title: Radiologic identification of disaster victims: a simple and reliable method using CT of the paranasal sinuses.
abstract: OBJECTIVE
  To assess the reliability of radiologic identification using visual comparison of ante and post mortem paranasal sinus computed tomography (CT).
  
  
  METHODS
  The study was approved by the responsible justice department and university ethics committee. Four blinded readers with varying radiological experience separately compared 100 post mortem to 25 ante mortem head CTs with the goal to identify as many matching pairs as possible (out of 23 possible matches). Sensitivity, specificity, positive and negative predictive values were calculated for all readers. The chi-square test was applied to establish if there was significant difference in sensitivity between radiologists and non-radiologists.
  
  
  RESULTS
  For all readers, sensitivity was 83.7%, specificity was 100.0%, negative predictive value (NPV) was 95.4%, positive predictive value (PPV) was 100.0%, and accuracy was 96.3%. For radiologists, sensitivity was 97.8%, NPV was 99.4%, and accuracy was 99.5%. For non-radiologists, average sensitivity was 69.6%, negative predictive value (NPV) was 91.7%, and accuracy was 93.0%. Radiologists achieved a significantly higher sensitivity (p < 0.01) than non-radiologists.
  
  
  CONCLUSIONS
  Visual comparison of ante mortem and post mortem CT of the head is a robust and reliable method for identifying unknown decedents, particularly in regard to positive matches. The sensitivity and NPV of the method depend on the reader's experience.
authors.affiliation: Center for Forensic Imaging and Virtopsy, Institute of Forensic Medicine, University of Bern, Buehlstrasse 20, CH-3012 Bern, Switzerland. thomas.ruder@irm.unibe.ch
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Ruder
authors.forename: Markus
authors.initials: M
authors.lastname: Kraehenbuehl
authors.forename: Walther F
authors.initials: WF
authors.lastname: Gotsmy
authors.forename: Sandra
authors.initials: S
authors.lastname: Mathier
authors.forename: Lars C
authors.initials: LC
authors.lastname: Ebert
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Thali
authors.forename: Gary M
authors.initials: GM
authors.lastname: Hatch
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D056667:Biometric Identification / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D004190:Disasters; D005260:Female; D018732:Forensic Anthropology / Q000379:methods*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010256:Paranasal Sinuses / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014218:Triage; D055815:Young Adult