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 provides better input to the physician's diagnosis, gives more accurate adult height prediction, 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
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.
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.
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.
December 2009: Dr. David Martin receives the Jürgen-Bierich Prize for work on adult height prediction
Bone Age Application Areas
Used by over 200 clinics
”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"
"El Servicio Médico del FC Barcelona, junto con el Barça Innovation Hub, acordamos usar BoneXpert como herramienta con el fin de crear un esquema para evaluar el desarrollo físico de los jugadores del club. En uno de los últimos estudios que está realizando el Barça Innovation Hub se incluye la recolección de datos de deportistas de talla alta, para optimizar el algoritmo de ese tipo de deportistas. El objetivo del estudio es comparar las diferentes fórmulas para evaluar la etapa madurativa y el punto de mayor velocidad de crecimiento (PHV), y determinar cómo trabajar con cada grupo en el mismo estadío madurativo, con el fin de disminuir el riesgo de lesiones y aumentar su talento y habilidades. El Índice de salud ósea (BHI) puede ayudarnos a encontrar una estructura ósea más débil con riesgo de fractura. Usamos regularmente BoneXpert en las revisiones médicas de deportistas, pero también confiamos en el software para llevar a cabo nuestros proyectos de investigación que tienen como objetivo mejorar el desarrollo y la salud de los deportistas del FC Barcelona. BoneXpert es una herramienta valiosa para cumplir nuestros proyectos en el Innovation Hub. “
“Χρειάζομαι το BoneXpet στο ιδιωτικό μου ιατρείο για ακριβή και γρήγορη εκτίμηση της οστικής ηλικίας. Χρειαζόμουν μια έγκυρη μέθοδο που θα παρέχει άριστη ανάλυση της οστικής ηλικίας και επίσης αποτελεί εξαιρετικό εργαλείο για τον γρήγορο εντοπισμό των ενδοκρινολογικών διαταραχών. Εκτιμώ ότι το BoneXpert εξηγεί τη συνολική οστική ηλικία ως τον μέσο όρο έναντι των ανώνυμων οστών, όπως θα έκανε ένας ανθρώπινος βαθμολογητής. Έχουμε περιπτώσεις διαταραχών ανάπτυξης και χρησιμοποιούμε το μοντέλο πρόβλεψης Ύψους Ενηλίκων, το οποίο είναι επικυρωμένο με σύγχρονα δεδομένα, όπου μας επιτρέπει την συμπερίληψη του κληρονομικού ύψους και προβλέπει την ηλικία κατά την ανάπτυξη. Το BoneXpert είναι και θα παραμείνει ως πολύτιμος βοηθός στην καθημερινή μου εργασία.”
"За кратко време BoneXpert се превърна в ценен помощник в нашата ежедневна работа в натоварената ни среда в Експертен център по редки ендокринни болести в УМБАЛ „Света Марина“ - Варна. BoneXpert ни помага за по-бързото диагностиране на нарушения на растежа при деца в ранна и по-късна детска възраст. Използването на BoneXpert не само спестява време, но позволява прецизност и по-точна оценка на някои предишни разчитания за костна възраст. В нашия Експертен център по редки ендокринни болести имаме комплицирани случаи на дефицит на растежа, а по литературни данни точността на оценката на BoneXpert е равна или по-добра от средната стойност от 3 „ръчни” отчитания, което значително подобрява надежността на нашата работа и ни дава повече увереност и спокойствие.“
“The automated software gives a specific age rather than an age range which makes it standardized for radiologists as well as the treating doctor. Even in medicolegal cases where age plays an important role in decision-making, automation removes indecisiveness to a great extent. It has reduced the turnaround time for reporting these radiographs. As the software gives the automated assessment of each bone individually as well as a composite age, it is also easy for the referring doctor to read them. The follow-up radiographs are mostly done for the endocrinological assessment of an individual. In such cases, the expected/ unexpected interval change in the bone age could assess the response to treatment and make future decisions by the treating doctor easier.”
“We began “testing” BoneXpert almost 4 years ago in our practice. Reluctantly at first, we had to learn to use a new tool, compare it with our own bone age assessments, and see whether there would be benefits in our clinical work. Now, we can say that the accuracy, objectiveness, and advantage of standardized comparing of bone maturation in the follow-up is so important that we cannot practically imagine our practice without BoneXpert. Moreover, we can admit that therapeutic decisions can be more balanced than before, also adding the patient and parental satisfaction from obtaining a computerized result on Bone Age and Adult Height Prediction. Saying that, we still need to remain cautious as we always did with adult height predictions, mainly in particularly advanced cases.”
“BoneXpert has really changed our workflow – now when I need a Bone Age, I send the child for the x-ray immediately, and even before they are back, we have the answer and, in a jiffy, a height prediction, too. We are doing far more bone ages than we expected.”
"The FC Barcelona Medical Service and the Barça Innovation Hub agreed to use BoneXpert to create a scheme to assess the physical development of the club's players. One of the latest studies being carried out by the Barça Innovation Hub includes collecting data from tall athletes, to optimize the algorithm for this type of athlete. The study’s objective is to compare the different formulas to evaluate the maturational stage and the point of greatest growth velocity (PHV), and to determine how to work with each group in the same maturational stage, to reduce the risk of injuries and increase your talent and skills. The Bone Health Index (BHI) can help us find weaker bone structures at risk of fracture. We regularly use BoneXpert for athlete medical check-ups. Still, we also rely on the software to carry out our research projects that aim to improve the development and health of FC Barcelona athletes. BoneXpert is a valuable tool for fulfilling our projects in the Innovation Hub. “
“I need BoneXpet in my private practice for accurate and quick bone age assessment. I needed a valid method that would provide excellent bone age analysis and also be an excellent tool for the rapid detection of endocrine disorders. I appreciate that BoneXpert explains the total bone age as the average against the anonymous bones, as a human rater would. We have cases of growth disorders and use the Adult Height prediction model, which is validated with modern data, which allows us to include the hereditary height and predict age at growth. BoneXpert is and will remain a valuable assistant in my daily work.”
“For a short time BoneXpert has become a valuable assistant in our daily work in our busy environment at the Expert Center for Rare Endocrine Diseases at the University Hospital "St. Marina" - Varna. BoneXpert helps us diagnose growth disorders more quickly in children in early and later childhood. Using BoneXpert not only saves time, but also allows precision and a more accurate estimate of some previous bone age readings. In our Expert Center for Rare Endocrine Diseases, we have complicated cases of growth deficiency, and according to the literature, the accuracy of BoneXpert's assessment is equal to or better than the average of 3 "manual" readings, which significantly improves the reliability of our work and gives us more confidence and peace of mind. "