Pubic Symphyseal Age Estimation from Three‐Dimensional Reconstructions of Pelvic CT Scans of Live Individuals

Skeletal age estimation using the pubic symphysis is a reliable and popular practice among forensic anthropologists. In instances in which accessing the skeleton is impossible, such as in the case of living individuals, three‐dimensional (3D) reconstructions of computed tomography (CT) scans can be created and analyzed for aspects of the biological profile. This study examined 3D reconstructions of pelvic CT scans of a sample of 44 live adults to estimate age using the Suchey–Brooks J Hum Evol 1990;5(3):227‐38 method. Images were created using OsiriX software (Pixmeo, Geneva, Switzerland). Estimated age ranges based on the 3D‐CT images captured the true age of the individual at the time of the CT scan 79.5% of the time with good intra‐observer reliability. The features best visualized on the 3D images included the ossific nodule and the pubic symphyseal rim. This study shows that clinical CT scanning parameters are adequate for creating 3D images to be analyzed for age using the pubic symphysis.     

A Comparison Between Digital Radiography,Computed Tomography,and Magnetic Resonance in the Detection of Gunshot Residues in Burnt Tissues and Bone

The radiological search for GSR is crucial in burnt material although it has been rarely tested. In this study, thirty‐one bovine ribs were shot at near‐contact range and burnt to calcination in an oven simulating a real combustion. Computed tomography (CT) and magnetic resonance (MR) were performed before and after carbonization and compared with former analyses with DR (digital radiography); thus comparing the assistance, the radiological methods can provide in the search for GSR in fresh and burnt bone. DR demonstrated the greatest ability in the detection of metallic residues, CT showed lower abilities, while MR showed a high sensitivity only in soft tissues. Thus, DR can be considered as the most sensitive method in the detection of GSR in charred bones, whereas CT and MR demonstrated much less reliability. Nonetheless, the MR ameliorates the analysis of gunshot wounds in other types of remains with large quantities of soft tissues.     

Technical and interpretive pitfalls of postmortem CT: Five examples of errors revealed by autopsy

Image acquisition of dead bodies, particularly using postmortem computed tomography (PMCT), has become common in forensic investigations worldwide. Meanwhile, in countries such as Japan which have an extremely low rate of autopsy, PMCT is being increasingly used in the clinical field to certify the cause of death (COD) without performing an autopsy or toxicological tests, even in cases of unnatural death. Additionally, these PMCT images are predominantly interpreted by clinical personnel such as emergency physicians or clinicians who are not trained in PMCT interpretation and who work for the police, that is, the so-called police doctors. Many potential pitfalls associated with the use of PMCT have been previously described in textbooks and published papers, including the pitfalls of not performing a complete forensic pathology investigation, and the use of physicians without appropriate PMCT training to interpret PMCT and direct death investigation and certification. We describe five examples in which apparent misdiagnosis of COD based on PMCT misinterpretation was revealed by autopsy. Here are the five examples of errors: (1) Postmortem changes were misinterpreted as COD, (2) resuscitation effects were misinterpreted as COD, (3) COD was determined after an incomplete examination, (4) fatal findings caused by external origin were wrongly interpreted as ‘of internal origin’ based on PMCT, and (5) non-fatal findings on PMCT were wrongly interpreted as fatal. Interpretation of PMCT by appropriately trained physicians and an accompanying complete forensic investigation, including autopsy when indicated, is necessary to prevent significant errors in COD determination and related potential adverse medicolegal consequences.     

Pulp volume quantification methods in cone-beam computed tomography for age estimation: A critical review and meta-analysis

The secondary dentin deposition that occurs after the tooth formation process results in a decrease in pulp cavity volume in adolescents and adults. The purpose of this critical review was to correlate pulpal and/or dental volume on cone-beam computed tomography (CBCT) with chronological age approximation. A subobjective was to investigate which methodology and CBCT technical parameters would be most appropriate to evaluate this correlation. This critical review followed the PRISMA guidelines, and it was conducted by a search through PubMed, Embase, SciELO, Scopus, Web of Science, Cochrane Library databases, as well as gray literature. Primary studies that used pulp volume, or pulp chamber to tooth volume ratio measured using CBCT were included. Seven hundred and eight indexed and 31 non-indexed records were identified. A qualitative analysis was performed including 25 selected studies with a total of 5100 individuals, age ranging from 8 to 87 years without sex predilection. The most used method was pulp volume/tooth volume. CBCT voxel size ranged between 0.09 and 0.5. Manual segmentation associated with threshold algorithms was used in most of the studies. Correlation between the pulp volume/tooth volume ratio was moderate: −0.66 for the upper central incisors, −0.59 for upper canines and −0.56 for lower canines. High heterogeneity was observed among the studies. It is concluded that pulp volume should be used with caution in age estimation. Evidence supports the preferable use of upper incisors with pulp volume/tooth volume ratio for age estimation. There is not enough evidence that voxel size interferes in age estimation by pulp volume.     

Skull and Encephalic Injuries Caused by Beach Umbrellas: Case Reports and Review of Literature

This study reports two unusual cases of skull‐encephalic injuries in bathers that were caused by violent impacts with beach umbrellas. The first case concerned a 36‐year‐old man who, while lying on a sun bed, was struck on his left temple by a beach umbrella, which had been blown away by a gust of wind. The second case concerned a six‐year‐old child who was struck on the right temporal region while he was playing on the sand. Both subjects died. A review of the literature was carried out. Various skull and brain injuries caused by several objects were found, but no injuries caused by beach umbrellas were detected. There were only cases of injuries caused by normal umbrellas. These cases showed that several objects can be responsible for traumas causing skull and brain injuries, therefore forensic investigation must be supplemented by circumstantial data.     

A Preliminary Investigation into the Accuracy of 3D Modeling and 3D Printing in Forensic Anthropology Evidence Reconstruction,

There is currently no published empirical evidence‐base demonstrating 3D printing to be an accurate and reliable tool in forensic anthropology, despite 3D printed replicas being exhibited as demonstrative evidence in court. In this study, human bones (n = 3) scanned using computed tomography were reconstructed as virtual 3D models (n = 6), and 3D printed using six commercially available printers, with osteometric data recorded at each stage. Virtual models and 3D prints were on average accurate to the source bones, with mean differences from ?0.4 to 1.2 mm (?0.4% to 12.0%). Interobserver differences ranged from ?5.1 to 0.7 mm (?5.3% to 0.7%). Reconstruction and modeling parameters influenced accuracy, and prints produced using selective laser sintering (SLS) were most consistently accurate. This preliminary investigation into virtual modeling and 3D printer capability provides a novel insight into the accuracy of 3D printing osteological samples and begins to establish an evidence‐base for validating 3D printed bones as demonstrative evidence.     

An Anthropological Examination of the Types of Skeletal Fractures Resulting from Fatal High (˃3 m) Free Falls,

Fatal falls from heights (?3 m) often result in blunt force trauma (BFT) to the skeleton. The fracture patterns that result from this BFT mechanism are well understood in forensic anthropology and forensic pathology; however, details of the specific types of fractures that result remain poorly documented. The aim of this study was to provide a detailed examination of the types of fractures that may result from fatal high falls. Fractures were recorded from 95 full‐body postmortem computed tomography scans of individuals known to have died from a high fall. Trauma was then analyzed taking into account the extrinsic and intrinsic variables known to influence a fall using multiple logistic regression. A total of 339 types of fractures were classified, of which 16 were significantly associated with this BFT mechanism. Classified fracture types will augment anthropological interpretations of the circumstances of death from BFT in cases of suspected high falls.     

Age estimation and the developing third molar tooth: an analysis of an Australian population using computed tomography

The third molar tooth is one of the few anatomical sites available for age estimation of unknown age individuals in the late adolescent years. Computed tomography (CT) images were assessed in an Australian population aged from 15 to 25 years for development trends, particularly concerning age estimation at the child/adult transition point of 18 years. The CT images were also compared to conventional radiographs to assess the developmental scoring agreement between the two and it was found that agreement of Demirjian scores between the two imaging modalities was excellent. The relatively wide age ranges (mean ± 2SD) indicate that the third molar is not a precise tool for age estimation (age ranges of 3-8 years) but is, however, a useful tool for discriminating the adult/child transition age of 18 years. In the current study 100% of females and 96% of males with completed roots were over 18 years of age.     

Human dental age estimation by calculation of pulp-tooth volume ratios yielded on clinically acquired cone beam computed tomography images of monoradicular teeth

Abstract: Secondary dentine is responsible for a decrease in the volume of the dental pulp cavity with aging. The aim of this study is to evaluate a human dental age estimation method based on the ratio between the volume of the pulp and the volume of its corresponding tooth, calculated on clinically taken cone beam computed tomography (CBCT) images from monoradicular teeth. On the 3D images of 111 clinically obtained CBCT images (Scanora^®3D dental cone beam unit) of 57 female and 54 male patients ranging in age between 10 and 65 years, the pulp–tooth volume ratio of 64 incisors, 32 canines, and 15 premolars was calculated with Simplant^® Pro software. A linear regression model was fit with age as dependent variable and ratio as predictor, allowing for interactions of specific gender or tooth type. The obtained pulp–tooth volume ratios were the strongest related to age on incisors.