Forensic Radiology and Imaging

Accuracy and reliability of enamel and dentin thickness measurements on micro-computed tomography and digital periapical radiographs# Publication date: Available online 4 June 2019 Source: Journal of Forensic Radiology and Imaging Author(s): Ceren Aktuna Belgın, Gozde Serindere, Kaan Orhan Abstract In the application of scientific human skeletal variation in medico-legal matters, virtual anthropology is the current technique performed to examine skeleton and its body parts. Digital imaging techniques are used in many areas of dentistry and forensic dentistry. Among all digital imaging modalities, digital periapical radiography (PR) are the most widely used, however, new contemporary imaging techniques micro-computed tomography (Micro-CT) can be also used. The aim of this study was to assess the accuracy and reliability of enamel and dentin thickness measurement through intra and inter-observer error analysis, and comparison was made between periapical radiographs and Micro-CT methods. In this study 15 maxillary first premolar were used which extracted for various reasons. Enamel and dentin thicknesses and maximum cervical crown widths (MCCW) of 15 premolar teeth were examined in both Micro-CT and periapical radiographs. The results obtained with the exact maximum cervical crown widths were compared Image J software version. A digital caliper was used to measure the actual MCCW of the teeth. Results exhibited no significant differences in the measurements by the intra or inter-observer error analyses. The intraclass correlation coefficients (ICC) were more than 0.95 by both intra and inter-observer error analyses. There was significant differences in the measurements by PR and Micro-CT methods. By parameters, Micro-CT showed the highest R value (0.962) with the least error in different methods and observers. In conclusion, dentin and enamel measurements by Micro-CT was highly accurate and reliable as in the conventional method (PR). Micro-CT evaluations should be recommended for implementation in the future anthropological studies especially in countries with limited source of dental data.

Morphological analysis of frontal sinuses registered in an occlusal film by intraoral radiographic device – A case report Publication date: June 2019 Source: Journal of Forensic Radiology and Imaging, Volume 17 Author(s): Rhonan Ferreira Silva, Lívia Graziele Rodrigues, Fernando Fortes Picoli, Juliano Martins Bueno, Raquel Porto Alegre Valente Franco, Ademir Franco Abstract Frontal sinuses have a distinctive morphology that may support human identifications in the routine of medico-legal institutes. On the other hand, forensic facilities in developing countries may be limited in radiologic technology. This study aims to report a case of human identification in which the frontal sinuses were assessed by means of an adapted radiographic technique. An unknown charred victim of car crash was referred to the local medico-legal institute for human identification. The antemortem (AM) data provided by the alleged relatives of the victims consisted of a posteroanterior (PA) radiograph of the skull. In order to reproduce the AM radiograph for comparison of the frontal sinuses, and adapted technique was performed by positioning an occlusal film on the anterior surface of the frontal bone of the victim to and the radiographic cylinder on the posterior surface of the skull. A PM radiograph of the frontal sinuses was obtained in PA projection. A qualitative radiographic analysis of the morphology of the frontal sinuses revealed the convergence of AM and PM evidences and contributed to the human identification process.

Applicability and reliability of foramen magnum for sex determination in contemporary Western Indian population: A computed tomographic study Publication date: June 2019 Source: Journal of Forensic Radiology and Imaging, Volume 17 Author(s): Mitalee Mehta, Vineeta Saini, M.N. Patel, S.K. Menon Abstract Establishing sex of fragmentary skeletal remains is a critical issue in forensic anthropology and is of prime importance, since it helps to significantly narrow down the number of potential victims. Forensic anthropologists have always advocated for population specific sex discriminant formula for each population using different skeletal parts. Till date Gujarati population of India has not have any discriminant formulae for sex determination from fragmentary crania. So, the current research aims to examine the usefulness of foramen magnum variables in sex estimation of Western Indian (Gujarati) population and to provide population data which can be used as reference in cases of establishing identity in unknown fragmentary skulls. A total of 553 adult individuals [♂ = 291, ♀ = 262] of Gujarati origin with age range 18–60 years were subjected to Computed Tomography (CT) scan of skull. Length and width of foramen magnum were measured and based on these, three other variables (areas by Radinsky and Teixeria formulae and foramen magnum index) were calculated. Descriptive and discriminant function analysis was performed using SPSS 20.00. Significant difference was observed in all variables except foramen magnum index, but sexing accuracy didn't exceed 69.1%, even after using multivariate discriminant analysis. It is concluded that the foramen magnum region is not suitable for sexing Gujarati population in forensic context.

Comparison of accuracy of the maxillary sinus area and dimensions for sex estimation lateral cephalograms of Iranian samples Publication date: June 2019 Source: Journal of Forensic Radiology and Imaging, Volume 17 Author(s): Pegah Abasi, Arash Ghodousi, Roshanak Ghafari, Somayeh Abbasi Abstract Background Sex estimation is a critical issue in forensic medicine. Since anthropologic evaluations on radiographs can contribute to more accurate sex estimation, this study measured the length and height, as well as area, of the maxillary sinus on lateral cephalometric radiography. Methods and materials In this descriptive-analytic study, 80 images obtained from 20 to 40-year-old individuals (40 males and 40 female) were selected. The height and anterior-posterior length of the maxillary sinus was performed using CATIA V5R20 (a software package for image analysis). Maxillary sinus area was determined using discriminant analysis in AutoCAD. Findings The mean maxillary sinus height was 40.48 mm in males and 38.7 mm in females. The mean maxillary sinus length was 40.31 mm in males and 37.31 mm in females. The area of the maxillary sinus was 1201.2 mm2 in males and 1043.4 mm2 in females. Two discriminant analysis models, one based on the height and length of the maxillary sinus and the other based on sinus area) were developed for sex estimation. The area under the receiver operating characteristic (ROC) curve was used for quality assessment of the fitted models and determination of their prediction ability. Conclusion The mean height, length and area of the maxillary sinus were significantly larger in males than in females (P < 0.05). While sex estimation can be performed based on either the area or a combination of the height and length of the maxillary sinus. The length/width perform better than area for sex estimation but, it is greatly overshadowed by the fact that both measures perform barely better than chance. Since classification accuracy is less than 80%, the method is not reliable and therefore not recommended for sex estimation.

Radiological image processing advantages applied to human age estimation based on dental parameters Publication date: June 2019 Source: Journal of Forensic Radiology and Imaging, Volume 17 Author(s): Luiz Eugenio Nigro Mazzilli, Rodolfo Francisco Haltenhoff Melani, Cesar Angelo Lascala, Gabriel Gonçalves Mariano, Nelson M. Sakaguti, Roberto Cameriere

Imaging of resuscitation and emergency resuscitation devices—Lessons learned from post mortem computed tomography Publication date: June 2019 Source: Journal of Forensic Radiology and Imaging, Volume 17 Author(s): Ferdia Bolster, Zabiullah Ali, David Fowler, Barry Daly Abstract This pictorial essay describes the use and value of post mortem computed tomography (PMCT) in imaging potential complications related to cardiopulmonary resuscitation and those related to commonly used pre-hospital medical resuscitation devices.

The use of dental CT for age profiling Publication date: June 2019 Source: Journal of Forensic Radiology and Imaging, Volume 17 Author(s): Pamoda Balasuriya, Edel Doyle

Development of three-dimensional facial approximation system using head CT scans of Japanese living individuals Publication date: June 2019 Source: Journal of Forensic Radiology and Imaging, Volume 17 Author(s): Kazuhiko Imaizumi, Kei Taniguchi, Yoshinori Ogawa, Kazutoshi Matsuzaki, Hidemasa Maekawa, Takeshi Nagata, Tsuyoshi Moriyama, Itsuko Okuda, Hideyuki Hayakawa, Seiji Shiotani Abstract We developed software for three-dimensional (3D) facial approximation from the skull based on computed tomography (CT) scans of the head obtained from 59 Japanese adult volunteers (40 males, 19 females). CT scanning was performed while participants raised their head in an upright position while in a prone body posture. The positional relationships between the skull and head surface shape were analyzed by creating anatomically homologous shape models. Before modeling, skull shapes were simplified by concealing hollow structures of the skull using in-house software. Surficial tissue thickness (STT), represented by the distances between corresponding vertices of the simplified skull and head surface, was calculated for each individual, and averaged for each sex. Although the approximate head shapes of known individuals showed a relatively good resemblance in both the shape of the whole head and facial parts, some errors were identified, particularly in areas with thick surficial tissue. The results revealed sexual dimorphism of STT, with males exhibiting thinner surficial tissue at the cheek, and thicker tissue at the glabella, nose, mouth, and chin. Moreover, we created referential models for craniofacial superimposition from average models of the skull and head surface shape for each sex.

Spleen measurements with reference to cause of death and spleen weight estimation: A study on postmortem computed tomography Publication date: Available online 10 May 2019 Source: Journal of Forensic Radiology and Imaging Author(s): Vasiliki Chatzaraki, Janette Verster, Carlo Tappero, Michael J Thali, Wolf Schweitzer, Garyfalia Ampanozi Abstract Purpose The spleen is the largest lymphatic organ in the human body. Its appearance and weight during autopsy can be relevant for the determination of cause of death. Postmortem computed tomography (PMCT) supplements traditional autopsy. The aims of this study were to investigate spleen radiodensity on PMCT with regards to prior hospitalization, spleen macroscopy, cause of death, and the utility of PMCT for estimation of spleen weight (SW). Methods Spleen density, width (W), thickness (T), greatest axial surface (S) and presence or absence of contrast medium (CM) residues were evaluated on PMCT axial images of 1035 cadavers retrospectively. Corresponding autopsy reports were reviewed for cause of death, evidence of prior hospitalization, SW at autopsy and macroscopic features of the spleen, like congestion, pallor or contraction. Results Spleen density on PMCT was significantly higher for cases with CM and lower for hospital deaths. Multiple organ failure as cause of death showed significantly lower spleen density than fatal hemorrhage, intoxication, asphyxia-strangulation, hypothermia and metabolic disorders. No significant density differences were noted for different macroscopic spleen findings. Spleen W, T and S strongly correlate with SW at autopsy and formulas for estimating SW were derived based on linear regression models. Conclusions Presence of CM, prior hospitalization and organ failure, fatal hemorrhage, intoxication, asphyxia-strangulation, hypothermia and metabolic disorders as causes of death have an influence on spleen's radiodensity on PMCT. Routine spleen measurements on PMCT can be used to predict SW prior to autopsy or estimate SW when complete forensic autopsy is not conducted.

Quantifying and comparing the radiopacity of five bulk fill composites in digital dental radiographs – a contribution to human identification Publication date: Available online 6 May 2019 Source: Journal of Forensic Radiology and Imaging Author(s): Daphne Azambuja Hatschbach de AQUINO, Ângela FERNANDES, Luiz Roberto Coutinho MANHÃES JUNIOR Abstract Objectives : To compare the quantified radiopacity of five bulk fill composites in digital dental radiographs. Material and methods : An in-vitro observational study was performed with five dental restoration materials: I) Bulk Fill Surefil SDR+ flow® (Dentsply Sirona®, York, PA, USA), II) Bulk Fill Sonic Fill® (Kerr Corp.®, Orange, CA, USA); III) Filtek Bulk Fill flow® (3M Company®, Maplewood, MN, USA); IV) Tetric N Ceram Bulk Fill® (Ivoclar Vivadent®, Schaan, Liechtenstein); and V) Aura® (SDI Ltd.®, Victoria, Australia). Digital radiographs were taken standardly from four samples of each composite (n = 20). The radiopacity inherent detected in the radiographs was quantified using a 9-level aluminum scale. Results : ANOVA and Tukey's test showed statistically significant differences between the radiopacity of all bulk fill composites (p<0.0001), except between I and IV (p = 1.0). Spearman's outcomes revealed that only composite I had positive moderate (rS=0.63) correlation with the respective radiopacity level in the aluminum scale (p = 0.027). Conclusion : Most of the bulk fill composites addressed in this study were distinguishable from each other based on their radiopacity. The identification of type and even brand of composites may be a promising task in human identification. However, this procedure remains challenging and the scientific evidence behind it is still scarce in the forensic literature.

Alexandros Sfakianakis
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