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Technical note: utilization of 3D-rendering for CT evaluation of extremitas sternalis claviculae within medical age assessment practice

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Abstract

According to the acknowledged recommendations of the multidisciplinary “Study Group on Forensic Age Diagnostics,” the indicator “medial clavicular ossification” carries the potential of delivering decisive evidence to proof age majority “beyond reasonable doubt” regarding age-disputed individuals within legal procedures. Yet, sternoclavicular thin-slice computed tomography, representing its preferred imaging modality, not rarely exhibits peculiar morphologies of the site, sometimes difficult to understand from the usually obtained, axial sections together with coronal reformations. Because of that, we utilized 3D-rendering of acquired CT data in 224 cases with the purpose to gain additional visualization of certain questionable appearances. Concerning reliable classification of medial clavicular ossification in line with the typologies of Schmeling et al. and Kellinghaus et al., it is concluded that such means of illustration contribute to recognition of polygonal or irregular, epiphyseal formations including the not-assessable shape variant “multiple, medial, secondary ossification centres” and of calcification of the articular capsule.

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References

  1. Austrian Asylum Act: https://www.ris.bka.gv.at/GeltendeFassung/Bundesnormen/20004240/AsylG%202005%2c%20Fassung%20vom%2015.08.2017.pdf. Accessed 15 Feb 2019

  2. Austrian BFA-Procedural Law: https://www.ris.bka.gv.at/GeltendeFassung/Bundesnormen/20007944/BFA-VG%2c%20Fassung%20vom%2001.01.2014.pdf?FassungVom=2014-01-01. Accessed 15 Feb 2019

  3. Eid M, De Cecco CN, Nance JW et al (2017) Cinematic rendering in CT: a novel, lifelike 3D visualization technique. Am J Roentgenol 209(2):370ff. https://doi.org/10.2214/AJR.17.17850

    Article  Google Scholar 

  4. EU-‘Asylum Procedure’ Directive 2013/32/EU (26.06.2013)

  5. EU-‘Asylum Procedure’ Directive 2005/85/EC (01.12.2005)

  6. EU-‘Qualification’ Directive 2011/95/EU (13.12.2011)

  7. EU-‘Radiation Protection’ Directive 2013/59/EURATOM (05.12.2013)

  8. EU-‘Radiation Protection’ Directive 97/43/EURATOM (30.06.1997)

  9. Glemser PA, Engel K, Simons D et al (2018) A new approach for photorealistic visualization of rendered CT images. World Neurosurg 114:e283ff. https://doi.org/10.1016/j.wneu.2018.02.174

    Article  Google Scholar 

  10. Kellinghaus M, Schulz R, Vieth V et al (2010) Enhanced possibilities to make statements on the ossification status of the medial clavicular epiphysis using an amplified staging scheme in evaluating thin-slice CT scans. Int J Legal Med 124(4):321ff. https://doi.org/10.1007/s00414-010-0448-2

  11. Kellinghaus M, Schulz R, Vieth V et al (2010) Forensic age estimation in living subjects based on the ossification status of the medial clavicular epiphysis as revealed by thin-slice multidetector computed tomography. Int J Legal Med 124(2):149ff. https://doi.org/10.1007/s00414-009-0398-8

    Article  Google Scholar 

  12. Rudolf E (2016) Medical age assessment in the case of a “doubtful” claim to being an unaccompanied minor as set forth in Article 25 para 5 sentences one to three of the recast Asylum Procedures Directive 2013. The Establishment of Identity in the Migration Process. EMN-Conference Vienna: https://www.emn.at/wp-content/uploads/2017/01/EMN-Tagungsbericht_web.pdf. Accessed 15 Feb 2019

  13. Rudolf E, Kramer J, Schmidt S et al (2018) Intraindividual incongruences of medially ossifying clavicles in borderline adults as seen from thin-slice CT-studies of 2,595 male persons. Int J Legal Med 132(2):629ff. https://doi.org/10.1007/s00414-017-1694-3

    Article  Google Scholar 

  14. Schmeling A, Dettmeyer R, Rudolf E et al (2016) Forensic age estimation: methods, certainty, and the law. Dtsch Arztebl Int 113(4):44ff. https://doi.org/10.3238/arztebl.2016.0044

    Google Scholar 

  15. Schmeling A, Grundmann C, Fuhrmann A et al (2008) Criteria for age estimation in living individuals. Int J Legal Med 122(6):457ff. https://doi.org/10.1007/s00414-008-0254-2

    Article  Google Scholar 

  16. Schmeling A, Schulz R, Reisinger W et al (2004) Studies on the time frame for ossification of the medial clavicular epiphyseal cartilage in conventional radiography. Int J Legal Med 118(1):5ff. https://doi.org/10.1007/s00414-003-0404-5

    Article  Google Scholar 

  17. Wei H, Zhu GY, Lei W et al (2014) Correlation between age and the parameters of medial epiphysis and metaphysis of the clavicle using CT volume rendering images. Forensic Sci Int 244:316.e1ff. https://doi.org/10.1016/j.forsciint.2014.09.006

    Article  Google Scholar 

  18. Wittschieber D, Schulz R, Pfeiffer H et al (2017) Systematic procedure for identifying the five main ossification stages of the medial clavicular epiphysis using computed tomography: a practical proposal for forensic age diagnostics. Int J Legal Med 131(1):217ff. https://doi.org/10.1007/s00414-016-1444-y

  19. Wittschieber D, Schulz R, Vieth V et al (2014) Influence of the examiner’s qualification and sources of error during stage determination of the medial clavicular epiphysis by means of computed tomography. Int J Legal Med 128(1):183ff. https://doi.org/10.1007/s00414-013-0932-6

    Article  Google Scholar 

  20. Wittschieber D, Schulz R, Vieth V et al (2014) The value of sub-stages and thin slices for the assessment of the medial clavicular epiphysis: a prospective multi-center CT study. Forensic Sci Med Pathol 10(2):163ff. https://doi.org/10.1007/s12024-013-9511-x

    Article  Google Scholar 

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Authors and Affiliations

  1. Wiesenstrasse 20, 4800, Attnang-Puchheim, Austria

    Ernst Rudolf

  2. Institute for CT and MRT Diagnostics, Rainerstr. 6-8, 4020, Linz, Austria

    Josef Kramer

  3. Raxbergen 27, 8380, Jennersdorf, Austria

    Ingomar Winkler

  4. Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany

    Andreas Schmeling

Authors
  1. Ernst Rudolf
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  2. Josef Kramer
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  3. Ingomar Winkler
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  4. Andreas Schmeling
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Rudolf, E., Kramer, J., Winkler, I. et al. Technical note: utilization of 3D-rendering for CT evaluation of extremitas sternalis claviculae within medical age assessment practice. Int J Legal Med 133, 931–934 (2019). https://doi.org/10.1007/s00414-019-02025-0

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  • DOI: https://doi.org/10.1007/s00414-019-02025-0

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