Author:

Keywords:

Science & Technology, Life Sciences & Biomedicine, Medicine, Legal, Legal Medicine, Age determination by skeleton, Age determination by teeth, Adolescent, Adult, Magnetic resonance imaging, MEDIAL CLAVICULAR EPIPHYSIS, 3RD MOLARS, T MRI, ACCURACY, SAMPLE, ERROR, Age Determination by Skeleton, Age Determination by Teeth, Bayes Theorem, Clavicle, Female, Forensic Anthropology, Forensic Dentistry, Humans, Magnetic Resonance Imaging, Male, Molar, Third, Prospective Studies, Radius, Sampling Studies, Ulna, White People, Young Adult, Legal & Forensic Medicine

Abstract:

Purpose: To study age estimation performance of combined magnetic resonance imaging (MRI) data of all four third molars, the left wrist and both clavicles in a reference population of females and males. To study the value of adding anthropometric and sexual maturation data. Materials and methods: Three Tesla MRI of the three anatomical sites was prospectively conducted from March 2012 to May 2017 in 14- to 26-year-old healthy Caucasian volunteers (160 females, 138 males). Development was assessed by allocating stages, anthropometric measurements were taken, and self-reported sexual maturation data were collected. All data was incorporated in a continuation-ratio model to estimate age, applying Bayes’ rule to calculate point and interval predictions. Two performance aspects were studied: (1) accuracy and uncertainty of the point prediction, and (2) diagnostic ability to discern minors from adults (≥ 18 years). Results: Combining information from different anatomical sites decreased the mean absolute error (MAE) compared to incorporating only one site (P < 0.0001). By contrast, adding anthropometric and sexual maturation data did not further improve MAE (P = 0.11). In females, combining all three anatomical sites rendered a MAE equal to 1.41 years, a mean width of the 95% prediction intervals of 5.91 years, 93% correctly classified adults and 91% correctly classified minors. In males, the corresponding results were 1.36 years, 5.49 years, 94%, and 90%, respectively. Conclusion: All aspects of age estimation improve when multi-factorial MRI data of the three anatomical sites are incorporated. Anthropometric and sexual maturation data do not seem to add relevant information.