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Rahbani D, Fliss B, Ebert LC, Bjelopavlovic M. Detecting missing teeth on PMCT using statistical shape modeling. Forensic Sci Med Pathol 2024; 20:23-31. [PMID: 36892806 PMCID: PMC10944413 DOI: 10.1007/s12024-023-00590-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2023] [Indexed: 03/10/2023]
Abstract
The identification of teeth in 3D medical images can be a first step for victim identification from scant remains, for comparison of ante- and postmortem images or for other forensic investigations. We evaluate the performance of a tooth detection approach on mandibles with missing parts or pathologies based on statistical shape models. The proposed approach relies on a shape model that has been built from the full lower jaw, including the mandible and teeth. The model is fitted to the target, resulting in a reconstruction, in addition to a label map that indicates the presence or absence of teeth. We evaluate the accuracy of the proposed solution on a dataset consisting of 76 target mandibles, all extracted from CT images and exhibiting various cases of missing teeth or other cases, such as roots, implants, first dentition, and gap closure. We show an accuracy of approximately 90% on the front teeth (including incisors and canines in our study) that decreases for the molars due to high false-positive rates at the wisdom teeth level. Despite the drop in performance, the proposed approach can be used to obtain an estimate of the tooth count without wisdom teeth, tooth identification, reconstruction of the existing teeth to automate measurements taken as part of routine forensic procedures, or prediction of the missing teeth shape. In comparison to other approaches, our solution relies solely on shape information. This means it can be applied to cases obtained from either medical images or 3D scans because it does not depend on the imaging modality intensities. Another novelty is that the proposed solution avoids heuristics for the separation of teeth or for fitting individual tooth models. The solution is therefore not target-specific and can be directly applied to detect missing parts in other target organs using a shape model of the new target.
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Affiliation(s)
- Dana Rahbani
- Graphics and Vision Research Group (GraVis), University of Basel, Basel, Switzerland
| | - Barbara Fliss
- Institute of Forensic Medicine, University Hospital of Mainz, Mainz, Germany
| | - Lars Christian Ebert
- 3D Center Zurich, Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - Monika Bjelopavlovic
- Department of Prosthodontics and Materials Science, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany.
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Paret C, Ustjanzew A, Ersali S, Seidmann L, Jennemann R, Ziegler N, Malki KE, Russo A, Wingerter A, Ortmüller F, Bornas A, Wehling PC, Lepădatu A, Ottenhausen M, Roth W, Sommer C, Fliss B, Frauenknecht KBM, Sandhoff R, Faber J. GD2 Expression in Medulloblastoma and Neuroblastoma for Personalized Immunotherapy: A Matter of Subtype. Cancers (Basel) 2022; 14:cancers14246051. [PMID: 36551537 PMCID: PMC9775636 DOI: 10.3390/cancers14246051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 11/30/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022] Open
Abstract
Neuroblastoma (NBL) and medulloblastoma (MB) are aggressive pediatric cancers which can benefit from therapies targeting gangliosides. Therefore, we compared the ganglioside profile of 9 MB and 14 NBL samples by thin layer chromatography and mass spectrometry. NBL had the highest expression of GD2 (median 0.54 nmol GD2/mg protein), and also expressed complex gangliosides. GD2-low samples expressed GD1a and were more differentiated. MB mainly expressed GD2 (median 0.032 nmol GD2/mg protein) or GM3. Four sonic hedgehog-activated (SHH) as well as one group 4 and one group 3 MBs were GD2-positive. Two group 3 MB samples were GD2-negative but GM3-positive. N-glycolyl neuraminic acid-containing GM3 was neither detected in NBL nor MB by mass spectrometry. Furthermore, a GD2-phenotype predicting two-gene signature (ST8SIA1 and B4GALNT1) was applied to RNA-Seq datasets, including 86 MBs and validated by qRT-PCR. The signature values were decreased in group 3 and wingless-activated (WNT) compared to SHH and group 4 MBs. These results suggest that while NBL is GD2-positive, only some MB patients can benefit from a GD2-directed therapy. The expression of genes involved in the ganglioside synthesis may allow the identification of GD2-positive MBs. Finally, the ganglioside profile may reflect the differentiation status in NBL and could help to define MB subtypes.
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Affiliation(s)
- Claudia Paret
- Department of Pediatric Hematology/Oncology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
- Helmholtz-Institute for Translational Oncology Mainz (HI-TRON), 55131 Mainz, Germany
- University Cancer Center (UCT), University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
- Correspondence:
| | - Arsenij Ustjanzew
- University Cancer Center (UCT), University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Sara Ersali
- Lipid Pathobiochemistry, German Cancer Research Center, 69120 Heidelberg, Germany
| | - Larissa Seidmann
- Helmholtz-Institute for Translational Oncology Mainz (HI-TRON), 55131 Mainz, Germany
- Institute of Pathology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Richard Jennemann
- Lipid Pathobiochemistry, German Cancer Research Center, 69120 Heidelberg, Germany
| | - Nicole Ziegler
- Department of Pediatric Hematology/Oncology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Khalifa El Malki
- Department of Pediatric Hematology/Oncology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
- Helmholtz-Institute for Translational Oncology Mainz (HI-TRON), 55131 Mainz, Germany
- University Cancer Center (UCT), University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Alexandra Russo
- Department of Pediatric Hematology/Oncology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
- University Cancer Center (UCT), University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Arthur Wingerter
- Department of Pediatric Hematology/Oncology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
- University Cancer Center (UCT), University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Franziska Ortmüller
- Department of Pediatric Hematology/Oncology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
- Helmholtz-Institute for Translational Oncology Mainz (HI-TRON), 55131 Mainz, Germany
| | - Angelina Bornas
- Department of Pediatric Hematology/Oncology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Pia Charlotte Wehling
- Department of Pediatric Hematology/Oncology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Adina Lepădatu
- Helmholtz-Institute for Translational Oncology Mainz (HI-TRON), 55131 Mainz, Germany
- Institute of Neuropathology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Malte Ottenhausen
- Department of Neurosurgery, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Wilfried Roth
- University Cancer Center (UCT), University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
- Institute of Pathology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Clemens Sommer
- University Cancer Center (UCT), University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
- Institute of Neuropathology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Barbara Fliss
- Institute of Forensic Medicine, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany
| | - Katrin B. M. Frauenknecht
- Helmholtz-Institute for Translational Oncology Mainz (HI-TRON), 55131 Mainz, Germany
- Institute of Neuropathology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
- National Center of Pathology (NCP), Laboratoire National de Santé, 3555 Dudelange, Luxembourg
- Luxembourg Center of Neuropathology (LCNP), Laboratoire National de Santé, 3555 Dudelange, Luxembourg
| | - Roger Sandhoff
- Helmholtz-Institute for Translational Oncology Mainz (HI-TRON), 55131 Mainz, Germany
- Lipid Pathobiochemistry, German Cancer Research Center, 69120 Heidelberg, Germany
| | - Jörg Faber
- Department of Pediatric Hematology/Oncology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
- Helmholtz-Institute for Translational Oncology Mainz (HI-TRON), 55131 Mainz, Germany
- University Cancer Center (UCT), University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
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Murdzinski J, Franckenberg S, Ebert L, Fliss B, Thali MJ, Blüthgen C. Correlation of a distended urinary bladder volume with lethal intoxication in general and for different substance subgroups in particular: A retrospective study. Toxicologie Analytique et Clinique 2022. [DOI: 10.1016/j.toxac.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Ebert LC, Rahbani D, Lüthi M, Thali MJ, Christensen AM, Fliss B. Reconstruction of full femora from partial bone fragments for anthropological analyses using statistical shape modeling. Forensic Sci Int 2022; 332:111196. [PMID: 35123259 DOI: 10.1016/j.forsciint.2022.111196] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 12/24/2021] [Accepted: 01/13/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Due to taphonomic processes such as burial, fire, or animal activity, bones are often found incomplete, which can pose problematic for establishing the biological profile of the deceased using anthropological methods. The aim of this study is to test the feasibility of using statistical shape modeling (SSM) to reconstruct full femora from simulated partial femora and determine the accuracy of the reconstruction. Moreover, we assess the accuracy of sex estimation and the degree of stature error added based on the reconstructed femur using different anthropological methods. METHODS A total of 42 (28 female, 14 female) 3D models of left femora extracted from computed tomography (CT) scans were used. We performed a leave-one-out cross-validation (LOOCV) where 41 bones were used to build the SSM and one bone was used for testing. This bone was cut in 1 cm steps proximally, distally and from both ends up to 10 cm, reconstructed using SSM, and tested using the methods established by Stewart and Purkait (2005), Trotter and Gleser (1952), as well as a method based on SSM. with landmarks being automatically identified. RESULTS The error induced by reconstructing the femur to the length measurements was low, which translated into useful stature estimations (single sided cuts up to 10 cm: 0.4-1.1%, double sided<2% for cuts shorter than 6 cm). Using Purkaits method for sex estimation on reconstructed bones looked promising as well (single sided: 90.5% when compared to applying Purkaits method on the original bone, double sided 78.6% (10 cm cut) to 97.6% (1-3 cm cuts)) Using SSM for sex classification looked promising as well (single sided cut: 81-85.7%, double sided cut: 59.5-85.3%) CONCLUSION: SSM can be used to reconstruct fragmented femora. These reconstructions can be used for sex and stature estimations, at the cost of lower accuracy. Using SSM might give investigators an additional tool to gain information about the biological profile of a deceased in cases where the fragmentation of a femur does not allow for using other anthropological methods.
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Affiliation(s)
- Lars C Ebert
- 3D Center Zurich, Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland.
| | - Dana Rahbani
- Department of Mathematics and Computer Science, University of Basel, Basel, Switzerland
| | - Marcel Lüthi
- Department of Mathematics and Computer Science, University of Basel, Basel, Switzerland
| | - Michael J Thali
- Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - Angi M Christensen
- Laboratory Division, Federal Bureau of Investigation (FBI), Quantico, VA, USA
| | - Barbara Fliss
- Institute of Forensic Medicine, University Hospital of Mainz, Mainz, Germany
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Weber S, Barrera V, Dobay A, Franckenberg S, Thali M, Ebert LC, Fliss B. Application of Purkait´s triangle for sex prediction in digital postmortem CT scans. Forensic Imaging 2021. [DOI: 10.1016/j.fri.2021.200476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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6
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Kreul D, Gascho D, Franckenberg S, Eggert S, Fliss B, Kubik-Huch R, Thali M, Niemann T. Postmortem determination of hepatic steatosis. Comparing Rho/Z and fat fraction measurements on dual-energy CT for histological grading: A retrospective analysis. Forensic Imaging 2020. [DOI: 10.1016/j.fri.2020.200422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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7
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Sieberth T, Ebert LC, Gentile S, Fliss B. Clinical forensic height measurements on injured people using a multi camera device for 3D documentation. Forensic Sci Med Pathol 2020; 16:586-594. [PMID: 32656642 PMCID: PMC7669809 DOI: 10.1007/s12024-020-00282-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2020] [Indexed: 11/16/2022]
Abstract
Documenting the existence, size, position and shape of injuries is an important part of medical forensic examinations. In the photography of an injury, the documentation is limited to an approximation of size and position of the injury based on a ruler included in the image. The documentation of injuries can be improved with photogrammetry, which allows the creation of scaled 3D models of an injury that can be used to not only document and visualize the injury but also to match the injury with an injury-causing object. In this paper, the multicamera device “Botscan” was used to perform 3D whole-body documentation and measure the positions of injuries. A major advantage of 3D whole-body documentation compared to photography is that the former can be performed at a later stage of the investigation. This makes the whole-body 3D documentation of injuries an important tool for re-examination.
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Affiliation(s)
- Till Sieberth
- 3D Zentrum Zurich, University of Zurich, Winterthurerstrasse 190/52, 8057, Zürich, Switzerland. .,Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse 190/52, 8057, Zürich, Switzerland.
| | - Lars C Ebert
- 3D Zentrum Zurich, University of Zurich, Winterthurerstrasse 190/52, 8057, Zürich, Switzerland.,Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse 190/52, 8057, Zürich, Switzerland
| | - Simon Gentile
- Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse 190/52, 8057, Zürich, Switzerland
| | - Barbara Fliss
- Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse 190/52, 8057, Zürich, Switzerland
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8
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Klein WM, Sonnemans LJP, Franckenberg S, Fliss B, Gascho D, Prokop M, Lamers WH, Hikspoors JPJM, Thali MJ, Flach PM. Pseudolesion in the right parafissural liver parenchyma on CT: The base is found in embryology and collagen content. PLoS One 2020; 15:e0221544. [PMID: 31986149 PMCID: PMC6984698 DOI: 10.1371/journal.pone.0221544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 01/02/2020] [Indexed: 11/18/2022] Open
Abstract
Background Computed tomography (CT) images of livers may show a hypo-attenuated structure alongside the falciform ligament, which can be a focal fatty pseudolesion and can mimic a malignancy. The preferred location is on the right parafissural site, ventral in segment IVa/b. The etiology is not clear, nor is it known how the histology of this location develops. These are evaluated in this study. Methods 40 adult cadavers with autopsy and / or postmortem CT in a university hospital and a forensic center were included. Liver biopsies were taken at the left side of the falciform ligament as control, and at the right side as the possible precursor of a pseudolesion; these were examined for collagen and fat content. Cadavers with steatotic (>5% fat) or fibrotic (>2% collagen) control samples were excluded. Results Significantly more collagen was present in the right parafissural liver parenchyma: median 0.68% (IQR: 0.32–1.17%), compared to the left side 0.48% (IQR: 0.21–0.75%) (p 0.008), with equal fat content and CT attenuation values. The etiophysiology goes back to the demise of the umbilical venes in the early embryonic and neonatal period. Conclusions The right parafissural area contains more collagen and an equal amount of fat compared to the control left side. This supports the hypothesis of delayed, ‘third’ inflow: the postnatal change in blood supply from umbilical to portal leaves the downstream parafissural area hypoperfused leading to hypoxia which in turn results in collagen accumulation and the persistence of paraumbilical veins of Sappey.
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Affiliation(s)
- Willemijn M. Klein
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
- * E-mail:
| | - Lianne J. P. Sonnemans
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Sabine Franckenberg
- Department of Forensic Medicine and Imaging, Institute of Forensic Medicine, University of Zürich, Zürich, Switzerland
| | - Barbara Fliss
- Department of Forensic Medicine and Imaging, Institute of Forensic Medicine, University of Zürich, Zürich, Switzerland
| | - Dominic Gascho
- Department of Forensic Medicine and Imaging, Institute of Forensic Medicine, University of Zürich, Zürich, Switzerland
| | - Mathias Prokop
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Wouter H. Lamers
- Department of Anatomy and Embryology, Maastricht University, Maastricht, the Netherlands
| | | | - Michael J. Thali
- Department of Forensic Medicine and Imaging, Institute of Forensic Medicine, University of Zürich, Zürich, Switzerland
| | - Patricia M. Flach
- Department of Forensic Medicine and Imaging, Institute of Forensic Medicine, University of Zürich, Zürich, Switzerland
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Hanson E, Salzmann A, Dorum G, Fliss B, Hess S, Haas C, Ballantyne J. mRNA MPS tissue identification assay to aid in the investigation of traumatic injuries. Forensic Science International: Genetics Supplement Series 2019. [DOI: 10.1016/j.fsigss.2019.09.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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10
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Obertová Z, Leipner A, Messina C, Vanzulli A, Fliss B, Cattaneo C, Sconfienza LM. Postmortem imaging of perimortem skeletal trauma. Forensic Sci Int 2019; 302:109921. [DOI: 10.1016/j.forsciint.2019.109921] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 07/31/2019] [Accepted: 08/04/2019] [Indexed: 12/30/2022]
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Fliss B, Luethi M, Fuernstahl P, Christensen AM, Sibold K, Thali M, Ebert LC. CT-based sex estimation on human femora using statistical shape modeling. Am J Phys Anthropol 2019; 169:279-286. [PMID: 30927271 DOI: 10.1002/ajpa.23828] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 03/14/2019] [Accepted: 03/17/2019] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Estimating the sex of decomposed corpses and skeletal remains of unknown individuals is one of the first steps in the identification process in forensic contexts. Although various studies have considered the femur for sex estimation, the focus has primarily been on a specific single or a handful of measurements rather than the entire shape of the bone. In this article, we use statistical shape modeling (SSM) for sex estimation. We hypothesize that the accuracy of sex estimation will be improved by using the entire shape. MATERIALS AND METHODS For this study, we acquired a total of 61 femora from routine postmortem CT scans at the Institute for Forensic Medicine of the University of Zurich. The femora were extracted using segmentation technique. After building a SSM, we used the linear regression and nonlinear support vector machine technique for classification. RESULTS Using linear logistic regression and only the first principal component of the SSM, 76% of the femora were correctly classified by sex. Using the first five principal components, this value could be increased to 80%. Using nonlinear support vector machines and the first 20 principal components increased the rate of correctly classified femora to 87%. DISCUSSION Despite some limitations, the results obtained by using SSM for sex estimation in femur were promising and confirm the findings of other studies. Sex estimation accuracy, however, is not significantly improved over single or multiple linear measurements. Further research might improve the sex determination process in forensic anthropology by using SSM.
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Affiliation(s)
- Barbara Fliss
- Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - Marcel Luethi
- Department of Mathematics and Computer Science, University of Basel, Basel, Switzerland
| | - Philipp Fuernstahl
- Universitätsklinik Balgrist, Balgrist University Hospital, Zurich, Switzerland
| | | | - Ken Sibold
- Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - Michael Thali
- Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - Lars C Ebert
- Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland.,3D Center Zurich, Balgrist University Hospital, Zurich, Switzerland
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12
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Barrera V, Fliss B, Panzer S, Bolliger SA. Gunshot residue on dark materials: a comparison between infrared photography and the use of an alternative light source. Int J Legal Med 2018; 133:1115-1120. [DOI: 10.1007/s00414-018-1965-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 11/07/2018] [Indexed: 10/27/2022]
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13
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Heimer J, Gascho D, Fliss B, Martinez RM, Zoelch N. Detection of elevated ketone bodies by postmortem 1H-MRS in a case of fetal ketoacidosis. J Forensic Leg Med 2018; 59:16-19. [PMID: 30067991 DOI: 10.1016/j.jflm.2018.07.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 07/04/2018] [Accepted: 07/17/2018] [Indexed: 01/16/2023]
Abstract
We report a fetal loss following maternal ketoacidosis in a case of cryptic pregnancy. Biochemical analysis of peripheral blood revealed highly elevated levels of beta-hydroxybutyrate (BHB) in the mother (9.2 mmol/l) and the fetus (4.2 mmol/l). Fetal ketoacidosis with hypoxic-ischemic brain damage was determined to be the cause of death. 1H-MRS of the right cerebral hemisphere presented with distinctive resonances of BHB and acetone. Acetoacetate and glucose were not detected. Due to reported chronic abuse of ethanol and a period of fasting, alcoholic ketoacidosis was concluded to be the cause of the metabolic disorder. 1H-MRS is a viable examination for the postmortem detection of ketone bodies and may be a key supplement to noninvasive fetal autopsy for the diagnosis of ketoacidosis.
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Affiliation(s)
- Jakob Heimer
- Institute of Forensic Medicine, Department of Forensic Medicine and Imaging, University of Zurich, Zurich, Switzerland.
| | - Dominic Gascho
- Institute of Forensic Medicine, Department of Forensic Medicine and Imaging, University of Zurich, Zurich, Switzerland
| | - Barbara Fliss
- Institute of Forensic Medicine, Department of Forensic Medicine and Imaging, University of Zurich, Zurich, Switzerland
| | - Rosa Maria Martinez
- Institute of Forensic Medicine, Department of Forensic Medicine and Imaging, University of Zurich, Zurich, Switzerland
| | - Niklaus Zoelch
- Institute of Forensic Medicine, Department of Forensic Medicine and Imaging, University of Zurich, Zurich, Switzerland; Hospital of Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland
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Abstract
Suitcases or other containers are occasionally involved in forensic investigations. If there is a suspicion that human remains are hidden inside such a container, medico-legal examinations are required. However, these containers are occasionally locked. Forced opening of a locked suitcase or container may cause damage to its contents. Additionally, the safety of the investigator has to be considered as such containers may be booby-trapped or contain other hazardous material. An overview of the contents before opening is desirable in order to avoid the possibility of encountering a Pandora's box. In forensic medicine, an established approach to examine the inside of a body before opening at autopsy is postmortem computed tomography (CT). However, there may be a reluctance to use this approach for suitcases or containers with metallic components because of the assumption that severe metal artifacts will result in inadequate images. In this article, we present a forensic case in which a CT scan of a metallic suitcase was performed in order to examine its contents. Additionally, we performed an experimental scan of a conventional safe in order to determine if CT is able to reveal the contents of such a highly radiopaque storage box.
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Affiliation(s)
- Dominic Gascho
- Department of Forensic Medicine and Imaging, Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse 190/52, 8057, Zurich, Switzerland.
| | - Stephan A Bolliger
- Department of Forensic Medicine and Imaging, Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse 190/52, 8057, Zurich, Switzerland
| | - Markus Enders
- Department of Forensic Medicine and Imaging, Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse 190/52, 8057, Zurich, Switzerland
| | - Michael J Thali
- Department of Forensic Medicine and Imaging, Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse 190/52, 8057, Zurich, Switzerland
| | - Barbara Fliss
- Department of Forensic Medicine and Imaging, Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse 190/52, 8057, Zurich, Switzerland
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15
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Schulze K, Ebert LC, Ruder TD, Fliss B, Poschmann SA, Gascho D, Thali MJ, Flach PM. The gas bubble sign-a reliable indicator of laryngeal fractures in hanging on post-mortem CT. Br J Radiol 2018; 91:20170479. [PMID: 29327945 DOI: 10.1259/bjr.20170479] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE The purpose was to evaluate the presence of gas in the tissue adjacent to the laryngeal structures, "the gas bubble sign", in cases of hanging as a diagnostic indicator of neck trauma. METHODS In this study, post-mortem CT (PMCT) scans and autopsies of 35 victims of hanging were examined to reveal age-dependent changes, laryngeal fracture, fracture location and the presence of gas. A matched group with cardiac arrest or intoxication was used as controls (n = 35). An autopsy was performed in each case. RESULTS Incomplete suspension was the most common method in hanging. The thyroid horns (90.5%) were identified as the most vulnerable location for fractures. Laryngeal deformity and dislocation, which was only detected on PMCT, was observed in 57.1% and was concomitant with fractures in 83.3%. Laryngeal fractures are more common with advanced age (>40 years, 88.9%) and less common in younger subjects (<40 years, 29.4%). The gas bubble sign with regard to laryngeal fractures yielded a sensitivity of 79.2%, a positive predictive value of 95%, a specificity of 90.9%, a negative predictive value of 34.5% and an accuracy of 83%. CONCLUSION The complex evaluation of the larynx is profoundly supported by PMCT and the detection of the gas bubble sign as a diagnostic indicator of neck trauma. This relevant diagnostic finding might aid in not only post-mortem cases but also clinical cases, for patients who survive an assault to the neck. Advances in knowledge: (1) The gas bubble sign is a diagnostic indicator of neck trauma in not putrefied bodies. (2) PMCT supports evaluation of trauma to the neck in hanging tremendously. (3) The diagnostic finding of gas located at the laryngeal structures may not only aid in post-mortem cases but also clinical cases of people who survive an assault to the neck.
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Affiliation(s)
- Katja Schulze
- 1 Institute of Forensic Medicine and Imaging, University of Zurich , Zurich , Switzerland
| | - Lars Christian Ebert
- 1 Institute of Forensic Medicine and Imaging, University of Zurich , Zurich , Switzerland
| | - Thomas Daniel Ruder
- 1 Institute of Forensic Medicine and Imaging, University of Zurich , Zurich , Switzerland.,2 Institute of Diagnostic, Interventional and Pediatric Radiology, University Hospital Bern , Bern , Switzerland
| | - Barbara Fliss
- 1 Institute of Forensic Medicine and Imaging, University of Zurich , Zurich , Switzerland
| | | | - Dominic Gascho
- 1 Institute of Forensic Medicine and Imaging, University of Zurich , Zurich , Switzerland
| | - Michael Josef Thali
- 1 Institute of Forensic Medicine and Imaging, University of Zurich , Zurich , Switzerland
| | - Patricia Mildred Flach
- 1 Institute of Forensic Medicine and Imaging, University of Zurich , Zurich , Switzerland.,3 Clinic for Radiology and Nuclear Medicine, Kantonal Hospital St. Gallen , St. Gallen , Switzerland
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Abstract
Dealing with a refurbished crime scene is a special challenge for forensic investigators. In such cases, a crime scene may not have only been cleaned in order to erase all traces but the walls of an indoor crime scene could also be painted over in order to mask traces of the crime. So far, very few publications have shown that painted-over traces of blood and seminal fluid can be detected using a forensic light source or infrared photography. To date, there have been no systematically executed research studies including guidelines on which settings to use depending on the color of the wall. Moreover, no comparative study has addressed the question of whether it is better to use infrared photography or a forensic light source to visualize painted-over bloodstains. The present study covers the aforementioned gaps and shows that painted-over bloodstains are most easily visualized by infrared photography, while traces of seminal fluid are most easily visualized at 440 nm in combination with a yellow filter-both independent of the color of the wall paint.
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Affiliation(s)
- V Barrera
- Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse 190/52, 8057, Zurich, Switzerland.
| | - C Haas
- Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse 190/52, 8057, Zurich, Switzerland
| | - E A Meixner
- Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse 190/52, 8057, Zurich, Switzerland
| | - B Fliss
- Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse 190/52, 8057, Zurich, Switzerland
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17
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Hinderberger P, Fliss B, Thali MJ, Schweitzer W. Fatal bronchovascular fistula after lobectomy visualized through postmortem computed tomography angiography: A case report. Forensic Sci Med Pathol 2017; 13:234-239. [DOI: 10.1007/s12024-017-9867-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2017] [Indexed: 11/21/2022]
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