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
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 150 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.”
“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.”
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.
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