Forensic age estimation based on T1 SE and VIBE wrist MRI: do a one-fits-all staging technique and age estimation model apply?

ObjectivesProviding recommendations for wrist MRI in age estimation by determining (1) which anatomical structures to include in the statistical model, (2) which MRI sequence to conduct, and (3) which staging technique to apply.MethodsRadius and ulna were prospectively studied on 3 T MRI in 363 healthy Caucasian participants (185 females, 178 males) between 14 and 26 years old, using T1 spin echo (SE) and T1 gradient echo VIBE. Bone development was assessed applying a 5-stage staging technique with several amelioration attempts to optimise staging. A Bayesian model rendered point predictions of age and diagnostic indices to discern minors from adults.ResultsAll approaches rendered similar results, with none of them outperforming the others. A single bone assessment of radius or ulna sufficed. SE and VIBE sequences were both suitable, but needed sequence-specific age estimation. A one-fits-all 5-stage staging technique—with substages in stage 3—was suitable and did not benefit from profound substaging. Age estimation based on SE radius resulted in a mean absolute error of 1.79 years, a specificity (correctly identified minors) of 93%, and a discrimination slope of 0.640.ConclusionRadius and ulna perform similarly to estimate age, and so do SE and VIBE. A one-fits-all staging technique can be applied.Key Points• Radius and ulna perform similarly to estimate age.• SE and VIBE perform similarly, but age estimation should be based on the corresponding sequence-specific reference data.• A one-fits-all 5-stage staging technique with substages 3a, 3b, and 3c can be applied to both bones and both sequences.