Estimating forensic age via magnetic resonance imaging of the distal radial epiphysis

Application of Vieth staging in forensic age estimation in the living using MRI of the distal radial epiphysis

Forensic age estimation is crucial in various legal and civil contexts, particularly in regions experiencing significant migration and inadequate birth registration systems. This study evaluates the applicability of the Vieth staging system for forensic age estimation in the living using MRI of the distal radial epiphysis. A retrospective analysis was conducted on 620 left wrist MRI scans from individuals aged 9.92 to 29.58 years. The study demonstrated high intra- and inter-observer agreement values (κ = 0.974 and κ = 0.961), confirming the method's reliability. Spearman's rank correlation analysis showed significant positive correlations between age and ossification stage for both sexes. The minimum ages observed for males were 9.92 years at stage 2, 15.00 years at stage 3, 15.00 years at stage 4, 17.00 years at stage 5, and 20.00 years at stage 6. For females, the minimum ages were 10.08 years at stage 2, 12.33 years at stage 3, 14.25 years at stage 4, 16.33 years at stage 5, and 18.42 years at stage 6. The study supports the applicability of the Vieth methodology for forensic age estimation in the living and suggests that MRI could be a non-invasive and potentially effective tool for determining critical age thresholds in forensic contexts. Further research is recommended to refine these methods and explore their applicability across different populations.

Skeletal age estimation of living adolescents and young adults: A pilot study on conventional radiography versus magnetic resonance imaging and staging technique versus atlas method

OBJECTIVE

To compare conventional radiography (CR) and magnetic resonance imaging (MRI) of the left hand/wrist and both clavicles for forensic age estimation of adolescents and young adults.

MATERIALS AND METHODS

CR and MRI were prospectively conducted in 108 healthy Caucasian volunteers (52 males, 56 females) aged 16 to 21 years. Skeletal development was assessed by allocating stages (wrist, clavicles) and atlas standards (hand/wrist). Inter- and intra-observer agreements were quantified using linear weighted Cohen's kappa, and descriptive statistics regarding within-stage/standard age distributions were reported.

RESULTS

Inter- and intra-observer agreements for hand/wrist CR (staging technique: 0.840-0.871 and 0.877-0.897, respectively; atlas method: 0.636-0.947 and 0.853-0.987, respectively) and MRI (staging technique: 0.890-0.932 and 0.897-0.952, respectively; atlas method: 0.854-0.941 and 0.775-0.978, respectively) were rather similar. The CR atlas method was less reproducible than the staging technique. Inter- and intra-observer agreements for clavicle CR (0.590-0.643 and 0.656-0.770, respectively) were lower than those for MRI (0.844-0.852 and 0.866-0.931, respectively). Furthermore, although shifted, wrist CR and MRI within-stage age distribution spread were similar, as were those between staging techniques and atlas methods. The possibility to apply (profound) substages to clavicle MRI rendered a more gradual increase of age distributions with increasing stages, compared to CR.

CONCLUSIONS

For age estimation based on the left hand/wrist and both clavicles, reference data should be considered anatomical structure- and imaging modality-specific. Moreover, CR is adequate for hand/wrist evaluation and a wrist staging technique seems to be more useful than an atlas method. By contrast, MRI is of added value for clavicle evaluation.

Analysis of various radiological age-assessment methods in children, adolescents and young adults regarding the differences between the sexes and sides of the body - A comparative review

A total of 76 articles published within the last twenty years, indexed in the PubMed and ResearchGate databases, were reviewed in order to compare medical imaging-based methods of age estimation of children, adolescents and young adults. The evaluated studies were analyzed for any statistically significant differences between the sexes and sides of the body, sample sizes, and population age. Irrespective of the evaluation method, there were some studies that showed a statistically significant differences in ossification stages between the male and female groups. Most of the studies whose authors conducted a statistical analysis demonstrated no significant differences between the left and right side of the body.

The fusion of ossification centers - A comparative review of radiographic and other imaging modalities of age assessment in living groups of children, adolescents, and young adults

A total of 227 articles published within the last twenty years, indexed in the PUBMED and Researchgate databases, were reviewed for the purpose of comparing medical imaging-based methods of age estimation. The evaluated studies were analyzed in terms of the assessed parts of the body, age, and epiphyseal fusion ages in children, adolescents, and young adults. Our analysis showed that an overwhelming majority of studies had been based on computed tomography and magnetic resonance imaging. A comparison of the studies showed that, irrespective of the imaging modality and the nationality of study population cohorts, the rates of development and the ages at which the process of ossification begins and ends show certain trends.

Magnetic resonance and diffusion tensor imaging of the adolescent rabbit growth plate of the knee

PURPOSE

To assess the ability of MRI-DTI to evaluate growth plate morphology and activity compared with that of histomorphometry and micro-CT in rabbits.

METHODS

The hind limbs of female rabbits aged 16, 20, and 24 wk (n = 4 per age group) were studied using a 9.4T MRI scanner with a multi-gradient echo 3D sequence and DTI in 14 directions (b-value = 984 s/mm² ). After MRI, the right and left hind limb were processed for histological analysis and micro-CT, respectively. The Wilcoxon signed-rank test was used to evaluate the height and volume of the growth plate. Intraclass correlation and Pearson correlation coefficient were used to evaluate the association between DTI metrics and age.

RESULTS

The growth plate height and volume were similar for all modalities at each time point and age. Age was correlated with all tractography and DTI metrics in both the femur and tibia. A correlation was also observed between all the metrics at both sites. Tract number and volume declined with age; however, tract length did not show any changes. The fractional anisotropy color map showed lateral diffusion centrally in the growth plate and perpendicular diffusion in the hypertrophic zone, as verified by histology and micro-CT.

CONCLUSION

MRI-DTI may be useful for evaluating the growth plates.

Forensic age estimation based on magnetic resonance imaging of the proximal humeral epiphysis in Chinese living individuals

Forensic age estimation in living individuals is mainly based on radiological features, but direct radiography and computed tomography lead to a rise in ethical concerns due to radiation exposure. Thus, the contribution of magnetic resonance imaging (MRI) to age estimation of living individuals is a subject of ongoing research. In the current study, MRIs of shoulder were retrospectively collected from a modern Chinese Han population and data from 835 individuals (599 males and 236 females) in the age group 12 to 30 years were obtained. A staging technique based on (Schmidt et al. Int J Legal Med 121(4):321-324, 2007) and (Kellinghaus et al. Int J Legal Med 124(4):321-325, 2010) was used and all images were evaluated with T1-wieghted turbo spin echo (T1-TSE) sequence and T2-weighed fat suppression (T2-FS) sequence. One-sided images were assessed because data from both sides were considered coincidental, as no significant differences were found (P > 0.05). Two MRI sequences were evaluated separately and subsequently compared. Regression models and supportive vector classification (SVC) models were established accordingly. The intraobserver and interobserver agreement levels were good. Compared with T1-TSE sequence, the R² values of T2-FS sequence were generally higher, while the mean absolute deviation (MAD) values were slightly lower. For T2-FS sequence, the MAD value was 1.49 years in males and 2.19 years in females. With two MRI sequences incorporated, the SVC model obtained with 85.7% correctly classified minors and 96.2% correctly classified adults in males, while 83.3% and 98.0% respectively in females. In conclusion, T2-FS sequence may slightly outperform the T1-TSE sequence in shoulder MRI analysis for age estimation, while shoulder MRIs could be a reliable prediction indicator for the 18-year threshold and two MRI sequences incorporated are encouraged.

Ultrasonographic assessment of ossification of the distal radial epiphysis for estimating forensic age

Since forensic age estimation is not a valid medical indication, research on the use of nonionizing methods is increasing. Ultrasonography is a radiological approach that protects patients from radiation exposure and offers special convenience to them. In this study, ultrasonography was used for age estimation by investigating the degree of ossification of the distal radial epiphysis. Its applicability on the Turkish population was investigated. The left wrist of 688 (322 males, 366 females) patients between the ages of 9 and 25 years was prospectively evaluated by ultrasonography. The intra- and interobserver reliabilities in evaluating the distal radial epiphysis and Cohen’s kappa statistics show that the interobserver error was very low, and the kappa value was found to be 0.919. Stage 3 and 4 ossification of the distal radial epiphysis was first detected at age 14.3 and 15.3 years in males and 12.7 and 14.8 years in females, respectively. The data obtained may help determine legally critical age limits of 14 and 15. Although it does not seem useful for the age of 18, ultrasonography may be recommended in selected cases as a fast, inexpensive, frequently reproducible radiological method without concern about radiation and without a predictable health risk.

Forensic age estimation based on fast spin-echo proton density (FSE PD)-weighted MRI of the distal radial epiphysis

Radiation exposure is a crucial factor to consider in forensic age estimation. The various magnetic resonance imaging (MRI) modalities used in forensic age estimation avoid radiation exposure. This study examined the reliability of distal radius ossification using fast spin-echo proton density (FSE PD)–weighted MRI to estimate age. Left wrist MRI findings of 532 patients aged 10–29 years were evaluated retrospectively using the five-stage system of Dedouit et al. The intra- and interobserver reliability values were κ = 0.906 and 0.869, respectively. Based on the results, the respective minimum ages estimated for stages 4 and 5 were 13.4 and 16.1 years for females, and 15.1 and 17.3 years for males; the method could not estimate an age of 18 years in any case. FSE PD MRI analysis of the distal radius epiphysis provides supportive data and can be used when evaluating the distal radius for forensic age estimation.

Bone age estimation with the Greulich-Pyle atlas using 3T MR images of hand and wrist

The age estimation of the hand bones by means of X-ray examination is a pillar of the forensic age estimation. Since the associated radiation exposure is controversial, the search for ionizing radiation-free alternatives such as MRI is part of forensic research. The aim of the current study was to use the Greulich-Pyle (GP) atlas on MR images of the hand and wrist to provide reference values for assessing the age of the hand bones. 3T hand MR images of 238 male participants between the ages of 13 and 21 were acquired using 3D gradient echo sequences (VIBE, DESS). Two readers rated the images using the X-ray-based GP atlas method. A descriptive analysis and a transitional analysis were used for the statistical processing of the data. The agreement between and within the raters was assessed. In addition, a comparison was made with the chronological age and with X-ray studies. The descriptive analysis and the transition analysis showed similar results. Both evaluations showed good agreement with X-ray studies. The comparison with the chronological age showed a difference of 0.37 and 0.54 years for the two readers. The age estimate based on the cross-validated transition analysis showed a mean error of -0.28 years. Inter- and intra-rater agreement were good. In summary, it can be concluded that age estimation of hand bones with MR images is routinely applicable with the GP atlas as an alternative without ionizing radiation. However, in order to reduce the estimation error, a multi-factorial assessment based on examinations of several body regions is still recommended.

Forensic age estimation via magnetic resonance imaging of knee in the Turkish population: use of T1-TSE sequence

The evaluation of epiphyseal areas by magnetic resonance imaging (MRI) for forensic age estimation is an important supportive diagnostic method to prevent repeated radiation exposure without a valid medical reason. There are still not enough individuals being analyzed with MRI for age estimation. The aim of this study was to investigate the utility of T1-weighted turbo spin echo (T1-TSE) MRI sequences in determining the degree of ossification of the distal femoral and proximal tibial epiphyses in a Turkish population. In this study, images from 649 patients (335 males and 314 females) aged 10–30 years were retrospectively evaluated with sagittal T1-weighted turbo spin echo (T1-TSE) MRI sequences of the knee. Proximal tibial and distal femoral epiphysis were scored by two different observers twice using the combined staging system described by Schmeling and Kellinghaus. Spearman’s rank correlation analysis indicated a significant positive relationship between age and ossification stages of the distal femoral and proximal tibial epiphyses (p < 0.001). The intra- and inter-observer reliabilities in evaluating the femur and tibia were separately determined and gave promising results and Cohen’s kappa statistics ranged from κ = 0.886 and κ = 0.961. The minimal ages of patients with stage 4 ossification were 15.1 years for females and 15.8 years for males for the distal tibial epiphysis and 15.4 years for females and 17 years for males for the distal femoral epiphysis. This study show that (T1-TSE) MRI and the applicability and Schmeling and Kellinghaus staging method of the knee can be performed for living 14- to 17-year-old individuals in need of a supportive noninvasive method for estimating forensic age.