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Comparison of different iterative CT reconstruction techniques and filtered back projection for assessment of the medial clavicular epiphysis in forensic age estimation

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Abstract

Purpose

To assess the impact of iterative reconstruction and filtered back projection (FBP) on image quality in computed tomography (CT)-based forensic age estimation of the medial clavicular epiphysis.

Methods and materials

CT of the clavicle was performed in 19 patients due to forensic reasons (70 mAs/140 kVp). Raw data were reconstructed with FBP and with an iterative algorithm at level 4 and 6. Clavicular ossification stage was determined by two radiologists in consensus, firstly on FBP reconstructed images and secondly after reviewing all reconstructions including iDose 4 and 6. In addition, the 3 reconstructions were compared regarding artefacts and delineation of the meta-/epiphyseal interface. Quantitative image noise was measured.

Results

Quantitative noise was lower in iDose 6 reconstructed images than in FBP (P < 0.042), but not significantly lower between iDose 4 and FBP (P = 0.127). Side by side comparison revealed lesser qualitative image noise on both iDose reconstructed images than for FBP. The meta-/epiphyseal interface delineation was rated better on both iDose levels than with FBP. In 3 of 19 patients, the clavicular ossification stage was reclassified after iterative reconstructions had been additionally reviewed.

Conclusion

Using iterative CT reconstruction algorithms, a reduction of image noise and an enhancement of image quality regarding the meta-/epiphyseal clavicular interface can be achieved. The study highlights the importance of image standardization as variation of reconstruction technique has impact on forensic age estimation.

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology and Nuclear medicine, Section of Pediatric Radiology, University Hospital Hamburg-Eppendorf, 20246, Hamburg, Germany

    Magdalini Tozakidou & Jochen Herrmann

  2. Children Clinical University Hospital, Riga, Latvia

    Ilze Apine

  3. Department of Psychiatry and Psychotherapy, University Hospital Tübingen, Tübingen, Germany

    Kay U. Petersen

  4. Department of Diagnostic and Interventional Radiology and Nuclear medicine, University Hospital Hamburg-Eppendorf, 20246, Hamburg, Germany

    Julius Matthias Weinrich

  5. Cantonal Hospital Aarau, Aarau, Switzerland

    Sebastian Schindera

  6. Department of Forensic Medicine, University Hospital Hamburg-Eppendorf, 22529, Hamburg, Germany

    Eilin Jopp-van Well & Klaus Püschel

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  1. Magdalini Tozakidou
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Correspondence to Magdalini Tozakidou.

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This retrospective study was approved by the local ethics committee with waived informed consent due to the use of anonymized data.

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Tozakidou, M., Apine, I., Petersen, K.U. et al. Comparison of different iterative CT reconstruction techniques and filtered back projection for assessment of the medial clavicular epiphysis in forensic age estimation. Int J Legal Med 134, 355–361 (2020). https://doi.org/10.1007/s00414-019-02214-x

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