Forensic age assessment of the knee: proposal of a new classification system using two-dimensional ultrasound volumes an
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FORENSIC MEDICINE
Forensic age assessment of the knee: proposal of a new classification system using two-dimensional ultrasound volumes and comparison to MRI Jochen Herrmann 1
&
Dennis Säring 2 & Markus Auf der Mauer 2 & Michael Groth 1 & Eilin Jopp-van Well 3
Received: 24 June 2020 / Revised: 27 August 2020 / Accepted: 23 September 2020 # The Author(s) 2020
Abstract Objectives To assess epiphyseal growth plate closure of the knee for forensic age estimation using an ultrasound (US)-based method and to compare the findings with MRI. Methods Thirty-three healthy male individuals (age, 14.4–19.3 years) were prospectively evaluated for epiphyseal growth plate closure of the right knee by recordings of two-dimensional US volumes and a high-resolution T1-weighted MRI sequence. The degree of epiphyseal growth plate closure was rated independently by two readers for each method using a modality specific three-point scale that differentiates between an open physis (S1), a partially closed physis (S2), and a closed physis (S3). Results The inter-rater agreement was high for the US (Cohen’s kappa (CK): femur 95.2%, tibia 81.3%, fibula 86.3%) and the MRI method (CK: femur 70.2%, tibia 90.8%, fibula 79.8%). The degree of growth plate closure associated positively with advancing age. The US system showed a clearer separation of median ages with lower overlap than the MRI system. Open growth plates on minors (< S3 on femur and tibia) were identified by US with higher sensitivity (1.0 vs. 0.7) and slightly lower specificity (0.7 vs. 0.85) compared with MRI. The examination time was substantially shorter on US than on MRI (2.65 ± 0.91 min vs. 24.72 ± 2.72 min; p < 0.001). Conclusions The US method for evaluation of growth plate closure of the knee can reliably assign male individuals to different ossification stages and identifies minors with high accuracy. More studies with larger numbers are needed to further evaluate this method. Key Points • US is feasible to determine the degree of epiphyseal growth plate closure of the knee, shows a high degree of reliability, and is comparable to MRI. • US of the knee can detect open growth plates on male minors with high accuracy. • US of the knee may be used as a fast, non-invasive imaging tool for forensic age estimation to identify male minors. Keywords Adolescent . Growth plate . Ultrasonography . Magnetic resonance imaging . Knee joint
Abbreviations 2d Two dimensional
CK MRI
Cohen’s kappa Magnet resonance tomography
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00330-020-07343-1) contains supplementary material, which is available to authorized users. * Jochen Herrmann [email protected] 1
Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Section of Pediatric Radiology, University Medical Center Hamburg-Eppendorf (UKE), Martinistrasse 52, 20246 Hamburg, Germany
2
Department of Medical and Industrial Image Processing, University of Applied Sciences of Wedel, Feldstraße 143, 22880 Wedel, Germany
3
De
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