Ruiz-Arana Inge-Lore, Lechanteur Victor, Busiah Kanetee, Bouthors Thérèse, Antoniou Maria-Christina, Stoppa-Vaucher Sophie, Ruspa Martina, Alamo Leonor, Hauschild Michael
Pediatric Endocrinology, Diabetes and Obesity Unit, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne 1004, Switzerland.
School of Medicine, Faculty of Biology and Medicine, University of Lausanne, Lausanne 1015, Switzerland.
J Endocr Soc. 2025 Jul 21;9(9):bvaf122. doi: 10.1210/jendso/bvaf122. eCollection 2025 Sep.
Bone age (BA) evaluation in children presenting growth problems is time-consuming. Artificial intelligence (AI) BA assessment programs are increasingly used. However, agreement between different commercially available methods in the same population, or possible age-, puberty- or sex-related differences have not been sufficiently evaluated.
BA assessment of 521 left hand radiographs of patients aged 2-19 years with IB-lab-PANDA® and BoneXpert® were compared. Of the 521 radiographs, 213 were compared to the Greulich-Pyle (GP) reference. We analyzed gender, age, diagnosis, body mass index (BMI) and puberty categories. Accuracy was calculated as mean-absolute-deviation (MAD) and root-mean-square-error (RMSE).
MAD was 0.61 years and the RMSE 0.83 years between BoneXpert and IB-lab-PANDA, with poor agreement in girls over 14 years (MAD 1.18 years).Compared to the manual rating, both methods showed a positive bias in boys (0.28 years BoneXpert vs 0.51 years IB-lab-PANDA) and in children with pathologies associated with BA delay (BoneXpert 0.18 years vs IB-lab-PANDA 0.35 years). IB-lab-PANDA underestimated BA in girls after 14 years (-0.67 years). IB-lab-PANDA had a MAD of 0.64 years and RMSE of 0.85 years compared to manual assessment, whereas BoneXpert had a MAD of 0.63 years and RMSE of 0.82 years.BoneXpert was significantly more accurate than IB-lab-PANDA in prepubertal children (MAD 0.7 vs 0.83 years; = .027).
The direct agreement between IB-lab-PANDA® and BoneXpert® falls within human inter-rater variability. Their agreement on manual BA determination is equivalent except in prepubertal children, where BoneXpert seems more accurate. Both are fast, valuable tools for determining BA accurately and efficiently.
对存在生长问题的儿童进行骨龄（BA）评估耗时较长。人工智能（AI）骨龄评估程序的使用越来越广泛。然而，同一人群中不同市售方法之间的一致性，以及可能存在的与年龄、青春期或性别相关的差异尚未得到充分评估。
对521例年龄在2至19岁患者的左手X光片分别采用IB-lab-PANDA®和BoneXpert®进行骨龄评估，并进行比较。在这521张X光片中，213张与格鲁利希-派尔（GP）参考标准进行了对比。我们分析了性别、年龄、诊断结果、体重指数（BMI）和青春期类别。准确性通过平均绝对偏差（MAD）和均方根误差（RMSE）来计算。
BoneXpert和IB-lab-PANDA之间的MAD为0.61岁，RMSE为0.83岁，14岁以上女孩的一致性较差（MAD为1.18岁）。与人工评级相比，两种方法在男孩中均表现出正偏差（BoneXpert为0.28岁，IB-lab-PANDA为0.51岁），在与骨龄延迟相关疾病的儿童中也表现出正偏差（BoneXpert为0.18岁，IB-lab-PANDA为0.35岁）。IB-lab-PANDA在14岁后的女孩中低估了骨龄（-0.67岁）。与人工评估相比，IB-lab-PANDA的MAD为0.64岁，RMSE为0.85岁，而BoneXpert的MAD为0.63岁，RMSE为0.82岁。在青春期前儿童中，BoneXpert比IB-lab-PANDA显著更准确（MAD分别为0.7岁和0.83岁；P = 0.027）。
IB-lab-PANDA®和BoneXpert®之间的直接一致性在人类评分者间的变异性范围内。它们在人工骨龄测定方面的一致性相当，除了青春期前儿童，在这一群体中BoneXpert似乎更准确。两者都是准确、高效测定骨龄的快速且有价值的工具。
