Assessment of Ankle Ossification for Forensic Age Estimation via 3.0 T MRI: A Preliminary Study

Forensic age estimation has become increasingly important in recent years due to its wide range of applications in both legal and clinical contexts, such as immigration procedures, criminal investigations, and the protection of minors. Radiological evaluation plays a key role in this process, and the methods recommended in current guidelines are predominantly X-ray-based. However, because of the potential risks of ionizing radiation, particularly for younger individuals, research on alternative radiological techniques has gained increasing attention. In this study, we aimed to evaluate the ossification stages of the distal tibial epiphysis and calcaneal apophysis in ankle MRI examinations in the context of forensic age estimation and to contribute to the existing data by comparing our results with those of previous studies.

The ankle MR images of subjects between 8 and 25 years old (71 females and 105 males), obtained with a 3.0 T MRI scanner, were evaluated retrospectively according to the staging method utilized by Saint-Martin et al. On T1-weighted images, the distal tibial epiphysis and calcaneal apophysis were independently assessed by two observers using a three-stage classification system.

According to the results of our study, the interobserver and intraobserver agreement in the assessment of the distal tibial epiphysis and calcaneal apophysis was very good. All cases observed with stage 1 in the distal tibia and calcaneus were under 15 years of age. All cases observed with stage 2 in the calcaneus were under 18 years of age.

The three-stage MRI method allows detailed assessment of ankle maturation and may provide supportive information for forensic age estimation. However, given the limitations with regard to defining some age thresholds, particularly at 18 years, this method should be regarded as a complementary rather than a stand-alone tool. Further studies with larger cohorts are required to better clarify its applicability at legally relevant ages.

· A three-stage method using ankle MRI scans may be useful for forensic age estimation.. · High inter- and intraobserver agreement supports the reliability of the method.. · MRI provides a safer, radiation-free alternative to X-ray..

· Altinsoy HB, Has B, Gurses MS et al. Assessment of Ankle Ossification for Forensic Age Estimation via 3 T MRI: A Preliminary Study. Rofo 2026; DOI 10.1055/a-2837-8981.