Evaluation of distal femoral and proximal tibial epiphyseal plate in bone age determination with 3.0t MRİ: A comparison of current methods

Age determination is an important matter due to age-dependent practices in medicine and law. Radiological determination of bone age is a frequently used method for this purpose. The aim of our study is to examine three different existing methods in our study population in which maturation stages of the distal femoral and proximal tibial epiphyses are evaluated by magnetic resonance imaging, to compare these methods and to discuss their applicability in forensic age determination. In this study, a total of 597 cases, 351 males and 246 females, aged between 10-30 years, with knee images obtained with 3.0T MR scanner were evaluated retrospectively. Within the scope of this study, T1 weighted turbo spin echo and fat suppressed proton density weighted turbo spin echo sequences were evaluated independently by two observers. Significant changes have been found in the epiphyseal plates of the distal femur and proximal tibia in stages depending to the ages of the patients in all three staging methods. Intra-observer and inter-observer agreement was found to be good-very good for each staging method. According to our findings of our study, the final stage of the combined method of Kramer et al. in the femur and tibia for the age limits of 14 and 15, the final stages of the methods of Dedouit et al. and Vieth et al. in the femur for the age limit of 18, the final stage of the method of Dedouit et al. in the femur for the age limit of 21 can be used as an additional criterion for age determination of both sexes. As a result, knee MRI (magnetic resonance imaging) stands out as an alternative modality that does not contain radiation. In age determination with magnetic resonance imaging, it is necessary to prefer the method intended for the investigated age range with an individual-specific approach. Further studies need to be carried out with larger populations by comparing these three methods in the future. KEYWORDS: Bone age assessment, Distal femoral epiphysis, Forensic age estimation, Magnetic resonance imaging, Proximal tibial epiphysis