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Are Automated and Visual Greulich and Pyle-Based Methods Applicable to Caucasian European Children With a Moroccan
Grammatina Boitsios1, Alessandro De Leucio1, Marco Preziosi1
1Radiology, Queen Fabiola Children's University Hospital, Brussels, BEL.
Insights
Bone age assessment using the Greulich and Pyle (GP) method is accurate for healthy European children of Moroccan origin. Both visual and automated methods, including BoneXpert®, show reliable results, confirming their confident use in this population.
Area of Science:
- Pediatric Endocrinology
- Radiology
- Anthropometry
Background:
- The Greulich and Pyle (GP) method is a standard for bone age assessment.
- Validation of existing methods in diverse ethnic groups is crucial for accurate clinical application.
Purpose of the Study:
- To evaluate the accuracy of visual and automated bone age assessment using the GP method.
- To compare these methods in healthy Caucasian European children of Moroccan origin versus a European Caucasian control group.
Main Methods:
- Retrospective analysis of 423 radiographs from children aged 2-15 years.
- Visual assessment by a blinded radiologist using the GP atlas.
- Automated assessment using BoneXpert® software.
- Statistical analysis included intraclass correlation coefficient (ICC) and Bland-Altman plots.
Main Results:
- Both visual and automated GP methods showed strong correlation with chronological age in all groups (ICC > 0.95 for most comparisons).
- Excellent agreement was observed between visual and automated methods, particularly in Moroccan boys before puberty.
- The GP method demonstrated reliable accuracy across both ethnic groups.
Conclusions:
- The Greulich and Pyle (GP) method, both visually and automated, is accurate for bone age assessment in healthy Caucasian European children of Moroccan origin.
- These methods can be confidently applied to this specific pediatric population.
- The findings support the use of established bone age assessment tools across diverse ethnic backgrounds.
Abstract:
Introduction To test the accuracy of the visual and automated bone age assessment base on the Greulich and Pyle (GP) method in healthy Caucasian European children with a Moroccan ethnic origin. Material and methods Moroccan Caucasian (MC) children were retrospectively and consecutively enrolled along with age- and sex-matched control group (CG) of European Caucasian (EC) children enrolled from the general population. The two groups included 423 children aged from 2 to 15 years with a normal left-hand radiograph performed to rule out a trauma between March 2008 and December 2017. One radiologist, blinded to the BoneXpert® (Visiana, Holte, Denmark) estimates, visually reviewed the radiographs using the GP atlas. The BoneXpert® automatically analysed all 423 radiographs. The intraclass correlation coefficient (ICC), linear regression and Bland-Altman plots were performed to describe the agreement between each method and the chronological age (CA) and the agreement between the two methods. Results Visual bone age assessment was related to the CA in both girls (MC ICC 0.97; EC ICC 0.97) and boys (MC ICC 0.95; EC ICC 0.96). Automated bone age assessment was related to the CA in both girls (MC ICC 0.97; EC ICC 0.96) and boys (MC ICC 0.88; EC ICC 0.96). Bland-Altman plots showed an excellent agreement between the two methods in both sexes and ethnicities before puberty especially in Moroccan boys. Conclusion Visual and automatic bone age assessment based on the GP method, previously validated in the general population of Caucasian European children, can be confidently used in healthy Caucasian European children with a Moroccan ethnic origin.
