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01-09-2017 | Original Article

Comparison of imaging planes during CT-based evaluation of clavicular ossification: a multi-center study

Authors: Philipp Scharte, Volker Vieth, Ronald Schulz, Frank Ramsthaler, Klaus Püschel, Thomas Bajanowski, Heidi Pfeiffer, Andreas Schmeling, Sven Schmidt, Daniel Wittschieber

Published in: International Journal of Legal Medicine | Issue 5/2017

Abstract

Determining the ossification stage of the medial clavicular epiphysis by computed tomography represents the currently recommended methodology for the question of whether a living individual has completed the 18th or 21st year of life. In the present study, thin-slice CT scans of 1078 sternoclavicular joints were reconstructed in axial and coronal image series and evaluated according to the two classification systems established for age diagnostics using the clavicle. Both image series (axial and coronal) were analyzed separately. When comparing the results of axial and coronal view, a different ossification stage was found in 35.6% of the clavicles. The results suggest an influence of the imaging plane on the process of stage determination. In order to further approximate the three-dimensional and asymmetrical structure of the epiphyseal ossification center, the usage of at least two different reformation types may be recommended. In practice, only those reference studies should be applied which exactly employed the same number and orientations of the reformation types that are going to be used in the respective routine case.

Schmeling A, Schmidt S, Schulz R, Wittschieber D, Rudolf E (2014) Studienlage zum zeitlichen Verlauf der Schlüsselbeinossifikation. Rechtsmedizin 24:467–474CrossRef

Schmeling A, Dettmeyer R, Rudolf E, Vieth V, Geserick G (2016) Forensic age estimation—methods, certainty, and the law. Dtsch Arztebl Int 113:44–50PubMedPubMedCentral

Schmidt S, Nitz I, Ribbecke S, Schulz R, Pfeiffer H, Schmeling A (2013) Skeletal age determination of the hand: a comparison of methods. Int J Legal Med 127:691–698CrossRefPubMed

Zabet D, Rérolle C, Pucheux J, Telmon N, Saint-Martin P (2015) Can the Greulich and Pyle method be used on French contemporary individuals? Int J Legal Med 129:171–177CrossRefPubMed

Tisè M, Mazzarini L, Fabrizzi G, Ferrante L, Giorgetti R, Tagliabracci A (2011) Applicability of Greulich and Pyle method for age assessment in forensic practice on an Italian sample. Int J Legal Med 125:411–416CrossRefPubMed

Wittschieber D, Vieth V, Domnick C, Pfeiffer H, Schmeling A (2013) The iliac crest in forensic age diagnostics: evaluation of the apophyseal ossification in conventional radiography. Int J Legal Med 127:473–479CrossRefPubMed

Wittschieber D, Vieth V, Wierer T, Pfeiffer H, Schmeling A (2013) Cameriere’s approach modified for pelvic radiographs: a novel method to assess apophyseal iliac crest ossification for the purpose of forensic age diagnostics. Int J Legal Med 127:825–829CrossRefPubMed

Wittschieber D, Schmeling A, Schmidt S, Heindel W, Pfeiffer H, Vieth V (2013) The Risser sign for forensic age estimation in living individuals: a study of 643 pelvic radiographs. Forensic Sci Med Pathol 9:36–43CrossRefPubMed

Gunst K, Mesotten K, Carbonez A, Willems G (2003) Third molar root development in relation to chronological age: a large sample sized retrospective study. Forensic Sci Int 136:52–57CrossRefPubMed

10.

Knell B, Schmeling A (2010) Einfluss der Retention auf die Weisheitszahnmineralisation. Rechtsmedizin 20:469–474CrossRef

11.

Schmeling A, Grundmann C, Fuhrmann A, Kaatsch HJ, Knell B, Ramsthaler F, Reisinger W, Riepert T, Ritz-Timme S, Rösing FW, Rötzscher K, Geserick G (2008) Criteria for age estimation in living individuals. Int J Legal Med 122:457–460CrossRefPubMed

12.

Wittschieber D, Ottow C, Vieth V, Küppers M, Schulz R, Hassu J, Bajanowski T, Püschel K, Ramsthaler F, Pfeiffer H, Schmidt S, Schmeling A (2015) Projection radiography of the clavicle: still recommendable for forensic age diagnostics in living individuals? Int J Legal Med 129:187–193CrossRefPubMed

13.

Wittschieber D, Ottow C, Schulz R, Püschel K, Bajanowski T, Ramsthaler F, Pfeiffer H, Vieth V, Schmidt S, Schmeling A (2016) Forensic age diagnostics using projection radiography of the clavicle: a prospective multi-center validation study. Int J Legal Med 130:213–219CrossRefPubMed

14.

Mühler M, Schulz R, Schmidt S, Schmeling A, Reisinger W (2006) The influence of slice thickness on assessment of clavicle ossification in forensic age diagnostics. Int J Legal Med 120:15–17CrossRefPubMed

15.

Wittschieber D, Schulz R, Vieth V, Küppers M, Bajanowski T, Ramsthaler F, Püschel K, Pfeiffer H, Schmidt S, Schmeling A (2014) Influence of the examiner’s qualification and sources of error during stage determination of the medial clavicular epiphysis by means of computed tomography. Int J Legal Med 128:183–191CrossRefPubMed

16.

Kreitner KF, Schweden F, Schild HH, Riepert T, Nafe B (1997) Die computertomographisch bestimmte Ausreifung der medialen Klavikulaepiphyse – eine additive Methode zur Altersbestimmung im Adoleszentenalter und in der dritten Lebensdekade? Rofo 166:481–486CrossRefPubMed

17.

Kreitner KF, Schweden FJ, Riepert T, Nafe B, Thelen M (1998) Bone age determination based on the study of the medial extremity of the clavicle. Eur Radiol 8:1116–1122CrossRefPubMed

18.

Schulz R, Mühler M, Mutze S, Schmidt S, Reisinger W, Schmeling A (2005) Studies on the time frame for ossification of the medial epiphysis of the clavicle as revealed by CT scans. Int J Legal Med 119:142–145CrossRefPubMed

19.

Schulze D, Rother U, Fuhrmann A, Richel S, Faulmann G, Heiland M (2006) Correlation of age and ossification of the medial clavicular epiphysis using computed tomography. Forensic Sci Int 158:184–189CrossRefPubMed

20.

Kaur G, Khandelwal N, Jasuja OP (2010) Computed tomographic studies on ossification status of medial epiphysis of clavicle: effect of slice thickness and dose distribution. J Indian Acad Forensic Med 32:298–302

21.

Kellinghaus M, Schulz R, Vieth V, Schmidt S, Schmeling A (2010) Forensic age estimation in living subjects based on the ossification status of the medial clavicular epiphysis as revealed by thin-slice multidetector computed tomography. Int J Legal Med 124:149–154CrossRefPubMed

22.

Kellinghaus M, Schulz R, Vieth V, Schmidt S, Pfeiffer H, Schmeling A (2010) Enhanced possibilities to make statements on the ossification status of the medial clavicular epiphysis using an amplified staging scheme in evaluating thin-slice CT scans. Int J Legal Med 124:321–325CrossRefPubMed

23.

Bassed RB, Drummer OH, Briggs C, Valenzuela A (2011) Age estimation and the medial clavicular epiphysis: analysis of the age of majority in an Australian population using computed tomography. Forensic Sci Med Pathol 7:148–154CrossRefPubMed

24.

El-Gerby KM, Mohammed AS, Gomaa MS (2013) Using thin-slice multidetector computed tomography in forensic age estimation based on the ossification status of the medial clavicular epiphysis among Egyptian subjects. Med J Cairo Univ 81:221–227

25.

Wittschieber D, Schulz R, Vieth V, Küppers M, Bajanowski T, Ramsthaler F, Püschel K, Pfeiffer H, Schmidt S, Schmeling A (2014) The value of sub-stages and thin slices for the assessment of the medial clavicular epiphysis: a prospective multi-center CT study. Forensic Sci Med Pathol 10:163–169CrossRefPubMed

26.

Wittschieber D, Schmidt S, Vieth V, Schulz R, Püschel K, Pfeiffer H, Schmeling A (2014) Subclassification of clavicular substage 3a is useful for diagnosing the age of 17 years. Rechtsmedizin 24:485–488CrossRef

27.

Milenkovic P, Djuric M, Milovanovic P, Djukic K, Zivkovic V, Nikolic S (2014) The role of CT analyses of the sternal end of the clavicle and the first costal cartilage in age estimation. Int J Legal Med 128:825–839CrossRefPubMed

28.

Pattamapaspong N, Madla C, Mekjaidee K, Namwongprom S (2015) Age estimation of a Thai population based on maturation of the medial clavicular epiphysis using computed tomography Forensic Sci Int 246:123.e1-5

29.

Ekizoglu O, Hocaoglu E, Inci E, Sayin I, Solmaz D, Bilgili MG, Can IO (2015) Forensic age estimation by the Schmeling method: computed tomography analysis of the medial clavicular epiphysis. Int J Legal Med 129:203–210CrossRefPubMed

30.

Ekizoglu O, Hocaoglu E, Inci E, Can IO, Aksoy S, Sayin I (2015) Estimation of forensic age using substages of ossification of the medial clavicle in living individuals. Int J Legal Med 129:1259–1264CrossRefPubMed

31.

Franklin D, Flavel A (2015) CT evaluation of timing for ossification of the medial clavicular epiphysis in a contemporary Western Australian population. Int J Legal Med 129:583–594CrossRefPubMed

32.

Zhang K, Chen XG, Zhao H, Dong XA, Deng ZH (2015) Forensic age estimation using thin-slice multidetector CT of the clavicular epiphyses among adolescent Western Chinese. J Forensic Sci 60:675–678CrossRefPubMed

33.

Houpert T, Rérolle C, Savall F, Telmon N, Saint-Martin P (2016) Is a CT-scan of the medial clavicle epiphysis a good exam to attest to the 18-year threshold in forensic age estimation? Forensic Sci Int 260:103.e1-3

34.

Gurses MS, Inanir NT, Gokalp G, Fedakar R, Tobcu E, Ocakoglu G (2016) Evaluation of age estimation in forensic medicine by examination of medial clavicular ossification from thin-slice computed tomography images. Int J Legal Med 130:1343–1352CrossRefPubMed

35.

Gurses MS, Inanir NT, Soylu E, Gokalp G, Kir E, Fedakar R (2017) Evaluation of the ossification of the medial clavicle according to the Kellinghaus substage system in identifying the 18-year-old age limit in the estimation of forensic age-is it necessary? Int J Legal Med 131:585–592CrossRefPubMed

36.

Schmeling A, Schulz R, Reisinger W, Mühler M, Wernecke KD, Geserick G (2004) Studies on the time frame for ossification of the medial clavicular epiphyseal cartilage in conventional radiography. Int J Legal Med 118:5–8CrossRefPubMed

37.

Wittschieber D, Schulz R, Pfeiffer H, Schmeling A, Schmidt S (2017) Systematic procedure for identifying the five main ossification stages of the medial clavicular epiphysis using computed tomography: a practical proposal for forensic age diagnostics. Int J Legal Med 131:217–224CrossRefPubMed

38.

Wei H, Zhi G, Wan L, Ying C, Wang Y (2014) Correlation between age and the parameters of medial epiphysis and metaphysis of the clavicle using CT volume rendering images. Forensic Sci Int 244:316.e1-7

39.

Schmidt S, Mühler M, Schmeling A, Reisinger W, Schulz R (2007) Magnetic resonance imaging of the clavicular ossification. Int J Legal Med 121:321–324CrossRefPubMed

40.

Hillewig E, De Tobel J, Cuche O, Vandemaele P, Piette M, Verstraete K (2011) Magnetic resonance imaging of the medial extremity of the clavicle in forensic bone age determination: a new four-minute approach. Eur Radiol 21:757–767CrossRefPubMed

41.

Hillewig E, Degroote J, Van der Paelt T, Visscher A, Vandemaele P, Lutin B, D'Hooghe L, Vandriessche V, Piette M, Verstraete K (2013) Magnetic resonance imaging of the sternal extremity of the clavicle in forensic age estimation: towards more sound age estimates. Int J Legal Med 127:677–689CrossRefPubMed

42.

Vieth V, Kellinghaus M, Schulz R, Pfeiffer H, Schmeling A (2010) Beurteilung des Ossifikationsstadiums der medialen Klaviculaepiphysenfuge. Vergleich von Projektionsradiographie, Computertomographie und Magnetresonanztomographie. Rechtsmedizin 20:483–488CrossRef

43.

Vieth V, Schulz R, Brinkmeier P, Dvorak J, Schmeling A (2014) Age estimation in U-20 football players using 3.0 tesla MRI of the clavicle. Forensic Sci Int 241:118–122CrossRefPubMed

44.

Tangmose S, Jensen KE, Lynnerup N (2013) Comparative study on developmental stages of the clavicle by postmortem MRI and CT imaging. J Forensic Radiol Imaging 1:102–106CrossRef

45.

Tangmose S, Jensen KE, Villa C, Lynnerup N (2014) Forensic age estimation from the clavicle using 1.0T MRI—preliminary results. Forensic Sci Int 234:7–12CrossRefPubMed

46.

Schmidt S, Henke CA, Wittschieber D, Vieth V, Bajanowski T, Ramsthaler F, Püschel K, Pfeiffer H, Schmeling A, Schulz R (2016) Optimising magnetic resonance imaging-based evaluation of the ossification of the medial clavicular epiphysis: a multi-centre study. Int J Legal Med 130:1615–1621CrossRefPubMed

47.

Ottow C, Krämer JA, Olze A, Schmidt S, Schulz R, Wittschieber D, Heindel W, Pfeiffer H, Ribbecke S, Vieth V, Schmeling A (2015) Magnetresonanztomographiestudie zur Altersschätzung von unbegleiteten minderjährigen Flüchtlingen. Rechtsmedizin 25:12–20CrossRef

Title: Comparison of imaging planes during CT-based evaluation of clavicular ossification: a multi-center study
Authors: Philipp Scharte
Volker Vieth
Ronald Schulz
Frank Ramsthaler
Klaus Püschel
Thomas Bajanowski
Heidi Pfeiffer
Andreas Schmeling
Sven Schmidt
Daniel Wittschieber
Publication date: 01-09-2017
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Legal Medicine / Issue 5/2017
Print ISSN: 0937-9827
Electronic ISSN: 1437-1596
DOI: https://doi.org/10.1007/s00414-017-1615-5

At a glance: The STEP trials

Springer Medicine

Comparison of imaging planes during CT-based evaluation of clavicular ossification: a multi-center study

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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