BoneXpert, an automated method for analysis of hand radiographs of children, has recently been developed and validated in European children. It determines Tanner-Whitehouse (TW) and Greulich Pyle (GP) bone ages (BA). The purpose of this work is to validate BoneXpert BA in Japanese children and determine the following two properties of the method: (1) The accuracy of the BA, i.e. the standard deviation from an experienced Japanese TW BA rater. (2) The precision of the BA, i.e. BoneXpert’s ability to yield the same BA value on a repeated radiograph. The data consist of two studies: 185 radiographs of 22 normal children followed longitudinally from approximately 7 years to full maturity, and 284 radiographs of 22 patients with growth hormone deficiency treated with growth hormone and gonadotropin-releasing hormone analogue followed from an age of 4–11 years to almost full maturity. All radiographs were rated manually according to the TW-Japan system. BoneXpert processed all images, and the accuracy (SD) of TW-Japan BA was 0.72 years (95% CI 0.68–0.76). The precision error (SD) on a single determination of GP BA was 0.17 years (95% CI 0.15–0.19). It is concluded that BoneXpert performs as well in Japanese children as it does in Caucasian children. This study accomplishes a calibration of BoneXpert to the TW-Japan standard, which performs well for the entire BA range from 4 years up to full maturity.

1.
Tanner JM, Gibbons RD, Bock RD: An image analysis system for TW skeletal maturity. Horm Res 1992;37:11.
2.
Sato K, Ashizawa K, Anzo M, Otsuki F, Kaneko S, Tanaka T, Tsukagoshi K, Nimura A, Matsuok H, Matsuo N: Setting up an automated system for evaluation of bone age. Endocr J 1999;46:S97–S100.
3.
Thodberg HH, Kreiborg S, Juul A, Pedersen KD: The BoneXpert method for automated determination of skeletal maturity. IEEE Trans Med Imaging 2009;28:52–66.
4.
van Rijn RR, Lequin MH, Thodberg HH: Automatic determination of Greulich and Pyle bone age in healthy Dutch children. Pediatr Radiol 2009;39:591–597.
5.
Martin DD, Deusch D, Schweizer R, Thodberg HH, Ranke MB: Validation of automatic Greulich Pyle bone age on GHD, UTS, SGA and Silver Russel syndrome children. Pediatr Radiol 2009;in press.
6.
Greulich WW, Pyle SI: Radiographic Atlas of Skeletal Development of the Hand and Wrist, ed 2. Standford, Stanford University Press, 1959.
7.
Tanner JM, Whitehouse RH, Cameron N, Marshall WA, Healy MJR, Goldstein H: Assessment of Skeletal Maturity and Prediction of Adult Height. New York, Academic Press, 1983.
8.
Tanner JM, Healy MJR, Goldstein H, Cameron N: Assessment of skeletal maturity and prediction of adult height (TW3 Method). London, Saunders, 2001.
9.
Murata M: Japanese specific bone age standard on the TW2. Clin Pediatr Endocrinol 1993;2:35–41.
10.
Tanner JM, Oshman D, Lindgren G, Grunbaum JA, Elouki R, Labarthe D: Reliability and validity of computer-assisted estimates of Tanner-Whitehouse skeletal maturity (CASAS): comparison with the manual method. Horm Res 1994;42:288–294.
11.
Bull RK, Edwards PD, Kemp PM, Fry S, Hughes IA: Bone age assessment: a large scale comparison of the Greulich and Pyle, and Tanner and Whitehouse (TW2) methods. R Coll Paediatr 1999:172–173.
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