RESUMEN
Resumen: Objetivo: Determinar el grado de correlación en la valoración de la edad ósea radiológica mediante el método de Greulich y Pyle versus la evaluación automatizada por el programa computacional BoneXpert® entre los años 2013-2016. Material y Método: Estudio de correlación de técnicas diag nósticas de 1500 radiografías de carpo para evaluar la edad ósea, en pacientes menores de 16 años pertenecientes a Clínica Alemana de Santiago. Las radiografías con evaluación de la edad ósea por el Atlas de Greulich y Pyle (GP) por 1 de 7 radiólogos pediatras fueron sometidas al programa BoneX pert (BE) para la evaluación automatizada de la edad ósea. Se tomó 100 casos al azar para un análisis/ re-análisis del método BE, para conocer su precisión. Se analizó el nivel de correlación de las medicio nes por coeficiente de correlación (r de Pearson) y la variabilidad de las mediciones mediante análisis de Bland-Altman. Resultados: Se incluyeron 1.493 casos, se excluyeron 7 por falla en técnica de la radiografía, 922 de sexo femenino (61.8%), mediana de edad cronológica 9.96 años y 11.12 años para los varones (p 0,001). La correlación entre la edad ósea manual GP y la edad ósea automatizada BE entre los lectores varió entre 0,91 y 0,93. El análisis de Bland-Altman indicó una diferencia promedio entre la edad ósea manual y la edad ósea BE de 0,19 años (IC 0,13 a 0,25). En el análisis/re-análisis de 100 casos al azar mediante BoneXpert, la correlación fue de 1,0. Conclusión: El análisis automatizado mediante BoneXpert permite una evaluación estandarizada, de baja variabilidad, y alta concordancia.
Abstract: Objective: To determine the degree of correlation in the radiological bone age assessment using the Greulich and Pyle method versus automated assessment through BoneXpert® software between 2013 and 2016. Material and Method: Correlation study of diagnostic techniques of 1500 carpal X-rays to assess bone age in patients under 16 years of age from Clínica Alemana de Santiago. X-rays with bone age assessment using the Atlas of Greulich and Pyle (GP) by 1 out of 7 pediatric radiologists, were analyzed using the BoneXpert (BE) software for automated bone age assessment. 100 cases were taken at random for analysis/re-analysis using the BoneXpert method to determine its accuracy. The level of correlation of the measurements was analyzed using the correlation coefficient (Pearson's r) and the variability of the measurements using the Bland-Altman analysis. Results: 1493 cases were assessed, seven were excluded due to failure in the X-ray technique, 922 females (61.8%), with a median chronological age of 9.96 years and 11.12 years for males (p 0.001). The correlation between manual bone age (GP) and automated bone age using BoneXpert method among radiologists ran ged from 0.91 to 0.93. The Bland-Altman analysis indicated an average difference between manual bone age and bone age using the BoneXpert method of 0.19 years (CI 0.13 to 0.25). In the analysis/ re-analysis of 100 random cases using the BoneXpert software, the correlation was 1.00 (100% accu racy). Conclusion: The automated analysis using BoneXpert allows for standardized, low-variability, and high-concordance assessment.
Asunto(s)
Humanos , Masculino , Femenino , Lactante , Preescolar , Niño , Adolescente , Programas Informáticos , Determinación de la Edad por el Esqueleto/métodos , Interpretación de Imagen Radiográfica Asistida por Computador , Radiografía , Estudios RetrospectivosRESUMEN
Objective To explore the application of the automatic bone age assessment of BoneXpert software in Children and adolescent of China (Shanghai).Methods Left hand and wrist radiographs of 434 cases of children from trauma (264 boys and 170 girls) were obtained from Jan.2010 to Dec.2013.Bone age was assessed by BoneXpert software and 40 radiographs were randomly chosen and re-evaluated after a week.Results Seven images were rejected by BoneXpert,so the efficiency of the software was 98.4％ and it takes only 14.5 s for every image.Sample assessments by two times are exactly the same.As to BoneXpert software,there were statistical differences between bone age and chronological age in 8 groups:7,8,9,11 years old boys and 2,3,9,11 years old girls(P ＜ 0.05) out of 26 groups,and the average difference was about 1 s.The following modifications suggested that 0.57,0.79,0.93,-0.38 and-0.22,0.30,0.37,0.59 years could be added respectively for the groups of boys aged 7,8,9,11 and girls aged 2,3,9,11 years old according to their average differences between the bone age and the chronological age.Conclusions The BoneXpert method for automated determination of skeletal maturity which evaluates bone age objectively and quickly can be applied clinically after slight adjustment in some age groups.BoneXpert software is 100 percent automatic and could eliminate the subjective evaluation inaccuracy.