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Thicot F, Egger C, Castiglioni C, Magnin V, Boudabbous S, Angelakopoulos N, Grabherr S, Genet P. Forensic age estimation at the University Center of Legal Medicine Lausanne-Geneva: a retrospective study over 12 years. Int J Legal Med 2024:10.1007/s00414-024-03254-8. [PMID: 38740629 DOI: 10.1007/s00414-024-03254-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 05/06/2024] [Indexed: 05/16/2024]
Abstract
With the undeniable increase in asylum requests from unaccompanied alleged minors, age estimation of living individuals has become an essential part of the routine work in European forensic centers. This study aims to review the forensic age estimations performed in our center since 2010, to evaluate the state-of-the-art of this practice in Switzerland with the evolution of the methodology according to upcoming recommendations. Our institute's expert reports performed between 2010 and 2022 were retrospectively analyzed. We gathered the following parameters: demographic data, morphological characteristics, alleged age compared with the assessed minimum age, sexual maturation, dental and bone age. When available, we collected personal and family history, medical history, records of torture-related/self-inflicted injuries, and information about eating habits that might affect skeletal development. Data collection amounted to 656 cases. Forensic age estimations ordered by the Swiss Secretariat for Migration (SEM) represented 76.4% of cases, with 23.6% of them ordered by the Court/Public Prosecutor. Most alleged minors were male (94.5%) and came from Afghanistan (53.4%). Adjunction of CT scans of the sternoclavicular joints was necessary in 86.4% of cases. Only 25.2% of our reports concluded on most probable minority, with 55.6% of definite majors; in 19.2% of our cases, minority could not be excluded. This study aspires to further broaden our expertise regarding forensic age estimations. Given the increasing migratory flows, we can expect a notable increase in the frequency of these requests. Consequently, this study aims to promote a multidisciplinary approach and the international standardization of the methodology of these estimations.
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Affiliation(s)
- Frederique Thicot
- Unit of Forensic Medicine, University Center of Legal Medicine Lausanne-Geneva (CURML), Geneva University Hospitals and University of Geneva, Rue Michel-Servet 1, 1211, Geneva 4, Switzerland.
| | - Coraline Egger
- Unit of Forensic Medicine, University Center of Legal Medicine Lausanne-Geneva (CURML), Geneva University Hospitals and University of Geneva, Rue Michel-Servet 1, 1211, Geneva 4, Switzerland
| | - Claudia Castiglioni
- Unit of Forensic Medicine, University Centre of Legal Medicine Lausanne-Geneva, Lausanne University Hospital and University of Lausanne, Chemin de La Vulliette 4, 1000, Lausanne 25, Switzerland
| | - Virginie Magnin
- Unit of Forensic Medicine, University Centre of Legal Medicine Lausanne-Geneva, Lausanne University Hospital and University of Lausanne, Chemin de La Vulliette 4, 1000, Lausanne 25, Switzerland
| | - Sana Boudabbous
- Radiology Division, Diagnostic Department, Geneva University Hospitals (HUG), Geneva, Switzerland
| | - Nikolaos Angelakopoulos
- Unit of Forensic Medicine, University Centre of Legal Medicine Lausanne-Geneva, Lausanne University Hospital and University of Lausanne, Chemin de La Vulliette 4, 1000, Lausanne 25, Switzerland
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland
| | - Silke Grabherr
- Unit of Forensic Medicine, University Center of Legal Medicine Lausanne-Geneva (CURML), Geneva University Hospitals and University of Geneva, Rue Michel-Servet 1, 1211, Geneva 4, Switzerland
- Unit of Forensic Medicine, University Centre of Legal Medicine Lausanne-Geneva, Lausanne University Hospital and University of Lausanne, Chemin de La Vulliette 4, 1000, Lausanne 25, Switzerland
| | - Pia Genet
- Unit of Forensic Medicine, University Centre of Legal Medicine Lausanne-Geneva, Lausanne University Hospital and University of Lausanne, Chemin de La Vulliette 4, 1000, Lausanne 25, Switzerland
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2
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Madentzoglou MS, Nathena D, Traithepchanapai P, Karantanas A, Kontakis G, Kranioti EF. Age estimation based on the metamorphosis of the clavicle end: A test of Falys and Prangle method in two contemporary samples. Leg Med (Tokyo) 2024; 67:102331. [PMID: 37838583 DOI: 10.1016/j.legalmed.2023.102331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 09/06/2023] [Accepted: 10/01/2023] [Indexed: 10/16/2023]
Abstract
Upon finding skeletal unidentified remains, four are the questions that must be answered: age, sex, ancestry, and stature. Regarding age estimation, clavicle has received special attention because medial epiphysis is the last epiphysis, among long bones that ossifies. Falys and Prangle proposed a method of age estimation based on three degenerative characteristics-surface topography (TOP), Porosity (POR) and Osteophyte formation (OST)-evaluated on the sternal end of the clavicle according to the descriptions and the illustrations provided in the original article producing satisfactory results. The current study aims to test the applicability of the Falys' and Prangle's method on 174 individuals from two contemporary samples, one from Greece (Cretan osteological Collection and Athens Forensic Anthropology Lab collection) and one from Thailand (Osteological collection in Chiang Mai). Composite scores were calculated, inter and intra- observer error were estimated by kappa statistics and regression equations of the original study were tested in our sample and in subsamples divided by sex and population. The Greek sample gave more accurate estimates compared to the Thai sample. Regressions of known sex gave slightly better results in most cases. When individuals <40 years old were excluded, classification increased for both Thai and Greeks. The results of this pilot study indicate that there are morphological features on the clavicle that are highly correlated with age. Thus, there is a scope of expanding research on the morphological features of the collar bone.
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Affiliation(s)
- M S Madentzoglou
- Department of Forensic Sciences, Faculty of Medicine, University of Crete, Greece.
| | - D Nathena
- Department of Forensic Sciences, Faculty of Medicine, University of Crete, Greece
| | | | - A Karantanas
- Department of Medical Imaging, University Hospital of Heraklion, Heraklion, Greece; Advanced Hybrid Imaging Systems, Institute of Computer Science, Foundation for Research and Technology (FORTH), Heraklion, Greece; Department of Radiology, School of Medicine, University of Crete, Heraklion, Greece
| | - G Kontakis
- Department of Orthopaedics and Traumatology, University Hospital of Heraklion, Crete, Greece
| | - E F Kranioti
- Department of Forensic Sciences, Faculty of Medicine, University of Crete, Greece
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Reder SR, Fritzen I, Brockmann MA, Hardt J, Elsner K, Petrowski K, Bjelopavlovic M. Comparing a common clavicle maturation-based age estimation method to ordinary regression analyses with quadratic and sex-specific interaction terms in adolescents. Sci Rep 2024; 14:2754. [PMID: 38307929 PMCID: PMC10837444 DOI: 10.1038/s41598-024-52980-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/25/2024] [Indexed: 02/04/2024] Open
Abstract
Established methods of age estimation are based on correlating defined maturation stages of bony structures with tables representing the observed range of biological ages in the majority of cases. In this retrospective monocentric study in southwestern Germany, common age estimation methodology was assessed in n = 198 subjects at the age of 25 or younger by analyzing the influence of age, quadratic age, biological sex and age-sex interaction on the ossification stages of the medial epiphysis fugue. Three readers (ICC ≥ 0.81 for left/right side) evaluated routine care computed tomography images of the clavicle with a slice thickness of 1 mm. By using least square regression analyses, to determine the real biological age a quadratic function was determined corrected for the age estimated by established methods and sex (R2 = 0.6 each side), reducing the mean absolute error and root mean squared error in the age estimation of women (2.57 and 3.19) and men (2.57 and 3.47) to 1.54 and 1.82 for women, and 1.54 and 2.25 for men. In women, the medial clavicle epiphysis seem to fuse faster, which was particularly observable from approximately 18 years of age. Before that age, the estimation method was relatively close to the ideal correlation between assessed and real age. To conclude, the presented new method enables more precise age estimation in individuals and facilitates the determination and quantification of additional variables, quantifying their influence on the maturation of the medial clavicle epiphysis based on the established ossification stages.
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Affiliation(s)
- Sebastian R Reder
- Department of Neuroradiology, University Medical Center, Johannes Gutenberg-University of Mainz, 55131, Mainz, Germany.
| | - Isabel Fritzen
- Department of Prosthetic Dentistry, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Marc A Brockmann
- Department of Neuroradiology, University Medical Center, Johannes Gutenberg-University of Mainz, 55131, Mainz, Germany
| | - Jochen Hardt
- Department of Medical Psychology and Medical Sociology, University Medical Center of the Johannes Gutenberg-University Mainz, Duesbergweg 6, 55131, Mainz, Germany
| | - Katrin Elsner
- Institute of Legal Medicine, University Medical Center of the Johannes Gutenberg-University of Mainz, Am Pulverturm 9, 55131, Mainz, Germany
| | - Katja Petrowski
- Department of Medical Psychology and Medical Sociology, University Medical Center of the Johannes Gutenberg-University Mainz, Duesbergweg 6, 55131, Mainz, Germany
| | - Monika Bjelopavlovic
- Department of Prosthetic Dentistry, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131, Mainz, Germany
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Ruder TD, Kuhnen SC, Zech WD, Klaus JB, Lombardo P, Ith M. Standards of practice in forensic age estimation with CT of the medial clavicular epiphysis-a systematic review. Int J Legal Med 2023; 137:1757-1766. [PMID: 37691040 PMCID: PMC10567934 DOI: 10.1007/s00414-023-03061-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 07/08/2023] [Indexed: 09/12/2023]
Abstract
The AGFAD (Arbeitsgemeinschaft für Forensische Alterdiagnostik, Study Group on Forensic Age Diagnostics) has published several recommendations regarding both technical aspects of computed tomography (CT) of the medial clavicular epiphysis (MCE) and the process of reading and interpreting the CT images for forensic age estimations (FAE). There are, however, no published recommendations regarding CT scan protocols and no dose reference values for CT of the MCE. The objective of this analysis was to assess adherence to AGFAD recommendations among practitioners of FAE and analyse reported dose-relevant CT scan parameters with the objective of helping to establish evidence-based dose reference values for FAE. A systematic literature search was conducted in PubMed and in Google Scholar with specific MeSH terms to identify original research articles on FAE with CT of the MCE from 1997 to 2022. A total of 48 studies were included. Adherence to AGFAD recommendations among practitioners of FAE is high regarding the use of Schmeling main stages (93%), bone window (79%), ≤ 1 mm CT slices (67%), axial/coronal CT images (65%), and Kellinghaus sub-stages (59%). The reporting of CT technique and CT dose-relevant scan parameters is heterogeneous and often incomplete in the current literature. Considering the success achieved by the AGFAD in creating standards of practice of FAE in living subjects, there is potential for the AGFAD to establish standards for radiation protection in FAE as well.
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Affiliation(s)
- Thomas D Ruder
- Institute of Diagnostic, Interventional and Pediatric Radiology, InselspitaI, Bern University Hospital, University of Bern, Freiburgstrasse, CH-3010, Bern, Switzerland.
| | - Saskia C Kuhnen
- Institute of Diagnostic, Interventional and Pediatric Radiology, InselspitaI, Bern University Hospital, University of Bern, Freiburgstrasse, CH-3010, Bern, Switzerland
| | - Wolf-Dieter Zech
- Institute of Forensic Medicine, University of Bern, Bern, Switzerland
| | - Jeremias B Klaus
- Institute of Diagnostic, Interventional and Pediatric Radiology, InselspitaI, Bern University Hospital, University of Bern, Freiburgstrasse, CH-3010, Bern, Switzerland
- Institute of Forensic Medicine, University of Bern, Bern, Switzerland
- Roentgen Institute Thun, Thun, Switzerland
| | - Paolo Lombardo
- Institute of Diagnostic, Interventional and Pediatric Radiology, InselspitaI, Bern University Hospital, University of Bern, Freiburgstrasse, CH-3010, Bern, Switzerland
| | - Michael Ith
- Institute of Diagnostic, Interventional and Pediatric Radiology, InselspitaI, Bern University Hospital, University of Bern, Freiburgstrasse, CH-3010, Bern, Switzerland
- Radiation Protection, Image Processing Systems & Radiological Processes, Hirslanden Private Hospital Group, Zurich, Switzerland
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Bjelopavlovic M, Reder SR, Fritzen I, Brockmann MA, Hardt J, Petrowski K. Forensic Age Estimation: A Multifactorial Approach in a Retrospective Population Study. Diagnostics (Basel) 2023; 13:2029. [PMID: 37370924 DOI: 10.3390/diagnostics13122029] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 05/30/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023] Open
Abstract
Objectives: The objective of this study was to evaluate the accuracy of forensic age estimation in a German population by combining clavicle and wisdom teeth assessments based on cone beam computed tomography (CT) data. The study aimed to determine the reliability of this approach in predicting biological age. Material and Methods: A total of 161 CT data sets from 120 males and 41 females with known exact ages were evaluated by three raters. The clavicle was assessed according to stages 1-5 (including substages 2a-c and 3a-c), and the Demirjian stage's classification method was used for the wisdom teeth. Inter-class correlation (ICC) was calculated to assess the agreement among the three raters. Additionally, ordinary least square regressions were performed to predict chronological age using the clavicle or one of the four teeth. Finally, age prediction models using multiple indicators were developed. Results: The ICCs ranged from 0.82 for the clavicle to 0.86 and 0.88 for the wisdom teeth. Linear estimation tended to overestimate chronological age, especially in subjects over 18 years old. The clavicle showed the strongest overestimation. Combining age estimation from the clavicle with the upper and lower wisdom teeth improved the predictive power, resulting in a 14% and 15% increase in R² for the upper and lower wisdom teeth, respectively. Adding more than one tooth to the prediction did not improve the predictive power (all ΔR² < 1%). Conclusions: Age estimation using CT can be significantly improved by combining information from the analysis of wisdom teeth with age estimation based on the clavicle.
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Affiliation(s)
- Monika Bjelopavlovic
- Department of Prosthetic Dentistry, University Medical Center, Johannes Gutenberg University Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Sebastian R Reder
- Department of Neuroradiology, University Medical Center, Johannes Gutenberg University Mainz, 55131 Mainz, Germany
| | - Isabel Fritzen
- Department of Prosthetic Dentistry, University Medical Center, Johannes Gutenberg University Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Marc A Brockmann
- Department of Neuroradiology, University Medical Center, Johannes Gutenberg University Mainz, 55131 Mainz, Germany
| | - Jochen Hardt
- Department of Medical Psychology and Medical Sociology, University Medical Center, Johannes Gutenberg University Mainz, Duesbergweg 6, 55131 Mainz, Germany
| | - Katja Petrowski
- Department of Medical Psychology and Medical Sociology, University Medical Center, Johannes Gutenberg University Mainz, Duesbergweg 6, 55131 Mainz, Germany
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Has B, Gurses MS, Altinsoy HB. Evaluation of distal femoral and proximal tibial epiphyseal plate in bone age estimation with 3.0T MRI: a comparison of current methods. Br J Radiol 2023; 96:20220561. [PMID: 36606509 PMCID: PMC9975374 DOI: 10.1259/bjr.20220561] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 11/28/2022] [Accepted: 12/04/2022] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE Dedouit et al, Kramer et al and Vieth et al defined different staging methods over different sequences in knee MRI for bone age determination. Our study aims to examine three different methods in which the maturation stages of the knee epiphyses are evaluated by MRI in the same population, to compare the methods and results and evaluate them for some age thresholds and to discuss their applicability in forensic age estimation. METHODS In this study, 597 knee images obtained using a 3.0T MR scanner were evaluated retrospectively. The T 1 weighted and proton density-weighted sequences were evaluated by two observers. Knee bone development was staged on the femur and tibia, and descriptive statistics were calculated for each stage according to age and sex. Descriptive statistics were presented according to the age and sex of the cases, and intra- and interobserver agreements were evaluated by the κ and κw statistics obtained by the Fleiss approach. RESULTS Significant changes were found in stages depending on age. The intra- and interobserver agreement levels were very good (κ > 0.80) for each method. The methods of Dedouit, Kramer and Vieth can be used as an additional criteria for forensic age estimation for 14, 15, 18 and 21 year thresholds. CONCLUSION Knee MRI stands out as an alternative modality for age estimation and it is necessary to prefer the method intended for the investigated age range with an individual-specific approach. ADVANCES IN KNOWLEDGE Our study stands out as the first study in which current classification methods were applied and compared in the same population for age estimation with knee MRI.
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Affiliation(s)
- Busra Has
- Department of Radiology, Nevsehir State Hospital, Nevsehir, Turkey
| | | | - Hasan Baki Altinsoy
- Department of Radiology, Faculty of Medicine, Duzce University, Duzce, Turkey
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Applicability of proximal humeral epiphysis ossification for forensic age estimation according to the Vieth method: a 3.0 T MRI study. Rechtsmedizin (Berl) 2021. [DOI: 10.1007/s00194-021-00459-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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De Tobel J, van Wijk M, Alberink I, Hillewig E, Phlypo I, van Rijn RR, Thevissen PW, Verstraete KL, de Haas MB. The influence of motion artefacts on magnetic resonance imaging of the clavicles for age estimation. Int J Legal Med 2020; 134:753-768. [PMID: 31915965 DOI: 10.1007/s00414-019-02230-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE To determine how motion affects stage allocation to the clavicle's sternal end on MRI. MATERIALS AND METHODS Eighteen volunteers (9 females, 9 males) between 14 and 30 years old were prospectively scanned with 3-T MRI. One resting-state scan was followed by five intentional motion scans. Additionally, a control group of 72 resting-state scans were selected from previous research. Firstly, six observers allocated developmental stages to the clavicles independently. Secondly, they re-assessed the images, allocating developmental statuses (immature, mature). Finally, the resting-state scans of the 18 volunteers were assessed in consensus to decide on the "correct" stage/status. Results were compared between groups (control, prospective resting state, prospective motion), and between staging techniques (stages/statuses). RESULTS Inter-observer agreement was low (Krippendorff α 0.23-0.67). The proportion of correctly allocated stages (64%) was lower than correctly allocated statuses (83%). Overall, intentional motion resulted in fewer assessable images and less images of sufficient evidential value. The proportion of correctly allocated stages did not differ between resting-state (64%) and motion scans (65%), while correctly allocated statuses were more prevalent in resting-state scans (83% versus 77%). Remarkably, motion scans did not render a systematically higher or lower stage/status, compared to the consensus. CONCLUSION Intentional motion impedes clavicle MRI for age estimation. Still, in case of obvious disturbances, the forensic expert will consider the MRI unsuitable as evidence. Thus, the development of the clavicle as such and the staging technique seem to play a more important role in allocating a faulty stage for age estimation.
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Affiliation(s)
- Jannick De Tobel
- Department of Diagnostic Sciences - Radiology, Ghent University, Ghent, Belgium. .,Department of Imaging and Pathology - Forensic Odontology, KU Leuven, Leuven, Belgium. .,Department of Oral Diseases and Maxillofacial Surgery, Maastricht UMC+, Maastricht, The Netherlands. .,Department of Oral and Maxillofacial Surgery, Leuven University Hospitals, Leuven, Belgium.
| | - Mayonne van Wijk
- Division of Special Services and Expertise, Section of Forensic Anthropology, Netherlands Forensic Institute, The Hague, The Netherlands
| | - Ivo Alberink
- Division of Special Services and Expertise, Section of Forensic Anthropology, Netherlands Forensic Institute, The Hague, The Netherlands
| | - Elke Hillewig
- Department of Diagnostic Sciences - Radiology, Ghent University, Ghent, Belgium
| | - Inès Phlypo
- Department of Oral Health Sciences - Special Needs in Dentistry, Ghent University, Ghent, Belgium
| | - Rick R van Rijn
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | | | | | - Michiel Bart de Haas
- Division of Special Services and Expertise, Section of Forensic Anthropology, Netherlands Forensic Institute, The Hague, The Netherlands
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Shedge R, Kanchan T, Garg PK, Dixit SG, Warrier V, Khera P, Krishan K. Computed tomographic analysis of medial clavicular epiphyseal fusion for age estimation in Indian population. Leg Med (Tokyo) 2020; 46:101735. [DOI: 10.1016/j.legalmed.2020.101735] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 05/26/2020] [Accepted: 06/03/2020] [Indexed: 11/28/2022]
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Altinsoy HB, Gurses MS, Bogan M, Unlu NE. Applicability of 3.0 T MRI images in the estimation of full age based on shoulder joint ossification: Single-centre study. Leg Med (Tokyo) 2020; 47:101767. [PMID: 32736165 DOI: 10.1016/j.legalmed.2020.101767] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 07/13/2020] [Accepted: 07/20/2020] [Indexed: 11/18/2022]
Abstract
Skeletal maturity is evaluated by many radiological methods for forensic age estimation. Direct radiography and computed tomography lead to a rise in ethical concerns due to radiation exposure. Therefore, magnetic resonance imaging (MRI) has currently been used in recent studies. In this study, the ossification stage of the shoulder joint was determined retrospectively in 178 male and 109 female individuals in the age group 12 to 30 years using 3.0 T MRI. All the images were evaluated with T1-weighted turbo spin echo (T1 TSE) sequence and T1 fast low angle shot two-dimensional sequence (T1 FL2D). The combined staging method, which was defined by Kellinghaus et al. and Schmeling et al., was used. The intra- and inter-observer agreement levels were very good (κ and κw). There were no significant age differences between males and females in all stages. In most of the stages, the ossification of the proximal humeral epiphyses occurred earlier in females than in males. Stage 4 did not occur in either of the sexes before the 18th birthday as the youngest patients in this stage was at 19 and 18 years of age in males and females, respectively. We concluded that evaluating the ossification of the proximal humeral epiphysis with MRI imaging for forensic age estimation may be beneficial. Evaluating the same anatomical structure with different MRI sequences may be useful for accurate staging diagnosis.
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Affiliation(s)
- Hasan Baki Altinsoy
- Department of Radiology, Faculty of Medicine, Duzce University, Duzce, Turkey
| | - Murat Serdar Gurses
- Department of Forensic Medicine, Faculty of Medicine, Sakarya University, Sakarya, Turkey.
| | - Mustafa Bogan
- Department of Emergency Medicine, Faculty of Medicine, Duzce University, Duzce, Turkey
| | - Nisa Elif Unlu
- Department of Radiology, Faculty of Medicine, Duzce University, Duzce, Turkey
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Cekdemir YE, Mutlu U, Karaman G, Balci A. Estimation of sex using morphometric measurements performed on cranial computerized tomography scans. Radiol Med 2020; 126:306-315. [PMID: 32533549 DOI: 10.1007/s11547-020-01233-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 05/25/2020] [Indexed: 11/30/2022]
Abstract
We aimed to evaluate the usefulness of morphometric measurements performed on cranial computerized tomography (CT) images for the estimation of sex. A retrospective study was performed in the radiology department of a tertiary care center using data collected from cranial CT scans of 616 Caucasian cases (307 women, 309 men) with an average age of 44.70 ± 16.43. The parameters under investigation consisted of maximum cranial length (MCL), minimum frontal breadth, bi-zygomatic breadth (BZB), parietal chord, maximum cranial breadth, bi-mastoid diameter (BIM) and the length of cranial base. Any statistically significant difference in terms of these parameters was found between males and females. In our series, women were remarkably older than men (47.56 ± 15.87 vs. 41.39 ± 16.43; p < 0.001). We observed that there was a statistically significant difference between males and females concerning all morphometric measurements and males displayed higher values in terms of all parameters (p < 0.001, for all). The variables with the most successful performance for discrimination of gender were BZB (89.2%), MCL (87.4%) and BIM (84.8%). The concomitant use of these morphometric measurements seems to improve the accuracy of sex estimation. We suggest that morphometric measurements performed on cranial CT images can be useful for the estimation of sex.
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Affiliation(s)
- Yasin Ertug Cekdemir
- Department of Radiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey.
| | - Uygar Mutlu
- Department of Radiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Gokce Karaman
- Department of Forensic Medicine, Council of Forensic Medicine, Manisa, Turkey
| | - Ali Balci
- Department of Radiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
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Gurses MS, Altinsoy HB. Evaluation of distal femoral epiphysis and proximal tibial epiphysis ossification using the Vieth method in living individuals: applicability in the estimation of forensic age. AUST J FORENSIC SCI 2020. [DOI: 10.1080/00450618.2020.1743357] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Murat Serdar Gurses
- The Council of Forensic Medicine of the Ministry of Justice, Bursa Group Chairmanship, Bursa, Turkey
| | - Hasan Baki Altinsoy
- Department of Radiology, Faculty of Medicine, Duzce University, Duzce, Turkey
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13
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Guo YC, Wang YH, Olze A, Schmidt S, Schulz R, Pfeiffer H, Chen T, Schmeling A. Dental age estimation based on the radiographic visibility of the periodontal ligament in the lower third molars: application of a new stage classification. Int J Legal Med 2019; 134:369-374. [PMID: 31664523 DOI: 10.1007/s00414-019-02178-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 10/07/2019] [Indexed: 10/25/2022]
Abstract
The purpose of the present study was to test whether a new stage classification based on radiographic visibility of the periodontal ligament in lower third molars in a Chinese population can be used for the 18- and 21-year thresholds. A total of 1300 orthopantomograms, including equal numbers of northern Chinese males and females evenly distributed between the ages of 15 and 40 years, were analyzed. The stages were defined according to the visibility of periodontal ligament for the outer parts of lower third molar roots because the visibility status of the periodontal ligament between the roots of lower third molars is none valuable in many Chinese individuals. Stage 0 was first achieved at the age of 17.05 years in males and 17.46 years in females. The earliest appearance of stage 1 was 17.47 years in males and 17.86 years in females. Stage 2 was first observed in males at the age of 21.43 years and in females at the age of 21.96 years. The onset of stage 3 was first observed at the age of 25.83 years in males and 23.14 years in females. Compared with the stage classification of Olze et al., which also considers the mesial parts of the roots, the number of assessable cases could be significantly increased. Therefore, our novel approach is effective for age estimation in the Chinese population.
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Affiliation(s)
- Yu-Cheng Guo
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, 98 XiWu Road, Xi'an, 710004, Shaanxi, People's Republic of China.,Department of Orthodontics, Stomatological Hospital of Xi'an Jiaotong University, 98 XiWu Road, Xi'an, 710004, Shaanxi, People's Republic of China.,Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany
| | - Ya-Hui Wang
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai, 200063, People's Republic of China
| | - Andreas Olze
- Institute of Legal Medicine, Charité-Universitätsmedizin Berlin, Turmstraße 21, 10559, Berlin, Germany
| | - Sven Schmidt
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany
| | - Ronald Schulz
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany
| | - Heidi Pfeiffer
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany
| | - Teng Chen
- College of Medicine and Forensics, Xi'an Jiaotong University Health Science Center, 76 West Yanta Road, Xi'an, 710004, Shaanxi, People's Republic of China.
| | - Andreas Schmeling
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany
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14
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Mustafa A, Abusamra H, Kanaan N, Alsalem M, Allouh M, Kalbouneh H. Morphometric study of the facial skeleton in Jordanians: A computed tomography scan-based study. Forensic Sci Int 2019; 302:109916. [PMID: 31426020 DOI: 10.1016/j.forsciint.2019.109916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 03/11/2019] [Accepted: 03/14/2019] [Indexed: 11/25/2022]
Abstract
Several studies have shown variability in osteometric measurements of the skull between populations. Therefore, each population should have specific standards to optimize the accuracy of identification. The aim of this study was to evaluate the sexual dimorphism in metric relations between anatomical points of the skull using CT scans in a Jordanian population by means of discriminant function analysis, to determine which continuous variables discriminate between sexes, and to examine the craniofacial changes according to age. 500 CT scans (240 males and 260 females) were used and a total of 11 craniofacial parameters were studied. The data were analyzed using distriminant function analysis. Sexual dimorphism was found mainly in the young adult group. Significant age related changes were noticed in minimum frontal breadth, orbital height and orbital index. In all subjects, the analysis of multivariate (dimorphic variables) and stepwise functions gave an accuracy of 58.8% and 57.0% respectively. Using stepwise analysis, the most dimorphic variables to estimate sex were maximum frontal breadth, bimaxillary breadth and orbital index. The multivariate analysis of all variables gave an accuracy of 58.8%. The percentages of correct sexing in Jordanian population were high using the single variable analysis in females only. In females, classification accuracies of 70.4% using bimaxillary breadth, 70.0% using the orbital index, and 68.1% using maximum frontal breadth were obtained. Additionally, discriminant analysis was conducted separately for each age group. Higher percentages of correct sexing were obtained only in young adults. The results of the discriminant function analysis did not appear to be significant. The results of discriminant function were insignificant in middle aged and elderly groups. Being female and young increases the percentages of correct sexing. Generally, low levels of accuracy of sexual dimorphism were obtained in our study, suggesting that population estimates of dimorphism are highly variable and the equations derived from the discriminant function analysis are not reliable in sex estimation in Jordanians.
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Affiliation(s)
| | | | | | - Mohammad Alsalem
- Faculty of Medicine, The University of Jordan, Amman, 11942, Jordan.
| | | | - Heba Kalbouneh
- Faculty of Medicine, The University of Jordan, Amman, 11942, Jordan.
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15
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Anatomic shape variants of extremitas sternalis claviculae as collected from sternoclavicular thin-slice CT-studies of 2820 male borderline-adults. Int J Legal Med 2019; 133:1517-1528. [PMID: 31104134 DOI: 10.1007/s00414-019-02065-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 04/05/2019] [Indexed: 10/26/2022]
Abstract
Within medical age assessment practice, the indicator "medial clavicular ossification" constitutes crucial evidence capable of excluding age minority "beyond reasonable doubt" concerning age-disputed individuals doubtfully claiming children's rights during legal procedures. Yet, one of its characteristics affects the morphological variability including a fair amount of downright peculiar appearances. As a result, inexperienced examiners are tempted to classify actually not-assessable formations according to the two established developmental typologies of Schmeling et al. and Kellinghaus et al. being at the same time the most frequent systemic error of age-related clavicular taxation. Since a respective overview appears missing, the study extracts not-assessable shape variants of the medial collar bone from a large sample of 2820 male borderline-adults as seen from thin-slice, sternoclavicular computed tomography. The two already highlighted configurations "more than one, medial, secondary ossification centres" and "medial metaphyseal concavity" are found as the most commonly encountered features impeding reliable delineation of staging criteria. In accordance with previous literature, it is emphasized that "qualified" rating of extremitas sternalis claviculae within age assessment practice presupposes "knowledge about the diversity of [its] anatomic shape variants."
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16
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Torimitsu S, Makino Y, Saitoh H, Ishii N, Inokuchi G, Motomura A, Chiba F, Yamaguchi R, Hoshioka Y, Urabe S, Iwase H. Age estimation based on maturation of the medial clavicular epiphysis in a Japanese population using multidetector computed tomography. Leg Med (Tokyo) 2019; 37:28-32. [DOI: 10.1016/j.legalmed.2018.12.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 12/12/2018] [Accepted: 12/22/2018] [Indexed: 10/27/2022]
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17
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Altinsoy HB, Alatas O, Gurses MS, Turkmen Inanir N. Forensic age estimation in living individuals by 1.5T magnetic resonance imaging of the knee: a retrospective MRI study. AUST J FORENSIC SCI 2018. [DOI: 10.1080/00450618.2018.1545868] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Hasan Baki Altinsoy
- Department of Radiology, Faculty of Medicine, Duzce University, Duzce, Turkey
| | - Ozkan Alatas
- Department of Radiology, The Health Sciences University, Elazıg Research and Education Hospital, Elazıg, Turkey
| | - Murat Serdar Gurses
- The Council of Forensic Medicine of the Ministry of Justice, Bursa Group Chairmanship, Bursa, Turkey
| | - Nursel Turkmen Inanir
- Department of Forensic Medicine, Faculty of Medicine, Uludag University, Bursa, Turkey
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18
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Hermetet C, Saint-Martin P, Gambier A, Ribier L, Sautenet B, Rérolle C. Forensic age estimation using computed tomography of the medial clavicular epiphysis: a systematic review. Int J Legal Med 2018; 132:1415-1425. [DOI: 10.1007/s00414-018-1847-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 04/09/2018] [Indexed: 02/03/2023]
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19
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Rudolf E, Kramer J, Schmidt S, Vieth V, Winkler I, Schmeling A. Intraindividual incongruences of medially ossifying clavicles in borderline adults as seen from thin-slice CT studies of 2595 male persons. Int J Legal Med 2017; 132:629-636. [PMID: 28944440 DOI: 10.1007/s00414-017-1694-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 09/19/2017] [Indexed: 11/25/2022]
Abstract
In the past, numerous studies have documented the possibility of intraindividual differing appearances of the paired age-marker "medial clavicular ossification" in borderline adults. However, the extent of the divergences is rarely mentioned. Against that the article describes this phenomenon from a large sample of 2595 male persons by means of thin-slice CT imaging of the sternoclavicular regions. For determining the ossification stage of the medial clavicles, the two accepted classifications by Schmeling et al. (five main stages) and Kellinghaus et al. (six substages) were applied and buildings deviating from that labelled as atypical "norm variants". The longstanding observation could be confirmed that intraindividual stage discrepancies of this age indicator are generally moderate and do not exceed one main stage or two substages of the respective classifications. It is concluded that stage determination should be scrutinized, if a dissimilarity seems to show larger differences.
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Affiliation(s)
- Ernst Rudolf
- , Wiesenstr. 20, 4800, Attnang-Puchheim, Austria.
| | - Josef Kramer
- Institute for CT and MRT Diagnostics, Rainerstr. 6-8, 4020, Linz, Austria
| | - Sven Schmidt
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany
| | - Volker Vieth
- Department of Clinical Radiology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany.,Clinic for Radiology, Klinikum Ibbenbüren, Große Straße 41, 49477, Ibbenbüren, Germany
| | | | - Andreas Schmeling
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany
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20
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Scharte P, Vieth V, Schulz R, Ramsthaler F, Püschel K, Bajanowski T, Pfeiffer H, Schmeling A, Schmidt S, Wittschieber D. Comparison of imaging planes during CT-based evaluation of clavicular ossification: a multi-center study. Int J Legal Med 2017; 131:1391-1397. [PMID: 28608146 DOI: 10.1007/s00414-017-1615-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 05/23/2017] [Indexed: 11/26/2022]
Abstract
Determining the ossification stage of the medial clavicular epiphysis by computed tomography represents the currently recommended methodology for the question of whether a living individual has completed the 18th or 21st year of life. In the present study, thin-slice CT scans of 1078 sternoclavicular joints were reconstructed in axial and coronal image series and evaluated according to the two classification systems established for age diagnostics using the clavicle. Both image series (axial and coronal) were analyzed separately. When comparing the results of axial and coronal view, a different ossification stage was found in 35.6% of the clavicles. The results suggest an influence of the imaging plane on the process of stage determination. In order to further approximate the three-dimensional and asymmetrical structure of the epiphyseal ossification center, the usage of at least two different reformation types may be recommended. In practice, only those reference studies should be applied which exactly employed the same number and orientations of the reformation types that are going to be used in the respective routine case.
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Affiliation(s)
- Philipp Scharte
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany
| | - Volker Vieth
- Institute of Clinical Radiology, University Hospital Münster, Münster, Germany
- Clinic of Radiology, Ibbenbüren Hospital, Ibbenbüren, Germany
| | - Ronald Schulz
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany
| | - Frank Ramsthaler
- Institute of Legal Medicine, University of the Saarland, Homburg, Saar, Germany
- Institute of Legal Medicine, University Hospital Frankfurt/Main, Frankfurt/Main, Germany
| | - Klaus Püschel
- Institute of Legal Medicine, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Thomas Bajanowski
- Institute of Legal Medicine, University Hospital Essen, Essen, Germany
| | - Heidi Pfeiffer
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany
| | - Andreas Schmeling
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany
| | - Sven Schmidt
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany
- Institute of Legal Medicine, Charité University Hospital, Berlin, Germany
| | - Daniel Wittschieber
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany.
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