Development of a novel humerus-clavicle model for sex determination using multi-detector computed tomography scanning in a sample of Egyptian population

Objectives

Sex determination is a critical step in personal identification. Both humerus and clavicle bones exhibit apparent sexual dimorphism in different populations. Multi-detector computed tomography (MDCT) scanning has been widely used in forensic sex estimation. It provides accurate bone measurements for the modern living population. This study aimed to develop a novel model to determine sex using MDCT scanning of humerus and clavicle bones in a sample of Egyptian population.

Material and Methods

Thoracic MDCT scans of 417 Egyptians of both sexes, aged 10-35 years were included. Three-dimensional volume rendering images were reconstructed using Vitrea® CT workstation. The vertical diameter of right humeral head (VDH) and right clavicular length (CL) were measured for each subject using Radiant DICOM viewer.

Results

Both measurements had significantly higher median values among males than females in all age groups above 15 years and were significantly valid for sex estimation. The highest AUC was reported for right VDH, followed by right CL (0.859 and 0.856, respectively). Optimal cut-off points of the right VDH and right CL for predicting males were >40.1 mm and >139.15 mm, respectively. Both studied measurements contributed significantly to univariate and multivariate regression models and gave rise to a novel model that could predict males with 83.5 % overall accuracy.

Conclusion

VDH and CL can be effectively used as an alternative in forensic sex estimation when only humerus and clavicle bones can be measured. The developed model can be easily applied by forensic specialists to estimate sex with high accuracy among Egyptian population.