Evidence map›Paper›PMID 41387761›Full record

ArticleScientific reports2025

Predicting biological sex in pediatric skeleton X-rays using artificial intelligence.

Michael Janisch, Mario Scherkl, Nikolaus Stranger, Hesham Elsayed, Georg Singer, Holger Till, Michael Zellner, Franko Hržić, Sebastian Tschauner

Abstract read
In one paragraph

Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Michael JanischDivision of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Auenbruggerplatz 9, 8036, Graz, Styria, Austria.
Mario ScherklDivision of Pediatric Radiology, Department of Radiology, Medical University of Graz, Auenbruggerplatz 34, 8036, Graz, Styria, Austria. mario.scherkl@medunigraz.at.
Nikolaus StrangerDivision of Pediatric Radiology, Department of Radiology, Medical University of Graz, Auenbruggerplatz 34, 8036, Graz, Styria, Austria.
Hesham ElsayedDepartment of Pediatric and Adolescent Surgery, Medical University of Graz, Auenbruggerplatz 34, 8036, Graz, Styria, Austria.
Georg SingerDepartment of Pediatric and Adolescent Surgery, Medical University of Graz, Auenbruggerplatz 34, 8036, Graz, Styria, Austria.
Holger TillDepartment of Pediatric and Adolescent Surgery, Medical University of Graz, Auenbruggerplatz 34, 8036, Graz, Styria, Austria.
Michael ZellnerDepartment of Imaging, University Children's Hospital Zurich, Lenggstrasse 30, 8008, Zurich, Switzerland.
Franko HržićCenter for Artificial Intelligence and Cybersecurity, University of Rijeka, Radmile Matejčić 2, 51000, Rijeka, Primorsko-Goranska, Croatia.
Sebastian TschaunerDivision of Pediatric Radiology, Department of Radiology, Medical University of Graz, Auenbruggerplatz 34, 8036, Graz, Styria, Austria.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Artificial intelligence (AI) is increasingly applied in medical imaging, yet its ability to predict biological sex from pediatric radiographs remains unclear. This study investigates the performance of convolutional neural network (CNN) models in sex classification using a large dataset of pediatric trauma imaging and compares results with human raters. Radiographs from computed and digital radiography systems were processed to normalize grayscale and enhance contrast. The EfficientNet family of CNN models (B0-B7) was trained on this dataset, with attention to balancing the test set by age, sex, and fracture visibility. A subset of 1,000 images was independently assessed by human raters for comparison. AI models achieved a mean precision of 0.731 ± 0.035, recall of 0.718 ± 0.110, accuracy of 0.722 ± 0.032, and F1-score of 0.724 ± 0.050 across all network variants. Performance improved with age, peaking in the 13-18 group. Pelvic X-rays achieved the highest classification metrics. Human raters showed significantly lower agreement. AI can classify biological sex from pediatric radiographs with high accuracy, surpassing human performance. Results vary by age and body region, supporting the potential for AI-assisted imaging in pediatric clinical practice.

Indexed as

Artificial IntelligenceRadiographySex Determination by SkeletonAdolescentChildChild, PreschoolFemaleHumansInfantMaleNeural Networks, ComputerX-RaysArtificial intelligenceChildrenDigital radiographySex

Identifiers

PMID41387761
PMCPMC12728230

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.