Age estimation in U-20 football players using 3.0 tesla MRI of the clavicle

Vieth, Volker; Schulz, Ronald; Brinkmeier, Paul; Dvořák, Jiří; Schmeling, Andreas

doi:10.1016/j.forsciint.2014.05.008

Cited by 72 publications

(40 citation statements)

References 20 publications

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“…In our total population this occurred in 2.7% (26/979). In the literature, 2.8% (50/1760) and 7.4% (18/243) have been reported. The prone position helps to reduce these artifacts .…”

Section: Discussionmentioning

confidence: 99%

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Staging Clavicular Development on MRI: Pitfalls and Suggestions for Age Estimation

Tobel¹,

Hillewig

Wijk

et al. 2019

Magnetic Resonance Imaging

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Background MRI of the clavicle's sternal end has been studied for age estimation. Several pitfalls have been noted, but how they affect age estimation performance remains unclear. Purpose/Hypothesis To further study these pitfalls and to make suggestions for a proper use of clavicle MRI for forensic age estimation. Our hypotheses were that age estimation would benefit from 1) discarding stages 1 and 4/5; 2) including advanced substages 3aa, 3ab, and 3ac; 3) taking both clavicles into account; and 4) excluding morphological variants. Study Type Prospective cross‐sectional. Population Healthy Caucasian volunteers between 11 and 30 years old (524; 277 females, 247 males). Field Strength/Sequence 3T, T1‐weighted gradient echo volumetric interpolated breath‐hold examination (VIBE) MR‐sequence. Assessment Four observers applied the most elaborate staging technique for long bone development that has been described in the current literature (including stages, substages, and advanced substages). One of the observers repeated a random selection of the assessments in 110 participants after a 2‐week interval. Furthermore, all observers documented morphological variants. Statistical Tests Weighted kappa quantified reproducibility of staging. Bayes' rule was applied for age estimation with a continuation ratio model for the distribution of the stages. According to the hypotheses, different models were tested. Mean absolute error (MAE) differences between models were compared, as were MAEs between cases with and without morphological variants. Results Weighted kappa equaled 0.82 for intraobserver and ranged between 0.60 and 0.64 for interobserver agreement. Stages 1 and 4/5 were allocated interchangeably in 4.3% (54/1258). Age increased steadily in advanced substages of stage 3, but improvement in age estimation was not significant (right P = 0.596; left P = 0.313). The model that included both clavicles and discarded stages 1 and 4/5 yielded an MAE of 1.97 years, a root mean squared error of 2.60 years, and 69% correctly classified minors. Morphological variants rendered significantly higher MAEs (right 3.84 years, P = 0.015; left 2.93 years, P = 0.022). Data Conclusion Our results confirmed hypotheses 3) and 4), while hypotheses 1) and 2) remain to be investigated in larger studies. Level of Evidence: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;51:377–388.

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“…In our total population this occurred in 2.7% (26/979). In the literature, 2.8% (50/1760) and 7.4% (18/243) have been reported. The prone position helps to reduce these artifacts .…”

Section: Discussionmentioning

confidence: 99%

“…A particularly challenging region of interest is the sternal end of the clavicle, which is studied when the age threshold of 18 years is of importance. 2 Few studies have applied MRI of this region in the living, [3][4][5][6][7][8] which might be due to the prevalence of motion artifacts, impeding an assessment of development.…”

mentioning

confidence: 99%

Staging Clavicular Development on MRI: Pitfalls and Suggestions for Age Estimation

Tobel¹,

Hillewig

Wijk

et al. 2019

Magnetic Resonance Imaging

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“…The performance of MR imaging of the medial clavicular epiphysis [9][10][11][12], distal tibia and calcaneus [13,14], proximal tibial epiphysis [15], iliac crest [16], hand-wrist [17], and distal femur [18][19][20] has tended to increase in frequency, and research on the use of the medial clavicular epiphysis for age estimation has gained importance. Current data on the distal tibial and calcaneal epiphysis are based only on Xray methods [21][22][23][24][25].…”

Section: Introductionmentioning

confidence: 99%

Magnetic resonance imaging of distal tibia and calcaneus for forensic age estimation in living individuals

et al. 2015

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In recent years, methods by which to decrease radiation exposure during age estimation have gained importance and become a main research area in the forensic sciences. Imaging tools such as X-ray and computed tomography (CT) are accepted as the main diagnostic methods for evaluation of the epiphysis in living individuals; however, radiation exposure and superimposition are the main disadvantages of these techniques. Magnetic resonance (MR) imaging provides an advantage in terms of preventing radiation exposure. In this study, we performed an MR analysis of the degree of fusion of the distal tibia and calcaneal epiphysis and investigated the utility of this technique in the Turkish population. Using the three-stage method described by Saint-Martin et al., we retrospectively evaluated 167 MR images (97 males, 70 females; mean age, 17.7 ± 4.8 years for males and 17.6 ± 4.9 years for females; age range of all subjects, 8-25 years). Intraobserver and interobserver evaluation showed good repeatability and consistency of this method. Stages 2 and 3 ossification of the distal tibial epiphysis first occurred at age 14 and 15 years in males and 12 and 14 years in females, respectively. Stages 2 and 3 ossification of the calcaneal epiphysis first occurred at age 14 and 16 years in males and 10 and 12 years in females, respectively. When performed alone, MR analysis of the distal tibial and calcaneal epiphysis offers limited information for forensic age estimation. However, we suggest that MR analysis can be used as a supportive method when it is necessary to avoid repeated radiation exposure.

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“…Besides radiography and computed tomography, in recent years, magnetic resonance imaging (MRI) of the clavicle has moved increasingly into focus of forensic age estimation research [12,13,24,28,29,31]. As a radiation-free method, the evaluation of the clavicle by MRI is of special interest not only with respect to criminal proceedings but also in terms of civil and asylum law, particularly as to the aforementioned unaccompanied minor refugees.…”

Section: Discussionmentioning

confidence: 99%

Projection radiography of the clavicle: still recommendable for forensic age diagnostics in living individuals?

et al. 2014

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As superimposition effects often impede the evaluation of the ossification status of the medial clavicular epiphysis in standard posterior-anterior (PA) radiographs, additional oblique images (right anterior oblique, RAO, and left anterior oblique, LAO) are currently recommended to allow for reliable stage assessments. The present study examines the influence of the radiographic projection type on stage determination. To this end, 836 sternoclavicular joints were prospectively obtained during forensic autopsies of bodies aged between 15 and 30 years. Subsequently, three different radiographs (PA, RAO, and LAO) were taken from each specimen and separately evaluated as to the developmental stage of the medial clavicular epiphysis. A forensically established five-stage classification system was used. In 25 % of the cases, the medial clavicular epiphysis depicted in an oblique projection showed a different ossification stage than in the PA projection. In at least 10 % of the cases, a higher ossification stage was observed which would have significant disadvantages in criminal proceedings (ethically unacceptable error). In conclusion, the usage of the current radiographic reference data, which rely upon chest radiographs taken as PA projections, appears to be inadmissible for oblique projections. Projection radiography of the clavicle can therefore no longer be recommended for forensic age estimation practice. As to the question of whether an individual has achieved the age of 18 or 21, computed tomography of the clavicle must be regarded as the exclusive method of choice.

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Age estimation in U-20 football players using 3.0 tesla MRI of the clavicle

Cited by 72 publications

References 20 publications

Staging Clavicular Development on MRI: Pitfalls and Suggestions for Age Estimation

Staging Clavicular Development on MRI: Pitfalls and Suggestions for Age Estimation

Magnetic resonance imaging of distal tibia and calcaneus for forensic age estimation in living individuals

Projection radiography of the clavicle: still recommendable for forensic age diagnostics in living individuals?

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