Pediatric Radiology

, Volume 46, Issue 2, pp 263–269 | Cite as

Validation of adult height prediction based on automated bone age determination in the Paris Longitudinal Study of healthy children

  • David D. Martin
  • Jan Schittenhelm
  • Hans Henrik Thodberg
Original Article



An adult height prediction model based on automated determination of bone age was developed and validated in two studies from Zurich, Switzerland. Varied living conditions and genetic backgrounds might make the model less accurate.


To validate the adult height prediction model on children from another geographical location.

Materials and methods

We included 51 boys and 58 girls from the Paris Longitudinal Study of children born 1953 to 1958. Radiographs were obtained once or twice a year in these children from birth to age 18. Bone age was determined using the BoneXpert method. Radiographs in children with bone age greater than 6 years were considered, in total 1,124 images.


The root mean square deviation between the predicted and the observed adult height was 2.8 cm for boys in the bone age range 6–15 years and 3.1 cm for girls in the bone age range 6–13 years. The bias (the average signed difference) was zero, except for girls below bone age 12, where the predictions were 0.8 cm too low.


The accuracy of the BoneXpert method in terms of root mean square error was as predicted by the model, i.e. in line with what was observed in the Zurich studies.


Automated image analysis Bone age Child Height prediction Model Radiography Validation 



We thank Professor Michel Sempé from Lyon for permission to scan the images and use the Paris data that he has kept so diligently for the last 60 years, and Jeffrey V. Martin for doing part of the scanning.

Compliance with ethical standards

Conflicts of interest

H.H. Thodberg is the owner of Visiana, which develops and markets the BoneXpert method for automated bone age assessment. He performed about half the data analysis and manuscript preparation. The remaining authors are not employed by, and have no financial or other interest in Visiana nor in any commercial product related to this work.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • David D. Martin
    • 1
    • 2
  • Jan Schittenhelm
    • 1
  • Hans Henrik Thodberg
    • 3
  1. 1.Tübingen University Children’s HospitalTübingenGermany
  2. 2.FilderklinikFilderstadtGermany
  3. 3.VisianaHolteDenmark

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