Financial impacts of BoneXpert; Webinar highlights with Prof. Amaka Offiah and Dr. Alistair Calder

Visiana held its BoneXpert webinar to explore the automation of the processes in radiology that is currently taking place in the UK.

Presenters were Professor Amaka Offiah, and Dr. Alistair Calder who presented their views and findings when using BoneXpert in the daily routine at Sheffield University Hospital and at Great Ormond Street Hospital in London.

The webinar was well-attended, and here are a some highlights. 

Prof. Amaka Offiah reported on a survey among radiologists using BoneXpert, yielding responses from 64 users (22% of those asked). The survey showed that the fraction of respondents using more than 2 minutes on bone age rating fell from 88% to 19% with the introduction of BoneXpert.

Although the system was developed to be able to replace the rater altogether, she recommended still looking at the images to check for abnormal structures and findings, and the survey showed that this is indeed the typical use.The survey found that 83% of the users override the BoneXpert bone age values in less than 5% of the cases. When asked whether they would recommend the system to other radiologists, 98% responded “Yes”.

A paper reporting the survey will soon be published in a radiology journal.


Dr. Alistair Calder enthusiastically pointed out that the hand radiograph with its many bones provides a powerful mini skeletal survey, ideal for recognizing patterns characteristic of a vast range of rare disorders. An example of a common image feature is cone-shaped epiphyses:


His experience is that BoneXpert rejects images with severe abnormalities such as skeletal dysplasia, but he noted that BoneXpert version 3 accepts more images than version 2.

He recommend that BoneXpert should do the tedious bone age rating, and then discussed how the radiologists could spent the time saved:




Kicky van Leeuwen (Radboud University, Netherlands) posed the following key question to the speakers on the webinar chat:

“Do you have an idea about the financial benefits for your department using BoneXpert?”


Prof. Amaka Offiah, Sheffield University Hospital:

“We do about 700 bone age exams per year here in Sheffield, and we used to rate a significant number by the TW3 method. Each rating took between 2 and 10 minutes depending on experience of the reader and method (G&P or TW3) of bone age assessment.  Once we got the BoneXpert software, that manual rating was no longer required. So it was a saving for us. I can’t give you the actual financial figure, but there has been a saving – reads now take less than a minute – and of course the software eradicates interobserver variability.”

Dr. Alistair Calder, Great Ormond Street Hospital in London:

“When we were looking at our business case for using BoneXpert, I think the financial side of it was quite hard to quantify. And actually, the real sell for us was precision and in consistency. Bone age was being done in quite a lot of different ways in the hospital by different people. So, although the radiologists were looking at bone ages, some of the endocrinologists were doing their own Greulich and Pyle, it was just a mess. Well now, everyone is using BoneXpert and we’ve got that greater consistency. Actually, the radiologists, we were quite biased in our GP readings. A lot of our bone age is abnormal and we tended to be anchored to the  chronological age.”