Images where ratings differed by more than 1.5 years were each rerated by four human raters.

Results

Rerating was necessary in 20 images and the rerating result was closer to the BoneXpert result than to the original manual rating in 18/20 (90 %). Bone age rating precision based on the smoothness of longitudinal curves comprising a total of 327 data triplets spanning less than 1.7 years showed BoneXpert to be more precise (P<0.001).

Conclusion

BoneXpert performs reliable bone age ratings in children with CAH.

The triplets formed from a child are not statistically independent because each visit can participate in up to three triplets. The confidence interval (CI) of the estimated precision was therefore estimated by a Monte Carlo technique, which showed that the CIs are a factor of 1.3 times larger than one would derive by assuming that the triplets were independent

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Titel: Validation of automatic bone age determination in children with congenital adrenal hyperplasia
verfasst von: David D. Martin
Katharina Heil
Conrad Heckmann
Angelika Zierl
Jürgen Schaefer
Michael B. Ranke
Gerhard Binder
Publikationsdatum: 01.12.2013
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Radiology / Ausgabe 12/2013
Print ISSN: 0301-0449
Elektronische ISSN: 1432-1998
DOI: https://doi.org/10.1007/s00247-013-2744-8

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