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Updated: Aug 1, 2026
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
AI-powered automated X-ray bone age analyzer for assisting bone age assessment in Chinese children and adolescents:
Yan Liang1,2, Xiumin Wang3, Xiao Bo Chen4
1Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Abstract:
This study aims to validate the auxiliary effect of a commercially available AI-powered X-ray bone age analyzer for physicians and to evaluate its impact on the accuracy, consistency, and time efficiency of bone age assessment in Chinese children and adolescents. We conducted a multicenter, prospective study involving 1000 children aged 1 to 18 years across five centers in China. Radiographs were independently assessed for TW3-RUS and TW3-Carpal bone age by five physicians-three juniors and two seniors-both without and with AI assistance. An additional AI group was included, relying solely on the AI analyzer. With AI assistance, the mean absolute error for TW3-RUS ranged from 0.34 to 0.49 for different raters, while for TW3-Carpal, it ranged from 0.32 to 0.46. The mean squared error was between 0.20 and 0.40 for TW3-RUS and between 0.18 and 0.36 for TW3-Carpal. The accuracy varied from 88.20 to 96.80% for TW3-RUS and from 90.60 to 97.20% for TW3-Carpal. Intraclass correlation coefficients exceeded 0.98 for both TW3-RUS and TW3-Carpal. For both the TW3-RUS and TW3-Carpal methods, junior raters exhibited statistically reduced error and increased accuracy with AI assistance (all P < 0.0001). The assistance of AI was also found to significantly benefit senior raters in specific age groups. Evaluation time was also significantly reduced with AI assistance (all P < 0.0001).
Conclusion:
Incorporating AI into BAA enhances accuracy and consistency, especially for junior raters, while reducing evaluation time. Senior raters also benefit in specific age groups.
What Is Known:
• Bone age assessment (BAA) is crucial for diagnosing and monitoring endocrine and growth disorders in children, traditionally relying on manual interpretation of radiographs, which is time-consuming and subject to variability.
What Is New:
• The incorporation of an AI-powered X-ray bone age analyzer significantly enhances the accuracy and consistency of BAA in Chinese children and adolescents, particularly benefiting junior raters while reducing evaluation time.
