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Published in: Pediatric Radiology 9/2019

01-08-2019 | Obesity | Original Article

Bone age determination in eutrophic, overweight and obese Brazilian children and adolescents: a comparison between computerized BoneXpert and Greulich-Pyle methods

Authors: Thiago O. Artioli, Matheus A. Alvares, Vanessa S. Carvalho Macedo, Tatiane S. Silva, Roberto Avritchir, Cristiane Kochi, Carlos A. Longui

Published in: Pediatric Radiology | Issue 9/2019

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Abstract

Background

Bone age determination is usually employed to evaluate growth disorders and their treatment. The Greulich-Pyle method is the simplest and most frequently used type of evaluation, but it presents huge interobserver variability. The BoneXpert is a computer-automated method developed to avoid significant bone age variability among distinct observers.

Objective

To compare the BoneXpert and Greulich-Pyle methods of bone age determination in eutrophic children and adolescents, as well as in overweight and obese pediatric patients.

Materials and methods

The sample comprised 515 participants, 253 boys (159 eutrophic, 53 overweight and 41 obese) and 262 girls (146 eutrophic, 76 overweight and 40 obese). Left hand and wrist radiographs were acquired for bone age determination using both methods.

Results

There was a positive correlation between chronological age and Greulich-Pyle, chronological age and BoneXpert, and Greulich-Pyle and BoneXpert. There was a significant increase (P<0.05) in bone age in both the Greulich-Pyle and BoneXpert methods in obese boys when compared to eutrophic or overweight boys of the same age. In girls, there was an increase in bone age in both obese and overweight individuals when compared to eutrophic girls (P<0.05). The Greulich-Pyle bone age was advanced in comparison to that of BoneXpert in all groups, except in obese boys, in which bone age was similarly advanced in both methods.

Conclusion

The BoneXpert computer-automated bone age determination method showed a significant positive correlation with chronological age and Greulich-Pyle. Furthermore, the impact of being overweight or obese on bone age could be identified by both methods.
Literature
1.
go back to reference Instituto Brasileiro de Geografia e Estatística, IBGE (2010) Pesquisa de Orçamentos familiares 2008–2009: antropometria e estado nutricional de crianças, adolescentes e adultos no Brasil.[Brazilian Institute of Geography and Statistics Report of the Familial Income Anthropometry and Nutritional Status of Children, Adolescents and Adults in Brazil]. Available from http://www.IBGE.gov.br Instituto Brasileiro de Geografia e Estatística, IBGE (2010) Pesquisa de Orçamentos familiares 2008–2009: antropometria e estado nutricional de crianças, adolescentes e adultos no Brasil.[Brazilian Institute of Geography and Statistics Report of the Familial Income Anthropometry and Nutritional Status of Children, Adolescents and Adults in Brazil]. Available from http://​www.​IBGE.​gov.​br
2.
3.
go back to reference Greulich WW, Pyle SI (1959) Radiographic atlas of skeletal development of the hand and wrist, 2nd edn. Stanford University Press, StanfordCrossRef Greulich WW, Pyle SI (1959) Radiographic atlas of skeletal development of the hand and wrist, 2nd edn. Stanford University Press, StanfordCrossRef
4.
go back to reference Sanctis V, Maio S, Soliman A et al (2014) Hand X-ray in pediatric endocrinology: skeletal age assessment and beyond. Indian J Endocrinol Metab 18:S63–S71CrossRefPubMedPubMedCentral Sanctis V, Maio S, Soliman A et al (2014) Hand X-ray in pediatric endocrinology: skeletal age assessment and beyond. Indian J Endocrinol Metab 18:S63–S71CrossRefPubMedPubMedCentral
5.
go back to reference Bull RK, Edwards PD, Kemp PM et al (1999) Bone age assessment: a large scale comparison of the Greulich and Pyle, and Tanner and Whitehouse (TW2) methods. Arch Dis Child 81:172–173CrossRefPubMedPubMedCentral Bull RK, Edwards PD, Kemp PM et al (1999) Bone age assessment: a large scale comparison of the Greulich and Pyle, and Tanner and Whitehouse (TW2) methods. Arch Dis Child 81:172–173CrossRefPubMedPubMedCentral
6.
go back to reference Thodberg HH (2009) Clinical review: an automated method for determination of bone age. J Clin Endocrinol Metab 94:2239–2244CrossRefPubMed Thodberg HH (2009) Clinical review: an automated method for determination of bone age. J Clin Endocrinol Metab 94:2239–2244CrossRefPubMed
7.
go back to reference Mansourvar M, Ismail MA, Herawan T et al (2013) Automated bone age assessment: motivation, taxonomies, and challenges. Comput Math Methods Med 2013:391626CrossRefPubMedPubMedCentral Mansourvar M, Ismail MA, Herawan T et al (2013) Automated bone age assessment: motivation, taxonomies, and challenges. Comput Math Methods Med 2013:391626CrossRefPubMedPubMedCentral
8.
go back to reference Thodberg HH, Kreiborg S, Juul A, Pedersen KD (2009) The BoneXpert method for automated determination of skeletal maturity. IEEE Trans Med Imaging 28:52–66CrossRefPubMed Thodberg HH, Kreiborg S, Juul A, Pedersen KD (2009) The BoneXpert method for automated determination of skeletal maturity. IEEE Trans Med Imaging 28:52–66CrossRefPubMed
10.
go back to reference Thodberg HH, Savendahl L (2010) Validation and reference values of automated bone age determination for four ethnicities. Acad Radiol 17:1425–1432CrossRefPubMed Thodberg HH, Savendahl L (2010) Validation and reference values of automated bone age determination for four ethnicities. Acad Radiol 17:1425–1432CrossRefPubMed
11.
go back to reference Martin DD, Heil K, Heckmann C et al (2013) Validation of automatic bone age determination in children with congenital adrenal hyperplasia. Pediatr Radiol 43:1615–1621CrossRefPubMed Martin DD, Heil K, Heckmann C et al (2013) Validation of automatic bone age determination in children with congenital adrenal hyperplasia. Pediatr Radiol 43:1615–1621CrossRefPubMed
12.
go back to reference Anink J, Nusman CM, van Suijlekom-Smit LW et al (2014) Automated determination of bone age and bone mineral density in patients with juvenile idiopathic arthritis: a feasibility study. Arthritis Res Ther 16:424CrossRefPubMedPubMedCentral Anink J, Nusman CM, van Suijlekom-Smit LW et al (2014) Automated determination of bone age and bone mineral density in patients with juvenile idiopathic arthritis: a feasibility study. Arthritis Res Ther 16:424CrossRefPubMedPubMedCentral
13.
go back to reference Martin DD, Meister K, Schweizer R et al (2011) Validation of automatic bone age rating in children with precocious and early puberty. J Pediatr Endocrinol Metab 24:1009–1014CrossRefPubMed Martin DD, Meister K, Schweizer R et al (2011) Validation of automatic bone age rating in children with precocious and early puberty. J Pediatr Endocrinol Metab 24:1009–1014CrossRefPubMed
14.
go back to reference De Onis M, Onyango AW, Borghi E et al (2007) Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ 85:660–667CrossRefPubMedPubMedCentral De Onis M, Onyango AW, Borghi E et al (2007) Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ 85:660–667CrossRefPubMedPubMedCentral
15.
go back to reference Vandewalle S, Taes Y, Fiers T et al (2014) Sex steroids in relation to sexual and skeletal maturation in obese male adolescents. J Clin Endocrinol Metab 99:2977–2985CrossRefPubMed Vandewalle S, Taes Y, Fiers T et al (2014) Sex steroids in relation to sexual and skeletal maturation in obese male adolescents. J Clin Endocrinol Metab 99:2977–2985CrossRefPubMed
16.
go back to reference de Groot CJ, van den Berg A, Ballieux BEPB et al (2017) Determinants of advanced bone age in childhood obesity. Horm Res Paediatr 87:254–263CrossRefPubMed de Groot CJ, van den Berg A, Ballieux BEPB et al (2017) Determinants of advanced bone age in childhood obesity. Horm Res Paediatr 87:254–263CrossRefPubMed
17.
go back to reference Sopher AB, Jean AM, Zwany SK et al (2011) Bone age advancement in prepubertal children with obesity and premature adrenarche: possible potentiating factors. Obesity (Silver Spring) 19:1259–1264CrossRef Sopher AB, Jean AM, Zwany SK et al (2011) Bone age advancement in prepubertal children with obesity and premature adrenarche: possible potentiating factors. Obesity (Silver Spring) 19:1259–1264CrossRef
18.
go back to reference Kim SE, Jang JW, Ahn MB et al (2017) The association between skeletal maturation and adrenal androgen levels in obese children and adolescents. Ann Pediatr Endocrinol Metab 22:108–114CrossRefPubMedPubMedCentral Kim SE, Jang JW, Ahn MB et al (2017) The association between skeletal maturation and adrenal androgen levels in obese children and adolescents. Ann Pediatr Endocrinol Metab 22:108–114CrossRefPubMedPubMedCentral
19.
go back to reference Martin DD, Wit JM, Hochberg Z et al (2011) The use of bone age in clinical practice - part 1. Horm Res Paediatr 76:1–9CrossRefPubMed Martin DD, Wit JM, Hochberg Z et al (2011) The use of bone age in clinical practice - part 1. Horm Res Paediatr 76:1–9CrossRefPubMed
Metadata
Title
Bone age determination in eutrophic, overweight and obese Brazilian children and adolescents: a comparison between computerized BoneXpert and Greulich-Pyle methods
Authors
Thiago O. Artioli
Matheus A. Alvares
Vanessa S. Carvalho Macedo
Tatiane S. Silva
Roberto Avritchir
Cristiane Kochi
Carlos A. Longui
Publication date
01-08-2019
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Radiology / Issue 9/2019
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-019-04435-z

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