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The Greulich-Pyle and Gilsanz-Ratib atlas method versus automated estimation tool for bone age: a multi-observer agreement study

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Abstract

Purpose

To evaluate the agreement between observers using Greulich-Pyle (GP) and Gilsanz-Ratib (GR) methods, between four specialities (radiology, pediatrics, pediatric endocrinology and pediatric radiology) and between observers and automated tool in the bone age estimation.

Materials and methods

A total of 99 observers participated in this questionnaire-based study. BoneXpert was used for the automated tool. Experienced, senior, and junior observers were defined by their experience, and the bone age determined by experienced observers was regarded as the ground truth. Agreement between observers was evaluated using the coefficient of variance (CV) and intraclass correlation coefficient (ICC), and they were reevaluated after adding BoneXpert to the observers. Agreement of BoneXpert, the senior, and the junior observers was also evaluated using the root-mean-square-error (RMSE) values and Blant Altman method by comparing with the ground truth.

Results

The CV ranged from 4.98% to 22.08%. The ICC were 0.980 for GP, 0.980 for GP and BoneXpert, 0.973 for GR, and 0.976 for GR and BoneXpert, and the ICC between four specialities ranged form 0.963 to 0.990. BoneXpert tool had the lowest RMSE values (0.504 years for GP atlas).

Conclusion

Automated bone age estimation showed comparable results with GP and GR methods and its utilization may decrease inter-observer variability.

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Acknowledgements

We acknowledge that Visiana, the producer of BoneXpert, gave us free access to the BoneXpert software for this study without any conditions regarding the content of the paper (a so-called unrestricted Grant).

Funding

No funding was received.

Author information

Author notes

  1. Onur Taydaş

    Present address: School of Medicine, Department of Radiology, Sakarya University, Sakarya, Turkey

Authors and Affiliations

  1. Radiology Section, Ankara Sehit Ahmet Ozsoy State Hospital, Ankara, Turkey

    Ural Koc

  2. Department of Pediatric Endocrinology, Adiyaman Training Research Hospital, Adiyaman, Turkey

    Semih Bolu

  3. Faculty of Medicine, Department of Biostatistics, Ankara University, Ankara, Turkey

    Atilla Halil Elhan

  4. Clinic of Pediatric Radiology, UCSF Benioff Children’s Hospital, Oakland, CA, USA

    S. Pınar Karakas

  5. Department of Radiology, Erzincan Mengucek Gazi Training and Research Hospital, Erzincan, Turkey

    Onur Taydaş

Authors
  1. Ural Koc
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Corresponding author

Correspondence to Ural Koc.

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The authors declare that they have no conflict of interest.

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The study was approved by the ethics committee of the Erzincan University.

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Koc, U., Taydaş, O., Bolu, S. et al. The Greulich-Pyle and Gilsanz-Ratib atlas method versus automated estimation tool for bone age: a multi-observer agreement study. Jpn J Radiol 39, 267–272 (2021). https://doi.org/10.1007/s11604-020-01055-8

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  • DOI: https://doi.org/10.1007/s11604-020-01055-8

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