Efficacy of three-dimensional cinematic rendering computed tomography images in visualizing features related to age estimation in pelvic bones.

Morphological changes on the surface of the pelvic bone can be used to estimate the age at death of a person. These features can be visualized using three dimensional computed tomography (3D CT) images. A newly introduced 3D CT technique, cinematic volume rendering, improves visualization of the surface of bones by integrating the effect of light on the images. The aim of this study is to evaluate the efficacy of this 3D CT technique in visualizing features related to age estimation in pelvic bones. Dry pelvic bones of 35 subjects were scanned and then 3D reconstruction of the images was performed using the cinematic rendering technique. The 3D CT images of the pubic symphyses and the auricular surfaces were interpreted by two radiologists and a forensic osteologist using age estimation features derived from the Suchey-Brooks and the Buckberry-Chamberlain methods The interpretation of the dry pelvic bones was done by an expert anatomist and used as a gold standard. The percentages of correct interpretations and level of agreement in grading using 3D CT and using dry bones were high for features in the pubic symphyses including surface patterns (100%, k=1), presence of lower extremities (100%, k=1), and patterns of pubic rims (91.4%, range 87.5-100%, k=0.88). In the auricular surface of the ilium, all specimens with an apical activity were correctly interpreted (100%, k=1), but detection was moderate to poor for transverse organization (71.4%, k=0.43), macroporosity (70%, k=0.38.), and microporosity (52.9%, k=0.25). Cinematic volume rendering has a high level of efficacy in identifying age-related features on pubic symphyses, but it inadequately displays features on the auricular surface.