Age estimation based on sternebral fusion in a sample of Egyptian population using three-dimensional computed tomography scanning

Objectives

Age estimation is a critical medico-legal issue in forensic medicine and sternebral fusion is recently supposed to be a helpful tool. Multidetector computed tomography (MDCT) scanning could provide three-dimensional (3D) imaging of the sternebral fusion. This study aimed to develop age estimation models based on the sternebral fusion state using MDCT scanning in a sample of Egyptians.

Material and Methods

The study included thoracic MDCT images of 261 Egyptians. The stage of sternebral fusion was evaluated in the 3D reconstructed images generated using Vitrea® software. Fusion between sternebrae 1&2, sternebrae 2&3, and sternebrae 3&4 were staged as non-fusion, partial fusion, and complete fusion. Scores 1, 2, and 3 were given to the three stages, respectively and their sum was the total sternebral fusion score.

Results

Significant positive correlations were observed between all sternebral fusions and the participants’ chronological age. Stages of sternebral fusion significantly contributed to age estimation using simple and multiple linear regression models (P < 0.001 for each). Using calibration curves, the total sternebral fusion score and the multivariate models had the best performance to predict the chronological age. At cut-off > 6, total sternebral fusion score was an excellent predictor for the age of 18 with areas under the curve = 0.943 and 0.952, in females and males respectively.

Conclusion

The developed models based on sternebral fusion stages can be used for forensic age estimation in the studied Egyptian sample. A total sternebral fusion score > 6 efficiently distinguished those aged 18 years.