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Magnetic resonance imaging for forensic age estimation in living children and young adults: a systematic review

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Abstract

The use of MRI in forensic age estimation has been explored extensively during the last decade. The authors of this paper synthesized the available MRI data for forensic age estimation in living children and young adults to provide a comprehensive overview that can guide age estimation practice and future research. To do so, the authors searched MEDLINE, Embase and Web of Science, along with cited and citing articles and study registers. Two authors independently selected articles, conducted data extraction, and assessed risk of bias. They considered study populations including living subjects up to 30 years old. Fifty-five studies were included in qualitative analysis and 33 in quantitative analysis. Most studies had biases including use of relatively small European (Caucasian) populations, varying MR approaches and varying staging techniques. Therefore, it was not appropriate to pool the age distribution data. The authors found that reproducibility of staging was remarkably lower in clavicles than in any other anatomical structure. Age estimation performance was in line with the gold standard, radiography, with mean absolute errors ranging from 0.85 years to 2.0 years. The proportion of correctly classified minors ranged from 65% to 91%. Multifactorial age estimation performed better than that based on a single anatomical site. The authors found that more multifactorial age estimation studies are necessary, together with studies testing whether the MRI data can safely be pooled. The current review results can guide future studies, help medical professionals to decide on the preferred approach for specific cases, and help judicial professionals to interpret the evidential value of age estimation results.

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Acknowledgments

We thank Tom Verschoore (Bimetra, Ghent University Hospital), for advice regarding the review protocol. We acknowledge Karoline Elisivdatter Nyhagen for providing us the reference list of her bachelor’s thesis at the University of Central Lancashire, titled “Age Estimation in the Living Using Magnetic Resonance Imaging — A Review of Current Methods Identifying the 18-Years-Old Threshold,” which rendered two additional references to screen. We also thank Michiel de Haas (Netherlands Forensic Institute) and Martin Urschler (Ludwig Boltzmann Institute for Clinical Forensic Imaging) for providing us additional papers.

Our sincerest gratitude goes out to the authors who provided additional data for this review: Markus Auf der Mauer, Astrid Junge, Martin Urschler. Furthermore, special thanks to Peter Roozenbeek (KU Leuven) for his advice and help to create the perfect graphs, and to Steffen Fieuws (I-BioStat, KU Leuven) for statistical support and advice.

Finally, we kindly acknowledge Inès Phlypo and Patrick Davis for their critical review of the manuscript.

Author information

Authors and Affiliations

  1. Department of Diagnostic Sciences–Radiology, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium

    Jannick De Tobel, Jeroen Bauwens, Griet I. L. Parmentier & Koenraad L. Verstraete

  2. Department of Imaging and Pathology–Forensic Odontology, KU Leuven, Leuven, Belgium

    Jannick De Tobel, Ademir Franco & Patrick W. Thevissen

  3. Department of Oral Diseases and Maxillofacial Surgery, Maastricht UMC+, Maastricht, The Netherlands

    Jannick De Tobel

  4. Ghent Knowledge Centre for Health, Ghent University, Ghent, Belgium

    Nele S. Pauwels

Authors
  1. Jannick De Tobel
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  2. Jeroen Bauwens
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  3. Griet I. L. Parmentier
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  4. Ademir Franco
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  5. Nele S. Pauwels
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  6. Koenraad L. Verstraete
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  7. Patrick W. Thevissen
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Corresponding author

Correspondence to Jannick De Tobel.

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De Tobel, J., Bauwens, J., Parmentier, G.I.L. et al. Magnetic resonance imaging for forensic age estimation in living children and young adults: a systematic review. Pediatr Radiol 50, 1691–1708 (2020). https://doi.org/10.1007/s00247-020-04709-x

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  • DOI: https://doi.org/10.1007/s00247-020-04709-x

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