Forensic age estimation based on distal radial epiphyseal maturation on wrist MRI: application of the Dedouit staging...

This study aimed to evaluate distal radial epiphyseal maturation using the Dedouit MRI staging system and to assess its applicability for forensic age estimation. In this retrospective study, clinical wrist MRI examinations of 516 subjects (252 females and 264 males) aged 10-27 years were evaluated. Coronal FS PD-weighted TSE images acquired on a 1.5 T MRI scanner were assessed independently by two radiologists according to the five-stage Dedouit classification system. Sex-specific age characteristics, minimum age thresholds, diagnostic performance at the 15- and 18-year age thresholds, and intra- and interobserver agreement were evaluated. Significant sex-related differences were observed in stages 3-5, with males reaching equivalent maturation stages at older ages than females (p < 0.05). Intra- and interobserver agreement was very good (weighted κ = 0.894 and 0.849, respectively). According to the minimum age concept, stage 5 was observed only in individuals older than 15 years in both sexes. The stage 4 or higher cutoff showed higher sensitivity, whereas stage 5 showed higher specificity for identifying individuals aged 15 years or older. Diagnostic performance for the 18-year threshold was limited. In conclusion, the Dedouit staging system demonstrated excellent reproducibility for the assessment of distal radial epiphyseal maturation on wrist MRI. The presence of stage 5 may support that an individual is older than 15 years. However, the method was insufficient for assessing the 18-year age threshold. These findings should be interpreted with caution because of the unbalanced age distribution of the study population. Further studies involving larger and more age-balanced populations are warranted.