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Automated Greulich-Pyle bone age determination in children with chronic kidney disease

Eva Nüsken1, Darja Imschinetzki, Kai-Dietrich Nüsken

  • 1Department of Pediatrics and Adolescent Medicine, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany.

Pediatric Nephrology (Berlin, Germany)
|March 20, 2015
PubMed

Insights

The automated BoneXpert™ method offers a valid, time-saving way to assess bone age in children with chronic kidney disease (CKD). However, it may slightly underestimate bone age acceleration or retardation.

Area of Science:

  • Pediatric Nephrology
  • Radiology
  • Medical Image Analysis

Background:

  • Children with chronic kidney disease (CKD) frequently experience growth restriction and delayed bone age.
  • Accurate bone age assessment is crucial for managing pediatric CKD.
  • Traditional manual assessment of hand X-rays is time-consuming and subjective.

Purpose of the Study:

  • To compare the accuracy and efficiency of the automated BoneXpert™ method versus manual assessment for bone age determination in pediatric CKD patients.
  • To evaluate the performance of BoneXpert™ in assessing bone age in children with varying stages of CKD.
  • To explore the utility of the bone health index (BHI) in this population.

Main Methods:

  • Retrospective multicenter study including 359 pediatric CKD patients (stages 2-5).
  • Bone age determined manually by three experts using Greulich and Pyle method.
  • Automated bone age assessment performed using BoneXpert™ image analysis software.

Main Results:

  • Strong correlation (r = 0.983, p < 0.001) observed between BoneXpert™ and manual methods.
  • BoneXpert™ tended to report higher bone age values in younger children (4-5 years).
  • Bone health index standard deviation score (BHI-SDS) showed a weak negative correlation with plasma PTH levels (r = 0.12, p = 0.019).

Conclusions:

  • BoneXpert™ provides an objective and efficient method for bone age assessment in pediatric CKD.
  • Clinicians should be aware of the potential for underestimation of bone age acceleration/retardation with BoneXpert™.
  • Further research is needed to validate the clinical utility of the bone health index (BHI) in pediatric CKD.
Abstract

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