Forensic age estimation based on fast spin-echo proton density (FSE PD)-weighted MRI 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.

Bone age assessment based on different MRI modalities of the proximal humerus epiphysis: the comparisons of T1WI, T2WI, and PDWI

Bone age assessment (BAA) is crucial in various fields, including legal proceedings, athletic competitions, and clinical medicine. However, the use of X-ray methods for age estimation without medical indication is subject to ethical debate, especially in forensic and athletic fields. The application of magnetic resonance imaging (MRI) with non-ionizing radiation can overcome this limitation in BAA. This study aimed to compare the application value of several MRI modalities of proximal humeral in BAA. A total of 468 patients with shoulder MRIs were retrospectively collected from a Chinese Han population aged 12-30 years (259 males and 209 females) for training and testing, including T1 weighted MRI (T1WI), T2 weighted MRI (T2WI), and Proton density weighted MRI (PDWI). Optimal regression models were established for age estimation, yielding mean absolute error (MAE) values below 2.0 years. The MAE values of T1WI were the lowest, with 1.700 years in males and 1.798 years in females. The area under the curve (AUC) and accuracy values of different MRI modalities of 16-year and 18-year thresholds were all around 0.9. For the 18-year threshold, T1WI outperformed T2WI and PDWI. In conclusion, the three MRI modalities of the proximal humerus can serve as reliable indicators for age assessment, while the T1WI performed better in age assessment and classification.

Demystifying the Radiography of Age Estimation in Criminal Jurisprudence: A Pictorial Review

Skeletal radiographs along with dental examination are frequently used for age estimation in medicolegal cases where documentary evidence pertaining to age is not available. Wrist and hand radiographs are the most common skeletal radiograph considered for age estimation. Other parts imaged are elbow, shoulder, knee, and hip according to suspected age categories. Age estimation by wrist radiographs is usually done by the Tanner-Whitehouse method where the maturity level of each bone is categorized into stages and a final total score is calculated that is then transformed into the bone age. Careful assessment and interpretation at multiple joints are needed to minimize the error and categorize into age-group. In this article, we aimed to summarize a suitable radiographic examination and interpretation for bone age estimation in living children, adolescents, young adults, and adults for medicolegal purposes.

Specialist learning curves and clinical feasibility of introducing a new MRI grading system for skeletal maturity

Objective

MRI is an emerging imaging modality to assess skeletal maturity. This study aimed to chart the learning curves of paediatric radiologists when using an unfamiliar MRI grading system of skeletal maturity and to assess the clinical feasibility of implementing said system.

Methods

958 healthy paediatric volunteers were prospectively included in a dual-facility study. Each subject underwent a conventional MRI scan at 1.5 T. To perform the image reading, the participants were grouped into five subsets (subsets 1-5) of equal size (n∼192) in chronological order for scan acquisition. Two paediatric radiologists (R1-2) with different levels of MRI experience, both of whom were previously unfamiliar with the study's MRI grading system, independently evaluated the subsets to assess skeletal maturity in five different growth plate locations. Congruent cases at blinded reading established the consensus reading. For discrepant cases, the consensus reading was obtained through an unblinded reading by a third paediatric radiologist (R3), also unfamiliar with the MRI grading system. Further, R1 performed a second blinded image reading for all included subjects with a memory wash-out of 180 days. Weighted Cohen kappa was used to assess interreader reliability (R1 vs consensus; R2 vs consensus) at non-cumulative and cumulative time points, as well as interreader (R1 vs R2) and intrareader (R1 vs R1) reliability at non-cumulative time points.

Results

Mean weighted Cohen kappa values for each pair of blinded readers compared to consensus reading (interreader reliability, R1-2 vs consensus) were ≥0.85, showing a strong to almost perfect interreader agreement at both non-cumulative and cumulative time points and in all growth plate locations. Weighted Cohen kappa values for interreader (R1 vs R2) and intrareader reliability (R1 vs R1) were ≥0.72 at non-cumulative time points, with values ≥0.82 at subset 5.

Conclusions

Paediatric radiologists' clinical confidence when introduced to a new MRI grading system for skeletal maturity was high from the outset of their learning curve, despite the radiologists' varying levels of work experience with MRI assessment. The MRI grading system for skeletal maturity investigated in this study is a robust clinical method when used by paediatric radiologists and can be used in clinical practice.

Advances in knowledge

Radiologists with fellowship training in paediatric radiology experienced no learning curve progress when introduced to a new MRI grading system for skeletal maturity and achieved desirable agreement from the first time point of the learning curve. The robustness of the investigated MRI grading system was not affected by the earlier different levels of MRI experience among the readers.

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.

Cartilage Tissue in Forensic Science—State of the Art and Future Research Directions

Cartilage tissue performs many functions in the human body. The diseases and injuries affecting it are prevalent due to its slow regeneration rate. However, cartilage tissue is exceptionally important for its auspicious use in forensic medicine due to its slow postmortem degradation rate. The presented review summarizes the latest research on cartilage tissues and their current and potential applications in forensic science. It also describes the most important studies on using cartilage and its microscopic and macroscopic analyses to estimate the deceased age and determine postmortem interval (PMI) values and the crime weapon. Additionally, the review describes attempts to isolate DNA from cartilage tissue for individual identification. The review also mentions recent, less abundant studies on the cartilage in forensic toxicology and genetics. It points out further directions and prospects for research development on cartilage tissue and its promising use in forensic medicine

Stereotactic Surgery of Parkinson’s Disease with Magnetic Resonance Imaging under Three-Dimensional Mark Point Positioning Algorithm

This research aimed to study the application of magnetic resonance imaging (MRI) under three-dimensional mark point positioning algorithm in stereotactic surgery for Parkinson's disease (PD) and improve clinical treatment effect. Eighty patients with PD in Tianjin Medical University General Hospital were selected as the research objects and randomly divided into two groups. The three-dimensional mark point positioning algorithm was applied to perform feature positioning on the MRI images of PD patients, and the international unified Parkinson's disease rating scale (UPDRS) was assessed before and after single-target surgery of the two groups. There was a significant difference in the postoperative treatment effect between the two groups compared with the preoperative one (P < 0.05). Among the patients in the observation group, 37 cases were marked as markedly effective, accounting for 92.5% of the total group; 1 case was ineffective and 2 cases were improved, accounting for 2.5% and 5%, respectively. In the control group, 35, 2, and 3 cases were assessed as markedly effective, ineffective, and improved, accounting for 87.5%, 5%, and 7.5%, respectively. The overall curative effect of the observation group was better than that of the control group, and the difference was significant (P < 0.05). The MRI manifestations of PD patients were diversified. MRI under the three-dimensional mark point positioning algorithm had a high value for the stereotactic treatment of PD patients, which was beneficial to the clinical surgery.