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Age estimation from pubic symphysis based on cinematic volume rendering: comparison between Suchey-Brooks staging and
Yu-Chi Zhou1,2, Shuai Luo1,3, Meng Liu1,3
1Department of Forensic Pathology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, 610041, Sichuan, P.R. China.
International Journal of Legal Medicine
|June 27, 2026
Summary
Forensic anthropology uses conventional methods and deep learning for adult age estimation from pelvic CT scans. Both approaches show similar accuracy, with deep learning offering a scalable, automated solution.
Area of Science:
- Forensic Anthropology
- Medical Imaging
- Artificial Intelligence
Background:
- Accurate adult age estimation is crucial in forensic anthropology.
- Conventional methods like the Suchey-Brooks (SB) method have limitations.
- Advancements in imaging and AI offer new possibilities for age estimation.
Purpose of the Study:
- To compare the performance of the conventional Suchey-Brooks (SB) method with a deep learning (DL) approach for adult age estimation.
- To evaluate age estimation accuracy using standardized cinematic volume rendering (cVR) from pelvic CT scans.
- To analyze age-dependent biases and the focus of DL models in age estimation.
Main Methods:
- Analysis of 1,359 pelvic CT scans from a Chinese cohort.
- Application of the conventional Suchey-Brooks (SB) method with cubic regression.
- Implementation of a deep learning (DL) model for age estimation.
- Utilized gradient-weighted class activation mapping (Grad-CAM) for DL model visualization.
Main Results:
- SB method achieved Mean Absolute Errors (MAE) of 5.94 years (males) and 6.06 years (females).
- DL model produced MAEs of 6.64 years (males) and 7.03 years (females).
- No significant accuracy difference was found between SB and DL methods.
- Both methods showed age-dependent bias: overestimation in younger adults and underestimation in older individuals.
- DL model visualization revealed focus on pubic symphyseal surface morphology.
Conclusions:
- Cinematic volume rendering (cVR)-based SB phase assignment and deep learning regression achieve compatible precision for adult age estimation.
- Deep learning offers a scalable, automated, first-line approach for objective age estimation in forensic anthropology.
- Both methods demonstrate age-related biases that warrant further investigation.