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DE Pediatric Bone Age and Developmental Assessment

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DE Radiological evaluation of bone age from x-rays of the left hand is the diagnostic standard for physicians looking to assess pediatric growth disorders.

While assessing bone age, radiologists use the Greulich & Pyle method and must do a manual comparison of digital radiographs from patients with reference images in an atlas, a time-consuming task with a high level of inter-rater variability.


IB LabPANDA™ provides a swift automated method to estimate bone age according to Greulich & Pyle in a standardized form to facilitate the monitoring of child growth and development.



5 radiological findings, measurements, and results including:

  • Pediatric bone age according to Greulich & Pyle,
  • Natural standard deviation,
  • Delayed/advanced bone age patient status,
  • Growth potential and height estimation according to Bayley&Pinneau


  •  Saves time: less than 5 seconds for calculating the pediatric bone age according to Greulich & Pyle
  • Enhances the consistency in reading and reporting of hand radiographs for bone age and height estimation
  • Facilitates monitoring and forecasting of physicians’ therapeutic success


Intended use:

The estimation of pediatric bone age according to the Greulich & Pyle method on hand radiographs of children aged between36 months and 192 months (girls) or 204 months (boys). The software should not be used in lieu of full patient evaluation or solely relied upon to make or confirm a diagnosis. The system is to be used by trained professionals including, but not limited to, radiologists, pediatricians, and endocrinologists.

The IBLab PANDA™ software is intended to be used on juvenile humans aged between36 months and 192 months (female) or 204 months (male) for the determination of bone age.

Training & Validation:

Trained on over 12,000 hand radiographs from two institutions in the US (Lucile Packard Children’s Hospital at StanfordUniversity and Children’s Hospital Colorado). 3

IB LabPANDA™ uses an ensemble of decision models to report bone age based on the Greulich & Pyle atlas.

The standard deviation for a given chronological age is determined by rounding down to the next age in the Brushtable for the appropriate sex. 6

  1. D. G. King, D. M. Steventon, M. P. O’Sullivan, A. M. Cook, V. P. L. Hornsby, I.G. Jefferson, and P. R. King: Reproducibility of bone ages when performed byradiology registrars: an audit of Tanner and Whitehouse II versus Greulich andPyle methods, The British Institute of Radiology, 2014.
  2. S.Serinellia, V.Panettab, P. Pasqualettib, D. Marchetti: Accuracy of three agedetermination X-ray methods on the left hand-wrist: A systematic review andmeta-analysis, Legal Medicine, 2011.
  3. Halabi, S. S., Prevedello, L. M., Kalpathy-Cramer, J., Mamonov, A. B., Bilbily,A., Cicero, M., … Flanders, A. E.: The RSNA Pediatric Bone Age Machine LearningChallenge, Radiology, 290(2), 2018. 498–503.
  4. Gaskin, C. M., Kahn, S. L., Bertozzi, J. C., & Bunch, P. M.: SkeletalDevelopment of the Hand and Wrist. Oxford University Press, 2011.
  5. IB Lab Clinical Evaluation Study
  6. Simmons K, Greulich WW. 1944. The Brush Foundation Study of Child Growth andDevelopment: II. Physical Growth and Development. Monogr. Soc. Res. Child Dev.9(1):i–87.

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