Part II-adult skeletal age estimation using CT scans of cadavers: Revision of the pubic symphysis methods

Objective

When present, the most commonly used element to estimate adult skeletal age at death is the pubic symphysis. In the second manuscript of this series, the Suchey–Brooks and Hartnett pubic symphysis methods are assessed to for their applicability to volume-rendered images (VRIs) generated from CT scans of cadavers to assess their applicability to VRIs.

Materials and Methods

CT scans of 420 cadavers from the Victorian Institute of Forensic Medicine were selected (age range 20 to 79 years). Siemens syngo.via software was used to view the DICOM images and create the VRIs. The Suchey–Brooks and Hartnett pubic symphysis methods were used to create a revised method to estimate age for VRIs.

Results and Conclusion

Several features described by Suchey–Brooks and Hartnett could be observed on the VRIs, including billows on the symphysis face in younger individuals, the ventral rampart, and the dorsal margin. However, distinguishing features such porosity and bone weight for the older phases could not always be assessed. A revised pubic symphysis method for use on VRIs was created using both morphological features and bone quality to assess age. The revised method is strongly correlated with age, and over 70% of the sample was placed in the correct age phase. The Suchey–Brooks method was more accurate for individuals under 40 years of age while the revised method was more accurate for individuals over 40 years of age, similar to the findings from other studies. This revised method should be tested on other populations using different CT settings and software.