Institute of Diagnostic, Interventional and Pediatric Radiology, InselspitaI, Bern University Hospital, University of Bern, Freiburgstrasse, CH-3010, Bern, Switzerland.
Institute of Forensic Medicine, University of Bern, Bern, Switzerland.
Int J Legal Med. 2023 Nov;137(6):1757-1766. doi: 10.1007/s00414-023-03061-7. Epub 2023 Sep 11.
The AGFAD (Arbeitsgemeinschaft für Forensische Alterdiagnostik, Study Group on Forensic Age Diagnostics) has published several recommendations regarding both technical aspects of computed tomography (CT) of the medial clavicular epiphysis (MCE) and the process of reading and interpreting the CT images for forensic age estimations (FAE). There are, however, no published recommendations regarding CT scan protocols and no dose reference values for CT of the MCE. The objective of this analysis was to assess adherence to AGFAD recommendations among practitioners of FAE and analyse reported dose-relevant CT scan parameters with the objective of helping to establish evidence-based dose reference values for FAE. A systematic literature search was conducted in PubMed and in Google Scholar with specific MeSH terms to identify original research articles on FAE with CT of the MCE from 1997 to 2022. A total of 48 studies were included. Adherence to AGFAD recommendations among practitioners of FAE is high regarding the use of Schmeling main stages (93%), bone window (79%), ≤ 1 mm CT slices (67%), axial/coronal CT images (65%), and Kellinghaus sub-stages (59%). The reporting of CT technique and CT dose-relevant scan parameters is heterogeneous and often incomplete in the current literature. Considering the success achieved by the AGFAD in creating standards of practice of FAE in living subjects, there is potential for the AGFAD to establish standards for radiation protection in FAE as well.
AGFAD（法医年龄诊断研究小组）已经发布了多项关于内侧锁骨骨骺（MCE）计算机断层扫描（CT）的技术方面以及阅读和解释 CT 图像进行法医年龄估计（FAE）的建议。然而，目前还没有关于 MCE CT 扫描协议和剂量参考值的建议。本分析的目的是评估 FAE 从业者对 AGFAD 建议的遵守情况，并分析报告的与剂量相关的 CT 扫描参数，以期有助于建立 FAE 的基于证据的剂量参考值。在 PubMed 和 Google Scholar 中使用特定的 MeSH 术语进行了系统的文献检索，以确定 1997 年至 2022 年 MCE CT 进行 FAE 的原始研究文章。共纳入 48 项研究。FAE 从业者对 AGFAD 建议的遵守情况很高，涉及 Schmeling 主要阶段（93%）、骨窗（79%）、≤1mm CT 切片（67%）、轴向/冠状 CT 图像（65%）和 Kellinghaus 亚阶段（59%）的使用。当前文献中 CT 技术和与剂量相关的扫描参数的报告存在异质性，且往往不完整。考虑到 AGFAD 在制定活体 FAE 实践标准方面取得的成功，AGFAD 有可能在 FAE 中建立辐射防护标准。
