Objectives:

To date, AI-supported programs for bone age (BA) determination for medical use in Europe have almost only been validated separately, according to Greulich and Pyle (G&P). Therefore, the current study aimed to compare the performance of three programs, namely BoneXpert, PANDA, and BoneView, on a single Central European population.

Methods:

For this retrospective study, hand radiographs of 306 children aged 1–18 years, stratified by gender and age, were included. A subgroup consisting of the age group accounting for 90% of examinations in clinical practice was formed. The G&P BA was estimated by three human experts—as ground truth—and three AI-supported programs. The mean absolute deviation, the root mean squared error (RMSE), and dropouts by the AI were calculated.

Results:

The correlation between all programs and the ground truth was prominent (R2 ≥ 0.98). In the total group, BoneXpert had a lower RMSE than BoneView and PANDA (0.62 vs. 0.65 and 0.75 years) with a dropout rate of 2.3%, 20.3% and 0%, respectively. In the subgroup, there was less difference in RMSE (0.66 vs. 0.68 and 0.65 years, max. 4% dropouts). The standard deviation between the AI readers was lower than that between the human readers (0.54 vs. 0.62 years, p < 0.01).

Conclusion:

All three AI programs predict BA after G&P in the main age range with similar high reliability. Differences arise at the boundaries of childhood.