title: Optimising magnetic resonance imaging-based evaluation of the ossification of the medial clavicular epiphysis: a multi-centre study.
abstract: Evaluation of the ossification of the medial clavicular epiphysis plays a key role in forensic age estimation, particularly in determining whether the age of 18 has been attained. A key research objective in the forensic age estimation field at present is to establish non-X-ray methods for investigating the clavicle. This paper looks at the use of magnetic resonance imaging for evaluating the developmental state of the medial clavicular epiphysis. Clavicle specimens obtained from autopsies of 125 female and 270 male subjects aged from 10 to 30 were examined using a 3-T magnetic resonance scanner. One FFE-3D-T1 gradient echo sequence and one 2D-T2 turbo spin echo sequence were acquired. In each case, two investigators undertook a consensual determination of the ossification stage of the medial clavicular epiphysis using recognised classification systems. To determine intra-observer and inter-observer agreement, 80 clavicle specimens were subjected to repeat evaluation. We present statistics relating to the ossification stages. The inclusion of established sub-stages of clavicular ossification offers an additional option for determining whether a subject has attained the age of 18 which is applicable in both sexes. For both sexes, the minimum ages for ossification stages 4 and 5 allow conclusions to be drawn about a subject's age at a point in time lying several years in the past. Magnetic resonance imaging is a valid investigatory procedure for determining the ossification stage of the medial clavicular epiphysis. This paper makes a contribution to expanding the range of methods available for forensic age estimation.
authors.affiliation: Institut für Rechtsmedizin, Universitätsklinikum Münster, Röntgenstraße 23, Münster, 48149, Germany.|Institut für Rechtsmedizin, Charité-Universitätsmedizin Berlin, Turmstraße 21, Berlin, 10559, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Schmidt
authors.affiliation: Institut für Rechtsmedizin, Universitätsklinikum Münster, Röntgenstraße 23, Münster, 48149, Germany.
authors.forename: C A
authors.initials: CA
authors.lastname: Henke
authors.affiliation: Institut für Rechtsmedizin, Universitätsklinikum Münster, Röntgenstraße 23, Münster, 48149, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Wittschieber
authors.affiliation: Institut für Klinische Radiologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Münster, 48149, Germany.|Klinik für Radiologie, Klinikum Ibbenbüren GmbH, Große Straße 41, Ibbenbüren, 49477, Germany.
authors.forename: V
authors.initials: V
authors.lastname: Vieth
authors.affiliation: Institut für Rechtsmedizin, Universitätsklinikum Essen, Hufelandstraße 55, Essen, 45122, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Bajanowski
authors.affiliation: Institut für Rechtsmedizin, Universität des Saarlandes, Gebäude 80. 2, Homburg Saar, 66421, Germany.|Institut für Rechtsmedizin, Universitätsklinikum Frankfurt, Kennedyallee 104, Frankfurt am Main, 60596, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Ramsthaler
authors.affiliation: Institut für Rechtsmedizin, Universitätsklinikum Hamburg-Eppendorf, Butenfeld 34, Hamburg, 22529, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Püschel
authors.affiliation: Institut für Rechtsmedizin, Universitätsklinikum Münster, Röntgenstraße 23, Münster, 48149, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Pfeiffer
authors.affiliation: Institut für Rechtsmedizin, Universitätsklinikum Münster, Röntgenstraße 23, Münster, 48149, Germany. andreas.schmeling@ukmuenster.de.
authors.forename: A
authors.identifier: http://orcid.org/0000-0002-0135-1617
authors.initials: A
authors.lastname: Schmeling
authors.affiliation: Institut für Rechtsmedizin, Universitätsklinikum Münster, Röntgenstraße 23, Münster, 48149, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Schulz
mesh_terms: D000293:Adolescent; D000328:Adult; D000365:Age Determination by Skeleton / Q000379:methods*; D002648:Child; D002968:Clavicle / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D004838:Epiphyses / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010012:Osteogenesis; D055815:Young Adult
keywords: Clavicle; Forensic age estimation; Magnetic resonance imaging; Ossification