Department of Paediatric Imaging, Queen Fabiola's Children Hospital (HUDERF), Free University of Brussels, Avenue Jean Joseph Crocq 15, 1020, Brussels, Belgium.
Faculty of Medecine, Free University of Brussels, Brussels, Belgium.
Pediatr Radiol. 2023 May;53(6):1100-1107. doi: 10.1007/s00247-023-05595-9. Epub 2023 Feb 28.
Bone age in children is mainly assessed using the Greulich and Pyle (GP) atlas, a validated method with limited interobserver accuracy. While automated methods increase interobserver accuracy, they represent considerable costs and technical requirements.
A proof-of-concept study to create and evaluate an online software program, Boneureka, based on linear metacarpal length measurements, to assess bone age in healthy children.
The study retrospectively included 434 consecutive children (215 girls) who underwent a left-hand radiograph to rule out trauma between March 2008 and December 2017. Two reviewers measured the second to fourth metacarpal lengths on each radiograph and the distance between the centre of the epiphyses of the second and fifth metacarpals. A single reviewer estimated the bone age using the GP atlas. The automated software assessed the bone age for all radiographs. A mathematical model was developed based on linear regressions to provide the mean bone age and standard deviation based on the estimates. Pearson and intraclass correlation coefficient (ICC) were used to evaluate the correlation and agreement between the estimated bone ages using Boneureka, the GP atlas and BoneXpert compared to chronological age.
The measure that showed the highest correlation (r=0.877 for girls and r=0.834 for boys; P<.001) and the highest ICC (ICC=0.937 for girls and ICC=0.926 for boys; P<0.001) with chronological age was length of the second metacarpal. The GP atlas and the automated software evaluation had excellent ICC with chronological age (ICC>0.95 for both methods and sexes). Using this data, we created an online software program based on the second metacarpal length to obtain bone age estimates, means and standard deviations.
The newly created online software Boneureka, based on the second metacarpal length, is a reliable and user-friendly tool to assess bone age in healthy children. Further studies on a larger population should be performed to validate the developed reference values.
儿童的骨龄主要通过 Greulich 和 Pyle（GP）图谱进行评估，这是一种经过验证的方法，但观察者间的准确性有限。虽然自动化方法可以提高观察者间的准确性，但它们需要大量的成本和技术要求。
本研究旨在创建和评估一种基于掌骨线性长度测量的在线软件程序 Boneureka，用于评估健康儿童的骨龄，这是一种基于线性掌骨长度测量的在线软件程序 Boneureka。
本回顾性研究纳入了 2008 年 3 月至 2017 年 12 月间因排除外伤而接受左手 X 线检查的 434 例连续患儿（215 例女孩）。两位观察者分别测量每张 X 线片的第二至第四掌骨长度以及第二和第五掌骨骨骺中心之间的距离。一位观察者使用 GP 图谱评估骨龄。自动化软件为所有 X 线片评估骨龄。基于线性回归，建立数学模型，提供基于估计值的平均骨龄和标准差。采用 Pearson 和组内相关系数（ICC）评估 Boneureka、GP 图谱和 BoneXpert 评估的骨龄与实际年龄之间的相关性和一致性。
与实际年龄相关性最高（女孩 r=0.877，男孩 r=0.834；P<.001）和 ICC 最高（女孩 ICC=0.937，男孩 ICC=0.926；P<0.001）的指标是第二掌骨长度。GP 图谱和自动化软件评估与实际年龄的 ICC 非常好（两种方法和两种性别 ICC>0.95）。基于这些数据，我们创建了一个基于第二掌骨长度的在线软件程序来获得骨龄估计值、平均值和标准差。
新创建的基于第二掌骨长度的在线软件 Boneureka 是一种可靠且易于使用的工具，可用于评估健康儿童的骨龄。应在更大的人群中进行进一步研究，以验证所开发的参考值。
