BoneXpert has been licensed to several major children's hospitals in Italy, culminating with the sales to the largest children's hospital in Europe Ospedale Pediatrico Bambino Gesù in Rome, run by the Vatican City. The number of sites having purchased a license to BoneXpert is now 135.

Professor Bram van Ginneken gave a great talk at ECR 2018 about the role of AI in radiology – watch the video here

There is a lot of talk about how artificial intelligence will affect radiology, but not much about the AI systems already in use.

It is therefore timely that Radboud University and EuSoMII are organising a Hands-on AI Day in Nijmegen on April 21, 2018.

Nine AI-products, including BoneXpert, are selected for presentation and practical use.

There are now 100 hospitals using BoneXpert for at least 100 analyses per year.

Some of the new sites are

  • Hôpital universitaire des enfants Reine Fabiola (HUDERF), Bruxelles, BE
  • Alder Hey Children’s NHS Foundation Trust, Liverpool, UK (depicted above)
  • John Radcliffe Hospital, Oxford, UK
  • University Hospital Prague-Motol, CZ
  • CHU Vaudois, Lausanne, CH

We welcome you to visit the BoneXpert stand at the following three conferences in September 2017:

  • PES: Pediatric Endocrine Society Annual Meeting, 13-17 September, Washington DC, USA
  • GPR: Jahrestagung der Gesellschaftfür Pädiatrische Radiologie, 21-23 September, Stuttgart, Germany
  • SFIPP: Congrès de la Société Francophone d'Imagerie Pédiatrique et Périnatale, 22-23 September, Liège, Belgium 

Prof Dr med Oskar Jenni of University of Zurich with expertise in developmental psychology, and PhD Hans Henrik Thodberg, developer of BoneXpert, will give a joint, interdisciplinary talk: Age estimation at the end of puberty: From a hand radiograph or from mental/psychological assessment

Visiana has moved 8 km north to new and larger offices in Scion DTU Science and Technology Park, Agern Allé 24, 2970 Hørsholm. 


Visiana is happy to welcome Sud Kannan as Director of Software Development. Previously he worked in Bangalore as Senior software engineer in AON, Dell and NTT Data.

BoneXpert has been introduced in four new countries through sales to the following hospitals

  • Great Ormond Street Hospital, London, England
  • CHU Toulouse, France 
  • Istituto Giannina Gaslini, Genova, Italy
  • Regency Hospital, Kanpur, India

Two new papers report the use of BoneXpert to assess rheumatoid and psoriatic arthritis. They exploit the recent extension of BoneXpert's measurement of cortical thickness in the metacarpals to adults.

The upcoming release of BoneXpert version 2.4 (version, released Dec 28) extends the Greulich-Pyle bone age range up to 19 years for boys and 18 years for girls. Previous versions were less reliable in the bone age range 17-19 for boys and 15-18 for girls. The validation of this extension is reported in the International Journal of Legal Medicine.

Wilhelm Conrad Röntgen’s first public presentation of the new X-rays took place on the 23rd of January 1896 in Würzburg. 

The Swiss anatomist Albert von Kölliker volunteered to have his hand X-rayed during the lecture, and the resulting image has now been analysed with a new version of BoneXpert, presented in the Archives of Osteoporosis

The number of hospitals having purchased a license to BoneXpert and doing at least 100 analyses per year has risen to 60.

Pediatric Radiology has published a paper on validation of adult height prediction (AHP) in the Paris longitudinal study of children born 1953-58. 

The Paris study was one of the five famous studies conducted in the 1950s under the coordination of the International Children’s Centre, situated in Paris. The other studies were in Zurich, Stockholm, Brussels and London. The Zurich study of 231 normal children was used to design the BoneXpert AHP model, and the fact that the method has now been validated on a sister study is very satisfactory.

The BoneXpert adult height predictor, based on the 2009 JCEM article, has been extended, so that it now plots the entire predicted growth path in a growth chart. It also predicts the age of peak height velocity. Click here to try it.

Visiana is happy to welcome Peter Thrane as Director of Sales and Marketing from August 17. Peter holds a MSc in Biomedicine from University of Copenhagen and an MBA in Bio-Entrepreneurship from Copenhagen Business School, and he has 3 years of experience in biotech sales and marketing.

Prof. Dr. David Martin will talk about The BoneXpert methods for fully automated assessment of skeletal maturity (bone age) and adult height prediction BoneXpert in the session  New technological aids in clinical pediatric endocrinology on Sep. 18 at ESPE in Dublin (16:00-16:30 in Liffey Hall 2)

 Thirty-two hospitals have now purchased a license to BoneXpert, a doubling since November 2012. This number refers to “larger clinics” doing at least 200 analyses per year. Nineteen of these are in Scandinavia, which amounts to more than 2/3 of the larger clinics in this region.

Three publications have appeared on BoneXpert in 2013.

ACTA Radiology’s November 2013 issue is devoted to invited articles on pediatric radiology and features a review entitled “Bone age assessment: automated techniques coming of age?”. It lists and discusses the requirements that such techniques must meet, and gives an overview of the validation studies performed on BoneXpert, addressing the three aspects: precision, accuracy, and validation through adult height prediction.

Pediatric Radiology reports a large validation study in Congenital Adrenal Hyperplasia.

ISRN Radiology presents a validation study on 6022 normal children from five large Chinese cities 

At the International Conference on Children's Bone Health (ICCBH) June 22-25, Thodberg will present a study of the secular trend of the Bone Health Index (BHI), and at the ESPE conference Sep 19-22, Dr. David Martin will present a new model for predicting adult height of black children.

The talk at ICCBH in Rotterdam, entitled “Bone Health Index: Swiss children have less in the bank than a generation ago”, exploits the unique opportunity in using hand X-rays to compare the bone health in two generations of Swiss children, one born in 1955 and the other on average 29 years later. While the adult height and the speed of maturation show no secular trend, BHI is found to decrease by 1.5%.


Hormone Research in Pædiatrics brings a new article on prediction of adult height of short children using manual methods and BoneXpert.

Adult height prediction methods are conventionally developed to be valid for normal children. It is then hoped that the method is also accurate for children outside the normal range, as long as these are non-pathological and untreated. From a clinical perspective, the most important such patient group is apparently healthy children with short stature. When they present in the clinic, it is common routine to perform a bone age assessment and predict the adult height as a first step in the work up, but the use of manual bone age rating and the classical Bayley Pinneau (BP) method is not optimal. The paper shows that for the short children, the BoneXpert method is indeed significantly better.

The 190 subjects born between 1970 and 1990 were seen in the Tubingen clinic, but never treated. These children have idiopathic short stature in the broad sense, including familial short stature and constitutional delay of growth and puberty. The paper compares four approaches to bone age (BA) assessment and adult height prediction (AHP), here listed in order of accuracy in these children:

  • Manual BA + Bayley Pinneau AHP
  • Manual BA + BoneXpert AHP
  • BoneXpert BA + BoneXpert AHP
  • BoneXpert BA + BoneXpert AHP including parental height

The adoption of the BoneXpert method can thus make this important diagnostic procedure more efficient and reliable. A reference to the paper is found on this page.


The BoneXpert Server version has been well received in Europe due to its ideal integration in the radiologists' workflow.

The key step in the installation is to establish a contact between Visiana and the local PACS administrator, who then downloads the program, installs it on a local machine, and configures it, whereafter it runs as a DICOM node, i.e. as an integral part of PACS. The image processing is done locally, and the counting of the analyses over the internet.


AnnHumBiolThe validation of BoneXpert is extended by three new publications:

  1. Annals of Human Biology describes the standarisation of Tanner Whitehouse bone age in BoneXpert
  2. Journal of Pediatric Endocrinology and Metabolism brings a validation of BoneXpert in children with precocious puberty
  3. Handbook of Growth features a review of adult height prediction models, reporting also a new validation study


Visiana presented the BoneXpert product at the meeting of the European Society for Pediatric Endocrinology (ESPE) in Prague 21-25 Sep. More than 100 delegates received a demonstration of the BoneXpert Windows program and registered for a free trial of 5 analyses. For those who missed this opportunity, there is the possibility to register on this website on the page "How to get started", and the BoneXpert pdf brochure is available here:  BoneXpert-Brochure.pdf   .

The BoneXpert bone age method has been validated in a study of healthy American children of four ethnicities in a paper published by the American journal Academic Radiology, thereby bringing the total number of peer-reviewed papers on BoneXpert up to ten. 

Lars Bo Klitgaard joins Visiana as Director of Development on June 1. Lars holds a MSc. Eng. from Technical University of Denmark and has 15 years of experience as an expert and as a manager in the field of medical software development.

Hormone Research in Paediatrics has published three papers on BoneXpert online.

The first paper verifies the bone age method in Japanese children and determines the precision to be 0.17 years (this is the SD on a single determination of bone age, including the effect of recording a new X-ray). These longitudinal Japanese data are well suited to this analysis, because they were taken at very short intervals, every 6 months.

The paediatrician Dr. David Martin (36) of the Children’s University Hospital in Tübingen received the Jürgen Bierich Prize of 5,000 Euros of the German Society of Endocrinology at the APE/SPED meeting in Kiel in November


 Osteoporosis International has published a paper on a new pediatric bone index in BoneXpert (also known as the Bone Health Index, BHI). The full text of the paper is freely avaliable as a pdfRead More

Please visit us at booth 1018 to get a demonstration and to register for a free trial

Caution: In USA, BoneXpert has the status of an investigational device, i.e. it is not for clinical use 

The Journal of Clinical Endocrinology and Metabolisms, the official journal The Endocrine Society, has published a succinct clinical review of the BoneXpert method for automated bone age determination (abstract) including an account on previous work on computerised methods. This review is a good starting point for getting acquainted with the new technology

JCEM has published an article on our new method for adult height prediction based on BoneXpert bone age: full paper 

The new method is available as a calculator at this site and it is also built into the BoneXpert bone age computer program.   

The United States Patent and Trademark Office has granted Patent No US 7,848,893 entitled "Method for skeletal maturity determination" to Hans Henrik Thodberg.