Staging Clavicular Development on MRI: Pitfalls and Suggestions for Age Estimation

Area of Science:

• Forensic anthropology
• Radiology
• Biometrics

Background:

• Sternal clavicle MRI is used for age estimation.
• Potential pitfalls in this method are known but their impact on accuracy is unclear.

Purpose of the Study:

• Investigate pitfalls in sternal clavicle MRI for forensic age estimation.
• Propose optimal methods for accurate age assessment using MRI.

Main Methods:

• Prospective cross-sectional study of 524 healthy Caucasian volunteers (11-30 years old).
• Utilized 3T MRI with T1-weighted VIBE sequence.
• Four observers applied advanced staging techniques and documented morphological variants.

Main Results:

• High intraobserver (0.82) and interobserver (0.60-0.64) agreement for staging.
• Excluding stages 1 and 4/5 and using both clavicles yielded a Mean Absolute Error (MAE) of 1.97 years.
• Morphological variants significantly increased MAE (P < 0.05).

Conclusions:

• Using both clavicles and excluding specific developmental stages (1 and 4/5) improves MRI-based age estimation.
• Morphological variants negatively impact accuracy and should be considered.
• Further research is needed to investigate other proposed methods.