Cameriere’s approach modified for pelvic radiographs: a novel method to assess apophyseal iliac crest ossification for the purpose of forensic age diagnostics

According to a modified method originally developed by Cameriere et al. (Int J Legal Med 120:143–146, 2006; J Forensic Sci 52:1151–1155, 2007; Forensic Sci Int 174:59–62, 2008; Forensic Sci Int 174:178–181, 2008; Forensic Sci Int 193:128.e1–128.e6, 2009), the suitability of the iliac crest apophysis (ICA) for the purpose of forensic age estimation in living individuals was investigated by means of area measurements in 643 pelvic radiographs of patients aged between 10 and 30 years. The area of the ossification centre(s) of the iliac crest and the area of the iliac wing (IW) were determined by manual segmentation. In 116 cases, area measurements were possible. ICA/IW ratios were calculated and used for regression analyses, yielding different regression equations. Depending on sex, pelvic side and ratio considered, R ² ranged between 0.20 and 0.38 and the standard error of the estimate, between 1.91 and 2.00 years. No statistical significant differences were found between the right and the left pelvic sides. In conclusion, this method is potentially applicable for forensic age estimation in living individuals. However, further studies under more standardised conditions and with higher case numbers are needed in order to decide whether the iliac crest apophysis might become suitable for routine age diagnostics.     

Reference data for the Thiemann–Nitz method of assessing skeletal age for the purpose of forensic age estimation

The aim of this study was to determine the statistical parameters of deviation in the Thiemann–Nitz method for use in forensic age diagnostics. To this effect, 402 hand radiograms, originally taken in two large German cities between 1983 and 2002 for the purpose of diagnosing trauma, were analyzed. At the time of examination, the patients were aged between 10 and 18 years. The study presents the mean, standard deviation, and median, with lower and upper quartiles, for the skeletal ages of 11.0 through 18.0 years. The simple standard deviations range between 0.2 and 1.2 years. To increase the accuracy of age estimates and improve the identification of age-relevant developmental disorders in forensic age estimation practice, the methods for determining skeletal age should always be combined with a physical and dental examination. In addition, the expert opinion should pay attention to the issue of different modernization levels in relevant populations.     

Dental age estimation in the living after completion of third molar mineralization: new data for Gustafson’s criteria

There is a need for dental age estimation methods after completion of the third molar mineralization. Degenerative dental characteristics appear to be suitable for forensic age diagnostics beyond the 18th year of life. In 2012, Olze et al. investigated the criteria studied by Gustafson using orthopantomograms. The objective of this study was to prove the applicability and reliability of this method with a large cohort and a wide age range, including older individuals. For this purpose, 2346 orthopantomograms of 1167 female and 1179 male Germans aged 15 to 70 years were reviewed. The characteristics of secondary dentin formation, cementum apposition, periodontal recession and attrition were evaluated in all the mandibular premolars. The correlation of the individual characteristics with the chronological age was examined by means of a stepwise multiple regression analysis, in which the chronological age formed the dependent variable. Following those results, R ² values amounted to 0.73 to 0.8; the standard error of estimate was 6.8 to 8.2 years. Fundamentally, the recommendation for conducting age estimations in the living by these methods can be shared. The values for the quality of the regression are, however, not precise enough for a reliable age estimation around regular retirement date ages. More precise regression formulae for the age group of 15 to 40 years of life are separately presented in this study. Further research should investigate the influence of ethnicity, dietary habits and modern health care on the degenerative characteristics in question.

     

Radiographic features of Ewing’s sarcoma of the bones of the hands and feet

The radiographic features of Ewing's sarcoma of the bones of the hands and feet are reviewed utilizing cases obtained from the Mayo Clinic patient files and the consultation files of Drs. D.C. Dahlin and K.K. Unni. This series consists of a total of 43 cases of pathologically proven Ewing's sarcoma involving the small bones of the hands and feet. The classic radiographic features of Ewing's sarcoma in the long bones, including lytic, permeative destruction, aggressive periosteal reaction, cortical violation, and a soft tissue mass, are also seen in the bones of the hands and feet, with similar frequency. These classic features are most commonly present in lesions affecting the short tubular bones. Lesions affecting the tarsal bones more often demonstrate atypical radiographic features. These atypical radiographic appearances may play a role in the reported delay in diagnosis of Ewing's sarcoma within the tarsal bones.     

CT of the medial clavicular epiphysis for forensic age estimation: hands up?

International Journal of Legal Medicine - The aim of this study was to assess the impact of arm position in computed tomography (CT) of the clavicle performed for forensic age estimation on...     

Correlation of MRI with arthroscopy for the evaluation of the subscapularis tendon: a musculoskeletal division’s experience

Objective

To determine the accuracy of MR imaging for the evaluation of the subscapularis tendon as well as define imaging findings that will increase accuracy.

Materials and methods

Retrospective review of the MR and operative (OR) reports of 286 patients was conducted and reviewed for the presence/degree (partial (PT)/full-thickness (FT)) of tearing; only PT articular tears were included. The presence of a supraspinatus tear and time interval between surgery and MRI were also documented. All of the PT tears called on MRI were also reviewed to see if there was a statistically significant association between certain imaging characteristics and the presence of a tear in surgery. Statistical analysis included 95 % confidence intervals, Fisher’s exact, and exact Mann–Whitney tests.

Results

A total of 244 patients were included in the study with a total of 25 subscapularis tears, 16 PT and nine FT, and 219 intact tendons in arthroscopy; 20/25 tears and 200 intact tendons were diagnosed correctly on MRI, resulting in sensitivity of 80 %, specificity of 91 %, accuracy of 90 %, positive predictive value of 51 %, and negative predictive value of 98 %. There was a significant association between the presence of a PT tear during arthroscopy and fluid-like signal within the tendon on more than one imaging plane (p?<?0.001) with an accuracy of 90 %.

Conclusions

This study reflects a musculoskeletal radiology section’s experience with the diagnosis of subscapularis tendon pathology, demonstrating that MRI could be used to accurately evaluate the subscapularis tendon. An understanding of certain imaging pitfalls and the presence of fluid-like signal on multiple imaging planes should increase the diagnostic accuracy of the radiologist evaluating the subscapularis tendon for the presence of a tear.     

Ultrasonographic evaluation of peyronie’s disease

High-resolution ultrasonography was performed on 58 patients with Peyronie’s disease and on 6 healthy men; in 3 patients the examination was repeated during medical treatment for a follow-up period of 4 months. Peyronie’s plaques always corresponded to abnormal echographic findings. In 54/58 cases (93%) they appeared as hyperechoic lesions. In 4 cases (7%) the plaques were hypoechoic and corresponded to a localized widening of the pericavernous tissues: this condition was observed more frequently in the earliest stages of the disease. There was good agreement between the palpable size of the plaques and their size measured by ultrasonography, with some degree of clinical overestimation of the smallest lesions. Calcified mature plaques corresponded to dense hyperechoic lesions with acoustical shadowing. High-resolution ultrasonography is proposed as a first-line diagnostic approach and as a reliable follow-up examination for Peyronie’s disease. The possibility of differentiating calcified plaques from the more recent ones is helpful to allow a correct choice of medical or surgical treatment.     

Comparative analysis of the applicability of the skeletal age determination methods of Greulich–Pyle and Thiemann–Nitz for forensic age estimation in living subjects

Evaluation of hand ossification is a main pillar of radiological age diagnosis in living subjects. In the present study, we comparatively assessed the Greulich–Pyle and Thiemann–Nitz methods for accuracy of age estimation and degree of acceleration in the respective reference populations. For this, the skeletal age of 649 hand X-rays from German subjects aged 1–18 years was determined by both methods. Accuracy of the age estimates was determined based on regression and measures of certainty. In terms of accuracy, both methods seem to be equally well suited for forensic age diagnostics. The degree of acceleration in the reference populations for the two methods was calculated as the mean difference between the estimated skeletal age and the actual age of a test subject. Compared to the Greulich–Pyle population, the Thiemann–Nitz population was accelerated by 0.44 years in both male and female subjects. When an expert opinion is required and one cannot exclude the possibility that the investigated subject may come from a population with a high acceleration status, the Thiemann–Nitz method should preferably be used to prevent overestimation of age.     

Recent advances in PET imaging for evaluation of Parkinson’s disease

Parkinson’s disease (PD) consists of loss of pigmented dopamine-secreting neurons in the pars compacta of the midbrain substantia nigra. These neurons project to the striatum (putamen and caudate nucleus) and their loss leads to alterations in the activity of the neural circuits that regulate movement. In a simplified model, two dopamine pathways are involved: the direct pathway, which is mediated through facilitation of the D₁ receptors, and the indirect pathway through D₂ receptors (inhibitory). Positron emission tomography (PET) tracers to image the presynaptic sites of the dopaminergic system include 6-[¹⁸F]FDOPA and 6-[¹⁸F]FMT, [¹¹C]dihydrotetrabenazine, [¹¹C]nomifensine and various radiolabelled cocaine derivatives. Postsynaptically, for the dopamine D₁ subtype the most commonly used ligands are [¹¹C]SCH 23390 or [¹¹C]NNC 112 and for the D₂ subtype [¹¹C]raclopride, [¹¹C]MNPA and [¹⁸F]DMFP. PET is a sensitive and specific non-invasive molecular imaging technique that may be helpful for evaluation of PD and its differential diagnosis from other parkinsonian syndromes.     

Development and evaluation of a rapid PCR method for the PowerPlex®S5 system for forensic DNA profiling

Forensic DNA profiling is a multi-step process taking approximately 10 h to complete. A reduction in the amount of time required for the amplification step would allow for faster human identification and increase laboratory throughput. The goal of this work was to optimize and evaluate a rapid PCR method for the PowerPlex®S5 system for forensic DNA profiling. By pairing fast chemistries with a fast thermal cycler, we were able to reduce the amplification time by 70% (1 h). Sensitivity and heterozygous peak height ratios were comparable between the fast and standard protocols. However, there was a notable decrease (5%) in peak height ratio at the D18S51 locus with the fast cycling method. An increase in average mean stutter for combined loci of 2.6% was observed in profiles amplified using the fast protocol compared to the standard system. Our results suggest that with further optimization and validation the fast protocol can be used to replace the standard amplification conditions.     

An evaluation of pathologists’ application of the diagnostic criteria from the San Diego definition of SIDS and unclassified sudden infant death

International Journal of Legal Medicine - Despite being widely used, few studies have assessed the utility of the San Diego definition of sudden infant death syndrome (SIDS). The purpose of this...     

The applicability of Willems’ and Lee’s dental age estimation methods for Japanese children and the comparison with the Korean population

This study aimed to examine the applicability of Willems’ and Lee’s methods in a Japanese population and to find the differences in teeth development between Japanese and Korean children by comparing the accuracy of their estimated age using the two methods. The developmental status of the lower left permanent teeth in 1,475 orthopantomograms of Japanese children were evaluated based on Demirjian’s criteria, and the ages were estimated using Willems’ and Lee’s methods. The errors in estimated ages were calculated and compared with equivalent Korean population data. The accuracy of both methods for estimating the age of the Japanese population was similar to that in the Korean population except for that of Lee’s method used in Japanese males. The results showed that there might be differences in teeth development between the Japanese and Korean boys. To increase the accuracy of the dental age estimation, the method that is derived from their own population data should be applied in forensic practice.     

Challenges for forensic science: new demands in today’s world

In their 2009 report entitled ‘Strengthening forensic science in the United States: a path forward,’ the National Research Council (NRC) provided an assessment of the past, present, and future state of forensic science – especially related to impression evidence. The NRC described the need for further advances in some forensic science disciplines in order to improve criminal investigations, reduce the possibility of wrongful convictions, and to enhance national security. Recent events in international and domestic terrorism and the identification of dozens of wrongful convictions have further demonstrated the need for forensic science to address new challenges. From the bioterrorism events within the United States related to the anthrax mailings, to the seemingly endless stream of improvised explosive devices in the Iraq/Afghanistan wars, forensic science has new demands and an increasingly important opportunity to play a vital role in the world’s major events. With this demand comes a requirement to enhance the very foundations on which many disciplines in forensic science rest. The need for objective, scientifically-based criteria for determining identifications has never been more important and it will take researchers and practitioners working together to move forensic science in the proper direction.     

Types of diatoms in China’s three major rivers and the possible application for an automatic forensic diatom test

The diatom test is the most reliable approach that provides scientific support for diagnosis of drowning. However, there are limitations, which, made forensic scientists stop using the test, such as the fact that it is time-consuming and lack of domain knowledge of the diatom identification. This study aims to find different types of diatoms that are commonly present in water bodies in China for a possible application of an automatic forensic diatom test. In total, 119 different water samples were obtained from different locations of the Yellow River, the Yangtze River and the Pearl River (China) and were analysed. About 50?ml of water of each sampling site was digested and then observed by a scanning electron microscopy. The diatom genera found in samples were recorded. Twenty-four diatom genera were found in all samples. Among them, Navicula, Nitzschia, Cyclotella, Synedra and Gomphonema were commonly presented (>70%) across the broad geographic regions. Navicula, Nitzschia, Cyclotella, Synedra and Gomphonema would be the main diatoms used in designing an automatic diatom identification system for forensic diatom test.     

The importance of Blumensaat’s line morphology for accurate femoral ACL footprint evaluation using the quadrant method

Purpose

The purpose of this study was to evaluate the difference in the center position of the ACL footprint based on grid placement using the quadrant method according to the morphological variations of the Blumensaat’s line.

Methods

Fifty-nine non-paired human cadaver knees were used. The ACL was cut in the middle, and the femoral bone was cut at the most proximal point of the femoral notch, and the digital images were evaluated using Image J software. The femoral ACL footprint was periphery outlined and the center position was automatically measured. Following Iriuchishima’s classification, the morphology of the Blumensaat’s line was classified into straight, small hill, and large hill types. From the images, grid quadrants were placed as: Grid (1) without consideration of hill existence and not including the chondral lesion. Grid (2) without consideration of hill existence and including the chondral lesion. Grid (3) with consideration of hill existence and not including the chondral lesion. Grid (4) with consideration of hill existence and including the chondral lesion.

Results

The straight type consisted of 19 knees, the small hill type 13 knees, and the large hill type 27 knees. Depending on the quadrant grid placement, significant center position difference was observed both in the shallow–deep, and high–low direction. When hill existence was considered, the center position of the ACL was significantly changed to a high position.

Conclusion

The center position of the ACL footprint exhibited significant differences according to Blumensaat’s line morphology. For clinical relevance, when ACL surgery is performed in knees with small or large hill type variations, surgeons should pay close attention to femoral tunnel evaluation and placement, especially when using the quadrant method.

     

In vivo evaluation of a novel tau imaging tracer for Alzheimer’s disease

Purpose

Diagnosis of tauopathies such as Alzheimer’s disease (AD) still relies on post-mortem examination of the human brain. A non-invasive method of determining brain tau burden in vivo would allow a better understanding of the pathophysiology of tauopathies. The purpose of the study was to evaluate ¹⁸F-THK523 as a potential tau imaging tracer.

Methods

Ten healthy elderly controls, three semantic dementia (SD) and ten AD patients underwent neuropsychological examination, MRI as well as ¹⁸F-THK523 and ¹¹C-Pittsburgh compound B (PIB) positron emission tomography (PET) scans. Composite memory and non-memory scores, global and hippocampal brain volume, and partial volume-corrected tissue ratios for ¹⁸F-THK523 and ¹¹C-PIB were estimated for all participants. Correlational analyses were performed between global and regional ¹⁸F-THK523, ¹¹C-PIB, cognition and brain volumetrics.

Results

¹⁸F-THK523 presented with fast reversible kinetics. Significantly higher ¹⁸F-THK523 retention was observed in the temporal, parietal, orbitofrontal and hippocampi of AD patients when compared to healthy controls and SD patients. White matter retention was significantly higher than grey matter retention in all participants. The pattern of cortical ¹⁸F-THK523 retention did not correlate with Aβ distribution as assessed by ¹¹C-PIB and followed the known distribution of tau in the AD brain, being higher in temporal and parietal areas than in the frontal region. Unlike ¹¹C-PIB, hippocampal ¹⁸F-THK523 retention was correlated with several cognitive parameters and with hippocampal atrophy.

Conclusion

¹⁸F-THK523 does not bind to Aβ in vivo, while following the known distribution of paired helical filaments (PHF)-tau in the brain. Significantly higher cortical ¹⁸F-THK523 retention in AD patients as well as the association of hippocampal ¹⁸F-THK523 retention with cognitive parameters and hippocampal volume suggests ¹⁸F-THK523 selectively binds to tau in AD patients. Unfortunately, the very high ¹⁸F-THK523 retention in white matter precludes simple visual inspection of the images, preventing its use in research or clinical settings.