Bone age can be automatically measured from a child's hand X-ray by the BoneXpert software. BoneXpert delivers precise and standardised readings, thus overcoming the problem of considerable reader variability of manual ratings.
Leading paediatric radiology departments have integrated BoneXpert seamlessly in their workflow. This leads to more accurate adult height prediction, better diagnosis, and more optimal treatment. In addition, clinics now have an improved workflow and treat patients quicker as bone age is provided by BoneXpert as soon as the X-ray is recorded.
Running on existing hardware and paid per analysis, BoneXpert is cost-effective from day one. Doctors are relieved from time-consuming manual ratings, leading to more time for patient care.
BoneXpert Core Values
Autonomous
BoneXpert is autonomous rather than just assisting. This level of ambition is crucial for delivering real value of AI, safely relieving the radiologist from tedious work. BoneXpert automatically rejects the image if the safe interpretation is not guaranteed.
Many of the radiologists using BoneXpert, are still looking at the hand image to check for signs of anatomical anomaly, and occasionally checking the bone age assessment.
Accurate
BoneXpert was trained on 30.000 X-rays, and its agreement with the average of six manual raters is excellent, with a mean absolute deviation of only 4.1 months.
BoneXpert has been validated across hospitals, modality brands and populations (Asian, Caucasian, Hispanic, African).
20 peer-reviewed publications document the clinical evaluation, including studies the of the accuracy of adult height prediction based on bone age.

Explained
BoneXpert explains the overall bone age as the averaging over the annotated bones, like a human rater would do.
For each bone, BoneXpert displays the boundary, which substantiates the analysis, e.g. the relative width of the epiphysis is a crucial maturity indicator.
A separate bone age value is given for the carpals, which are known to respond differently to sex steroids.
Fracture study from Birmingham
Widespread use of BoneXpert in the United Kingdom
Swiss study compares two bone age algorithms
BoneXpert – the most widely used radiology AI in the Netherlands in 2022
BoneXpert knows its own limitation
New paper: How do radiologists use BoneXpert?
Update on autonomous AI in Radiology
United States patent granted to Visiana
Over 200 hospitals have licensed BoneXpert
Bone Health Index demonstrates relation to fractures in Klinefelter children
Financial impacts of BoneXpert; Webinar highlights with Prof. Amaka Offiah and Dr. Alistair Calder
How well does Bone Health Index correlate with DXA?
BoneXpert – A mature AI product
Almost full house in Scandinavia
BoneXpert validated in Afghan toddlers
BoneXpert is accurate in Moroccan children
Celebrating 50 BoneXpert publications on PubMed
New Adult Height Predictor supports three ethnicities
What do PACS admins say about BoneXpert?
BoneXpert Online: Automated bone age in your browser
September 2020: New bone age reference curves from Taiwan
September 2020: Visiana expands and unveils new office space
August 2020: New bone age reference curves from Mexico
How well can you rate bone age?
June 2020: Dutch paper on implementation of AI in radiology
May 2020: BoneXpert – the most widespread AI radiology software in the Netherlands
May 2020: Reduced use of bone age during Covid-19
April 2020: BoneXpert in Chile
RSNA challenge boosts automated bone age ratings
September 2019: BoneXpert version 3.0 released
October 2018: BoneXpert in 135 hospitals
Video on AI in radiology
February 2018: Hands-on AI
October 2017: BoneXpert licensed to 100 hospitals
May 2017: Special Focus Session on age assessment at ESPR 2017
February 2017: BoneXpert licensed to 80 hospitals
January 2017: Assessment of arthritis with BoneXpert
Automated bone age extended up to 19 years
The world’s first osteoporosis screening
April 2016: BoneXpert licensed to 60 hospitals
November 2015: Adult height Prediction Study in Paris
New Adult Height Predictor with growth path
September 2014: BoneXpert presented at ESPE in Dublin
The friendly co-existence of BoneXpert and image post-processing
January 2014: BoneXpert licensed to 32 hospitals
December 2013: Three new publications
June 2013: Talks about BoneXpert at ICCBH and ESPE
January 2013: Adult height prediction for short children
November 2012: BoneXpert licensed to 16 hospitals
New thoughtful article in Radiology about CAD
How dangerous is it to eat a banana?
January 2012: Three new publications
December 2010: BoneXpert United States patent has been issued
August 2010: New validation study of BoneXpert in Academic Radiology
April 2010: Three new publications
December 2009: Dr. David Martin receives the Jürgen-Bierich Prize for work on adult height prediction
November 2009: New paper on Bone Health Index
July 2009: Clinical Review of BoneXpert in JCEM
Bone Age Application Areas
Clinical Use
Installed in the radiology department and serving mainly paediatric endocrinology and orthopedics
Clinical Trials
Academic research or drug trials sponsored by pharmaceutical companies
Sports Medicine
Talent identification and prevention of injuries
Orthodontics
Planning the timing of treatment
Used by over 200 clinics

Testimonials
”At the Department for Growth and Reproduction, we have a large number of children with tall or short stature. As part of the examination, we use BoneXpert to determine skeletal maturity and make a qualified prediction of the final height. Many of these patients do not require treatment, but it is important to rule out any underlying pathologies as the cause of their disrupted growth. Today, BoneXpert is an invaluable tool in our clinical practice.”

"La valutazione dell'età ossea tramite atlante GP è viziata da grande variabilità intra e inter osservatore. BoneXpert è preciso, rapido, riproducibile e affidabile rispetto alla valutazione su atlante. L’età ossea è rapidamente calcolata in automatico dal programma BE e il risultato viene “incollato” direttamente sul referto. Ha velocizzato la refertazione che è oggettiva. L’istallazione è stata molto semplice e rapida. Non si sono mai verificati conflitti tra il software BA e gli altri software nativi La velocità di refertazione consente di risparmiare ore di lavoro annuali del medico specialista radiologo che può essere quindi impiegato in altra attività/refertazione."

"We are very pleased to finally have access to BoneXpert at Rikshospitalet in Oslo. We have many chronically ill children at our hospital and, in addition to being an efficient and reliable programme, BoneXpert has also increased our awareness of bone health, especially in the transplanted children (mostly liver and kidneys). We experience that many of our patients have pathological BHI which may warrant further investigations to prevent or diagnose and treat osteoporosis"

“When we used the old atlas, the time taken to perform bone ages manually meant that they would often sit unreported for a while. Also, the variability between follow-up bone ages meant needing to check previous results sometimes. With BoneXpert, we have a system that accurately measures trends in bone age. The ease of bone age reporting is fantastic and bone age studies no longer wait to be reported.”

"After switching to BoneXpert, we are getting more consistent bone age ratings than we did with the atlas. We let BoneXpert process all films of the left hand for bone age determination that were already reported by radiologists. We looked further at the films in which there was more than 12 months’ discrepancy between BoneXpert and the radiologist. There were 20 discrepancies. In 19 cases, BoneXpert was right."

“Using the G&P atlas can lead to different interpretations, particularly when there are no experienced paediatric radiologists available to read the studies. Especially in longitudinal follow-up this can lead to conflicting reporting. Having been involved in validation studies I knew that, as long as the hand has a normal anatomy, I can trust the system. The installation was easy, and BoneXpert gives consistent results – I haven’t restudied radiographs after making the switch.”

"Bone age is often a chore for radiologists who don't do them that often and have to refer to an atlas for 20 minutes per case! BoneXpert is a major advance in the assessment of children’s bone age and bone health. Since we introduced it into our clinical service last year it has reduced the radiologists workload and provided reliable and immediate reports for our clinicians.”

"The rating of bone age manually was rather time consuming and not very exact. In my hospital more than thousand bone age ratings are done yearly. A lot of time has been saved in the department with a large bulk of these studies. BoneXpert is also a useful tool for the less experienced radiologist and a way to teach manual rating. In the beginning I double checked BoneXpert results with manual ratings. However, there is literature available that shows the reliability of the method. I also supervised a small study comparing the BoneXpert ratings with the calendar age of Finnish children who had been imaged for trauma. We found very good correlation"
"Our bone ages were being reported by a single staff member who became unwell and was unable to provide these time-consuming exams consistently. We were relieved to switch to an automated system, supported by robust research. BoneXpert integrates with our local PACS and has given us rapid turnaround and improved consistency. In fact, our radiologists have stopped doing bone ages manually now"