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Fortuitous discovery of a metallic foreign body on post-mortem CT scan: bullet or not bullet? 在死后CT扫描中意外发现金属异物:子弹还是不是子弹?
IF 0.8 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-09-01 Epub Date: 2025-06-03 DOI: 10.1016/j.fri.2025.200641
E. Pefferkorn , L. Pestourie , F. Savall , N. Telmon , F. Dedouit , C. Guilbeau-Frugier
In the expanding field of post-mortem imaging, post-mortem computed tomography (PMCT) has emerged as an essential tool for forensic pathologists. It is particularly valuable for detecting and accurately localizing metallic foreign bodies, thereby assisting the forensic pathologist during the autopsy. This study presents a case of an accidental finding of a foreign body during a PMCT, initially misinterpreted as a potential ballistic foreign body by the forensic pathologist who had quickly reviewed the scan prior to the autopsy, due to its metallic appearance and the victim’s history of involvement in armed conflicts. The forensic pathologist, unaware of a miniaturized pacemaker, specifically a Transcatheter Pacing System (TPS), initially suspected a cardiac bullet but ruled this out upon autopsy, as there were no signs of trauma or cutaneous entry wounds and the discovery of the TPS. Advanced processing techniques allowed the identification of the characteristic anchoring tines of the TPS, confirming its nature and distinguishing it from a bullet. This highlights the importance of precise post-mortem images’ interpretation.
在不断扩大的尸体成像领域,尸体计算机断层扫描(PMCT)已经成为法医病理学家的重要工具。它对于检测和准确定位金属异物特别有价值,从而协助法医病理学家进行尸检。本研究提出了一个在PMCT中意外发现异物的案例,由于其金属外观和受害者参与武装冲突的历史,法医病理学家在尸检前迅速审查了扫描结果,最初将其误认为是潜在的弹道异物。法医病理学家不知道微型起搏器,特别是经导管起搏系统(TPS),最初怀疑是心脏子弹,但在尸检中排除了这种可能性,因为没有外伤或皮肤进入伤口的迹象,也没有发现TPS。先进的处理技术可以识别出TPS的特征锚定时间,确认其性质并将其与子弹区分开来。这突出了精确的尸检图像解释的重要性。
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引用次数: 0
Withdrawal notice to “ISFRI Guidelines Working Group: Best Practice Standards for Non-Contrast Postmortem Computed Tomography (PMCT) of Overdose” [Forensic Imaging (2025) 200633] 对“ISFRI指引工作小组:药物过量非对比死后计算机断层扫描(PMCT)最佳实践标准”的撤回通知[法医影像(2025)200633]
IF 1 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-09-01 Epub Date: 2025-07-17 DOI: 10.1016/j.fri.2025.200644
Jamie Elifritz , Micillo Andrea , Fabrice Dedouit , Laura Filograna , ISFRI Guidelines Working Group
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引用次数: 0
ISFRI Guidelines Working Group: best practice standards for non-contrast postmortem computed tomography (PMCT) of gunshot wound deaths ISFRI指南工作组:枪伤死亡的非对比死后计算机断层扫描(PMCT)最佳实践标准
IF 0.8 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-09-01 Epub Date: 2025-05-14 DOI: 10.1016/j.fri.2025.200631
Jamie Elifritz , Fabrice Dedouit , Fox Marttinen , Laura Filograna
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引用次数: 0
Assessment of knee ossification timings: Development and validation of an ordinal scoring protocol for age estimation using medical imaging 评估膝关节骨化时间:开发和验证使用医学影像进行年龄估计的顺序评分方案
IF 0.8 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-06-01 Epub Date: 2025-04-17 DOI: 10.1016/j.fri.2025.200625
Taliah Swart , Samantha K. Rowbotham , Soren Blau , Nicolene Lottering

Objectives

Assessing skeletal maturity using epiphyseal and morphological features with modern, reliable evaluation protocols is crucial for human identification efforts and paediatric growth monitoring. This study aims to develop and validate a scoring system for knee skeletal development on post-mortem computed tomography (PMCT) and magnetic resonance imaging (MRI) acquired from Australian and New Mexican children.

Materials & Methods

A protocol for the skeletal knee was developed on 30 PMCT and 30 T2-weighted MRI scans of subadults aged eight- to- 22 years. DICOM image stacks from a Brisbane children’s hospital and the New Mexico Decedent Image Database (NMDID) underwent multiplanar reconstruction and anatomical alignment. The protocol comprised a three- to- six stage scoring process at four epiphyseal fusion and seven maturity indicator sites. Three observers of varying experience levels assessed the images across three days, with reliability quantified using an intraclass correlation coefficient (ICC).

Results

The protocol demonstrated high reliability and consistency, with excellent intraobserver agreement for CT (ICC = 0.985 (95 % CI: 0.93-1.00)) and MRI (ICC = 0.979 (95 % CI: 0.85-1.00)). Mean inter-observer reliability measures were good for CT (ICC = 0.886 (95 % CI: 0.75-0.95)) and MRI (ICC = 0.852 (95 % CI: 0.68-0.95)). The tibial tubercle demonstrated the most variability and long-bone epiphyseal union the least

Conclusions

This research presents a highly reproducible method for assessing skeletal development of the knee in subadults, aligned with modern imaging standards. The methodology will have application in forensic human identification, age confirmation and clinical growth assessment
目的:采用现代可靠的评估方案,利用骨骺和形态学特征评估骨骼成熟度,对于人类识别工作和儿科生长监测至关重要。本研究旨在通过对澳大利亚和新墨西哥儿童的死后计算机断层扫描(PMCT)和磁共振成像(MRI)来开发和验证膝关节骨骼发育的评分系统。材料,方法对30例8 ~ 22岁的亚成人患者进行PMCT和30例t2加权MRI扫描,建立骨性膝关节的扫描方案。来自布里斯班儿童医院的DICOM图像堆栈和新墨西哥已故图像数据库(NMDID)进行了多平面重建和解剖对齐。该方案包括在4个骨骺融合和7个成熟度指标部位进行3到6个阶段的评分过程。三名不同经验水平的观察员在三天内评估了这些图像,并使用类内相关系数(ICC)对可靠性进行了量化。结果该方案具有较高的可靠性和一致性,CT (ICC = 0.985 (95% CI: 0.93-1.00))和MRI (ICC = 0.979 (95% CI: 0.85-1.00))的观察者内一致性很好。CT (ICC = 0.886 (95% CI: 0.75-0.95))和MRI (ICC = 0.852 (95% CI: 0.68-0.95))的平均观察者间信度测量良好。胫骨结节表现出最大的可变性,长骨骨骺愈合最少。结论:本研究提出了一种高度可重复的方法来评估亚成人膝关节骨骼发育,与现代成像标准一致。该方法将在法医人体鉴定、年龄确认和临床生长评估中得到应用
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引用次数: 0
A deep-learning-aided diagnosis of drowning using post-mortem lung computed tomography 用死后肺计算机断层扫描深度学习辅助诊断溺水
IF 0.8 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-06-01 Epub Date: 2025-04-25 DOI: 10.1016/j.fri.2025.200629
Amber Habib Qureshi, Takuro Ishii, Yoshifumi Saijo
Identifying the cause of death using postmortem CT images is crucial since it provides a non-invasive, objective approach for forensic investigations while offering significant advantages in terms of time efficiency and cost-effectiveness compared to traditional autopsy methods. However, due to varied lung conditions in the postmortem CT images, a standardized method to diagnose drowning using CT images has not been established. This study aimed to devise a deep-learning-aided framework for diagnosing drowning from postmortem lung CT images. First, to find the suitable convolutional neural network (CNN) architecture for classifying lung CT images into drowning and non-drowning cases, three well-known CNNs, AlexNet, VGG16, and MobileNet, were trained with a single-institute postmortem CT image dataset and the performance and generalizability were also evaluated using images extracted from a public decedent CT image database. The results showed that VGG16 architecture outperformed the three models with the highest mean AUC-ROC and accuracy values of 88.42 % and 80.56 % respectively for drowning image classification, as well as the highest generalizability with an AUC-ROC of 71.79 % on a public image dataset. Additionally, the case-based diagnosis was performed using probability scores given from the model to each slice taken in the same subject. The final diagnosis accuracy was 96 % on the original dataset and 79 % on the public dataset, showing the strong potential that the devised framework can be used as a screening tool to identify drowning cases using postmortem CT images.
使用死后CT图像确定死因至关重要,因为它为法医调查提供了一种非侵入性、客观的方法,同时与传统尸检方法相比,在时间效率和成本效益方面具有显著优势。然而,由于死后CT图像中肺部状况的不同,尚未建立一种标准化的方法来诊断溺水。本研究旨在设计一个深度学习辅助框架,用于从死后肺部CT图像中诊断溺水。首先,为了找到合适的卷积神经网络(CNN)架构,将肺部CT图像分类为溺水和非溺水病例,使用单个机构的尸体CT图像数据集训练三个著名的CNN, AlexNet, VGG16和MobileNet,并使用从公开的死者CT图像数据库中提取的图像来评估其性能和泛化性。结果表明,VGG16架构在溺水图像分类上的平均AUC-ROC最高,准确率分别为88.42%和80.56%,在公共图像数据集上的泛化性最高,AUC-ROC为71.79%。此外,基于病例的诊断是使用从模型到同一受试者的每个切片给出的概率分数进行的。原始数据集的最终诊断准确率为96%,公共数据集的最终诊断准确率为79%,表明所设计的框架可以用作使用死后CT图像识别溺水病例的筛查工具的巨大潜力。
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引用次数: 0
High diagnostic accuracy of postmortem CT for hemothorax with volume estimation challenges: A comparative study with autopsy 死后 CT 对血气胸的诊断准确性很高,但存在体积估计方面的挑战:与尸检的比较研究
IF 0.8 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-06-01 Epub Date: 2025-04-17 DOI: 10.1016/j.fri.2025.200626
Punpramepree Yeesakhorn , Wanlapha Tungsub , Nitima Saksobhavivat , Wisarn Worasuwannarak

Background

Estimating hemothorax volume via postmortem computed tomography (PMCT) remains challenging because of postmortem artifacts that can impact interpretation and accuracy. This study aimed to evaluate the accuracy of PMCT in estimating hemothorax volume compared with standard autopsy.

Methods

Forty deceased individuals who underwent both PMCT and autopsy were examined. PMCT volumes were manually segmented, and the results were compared with autopsy findings. Spearman's rank correlation and paired t-tests were used to assess accuracy.

Results

PMCT showed a high diagnostic accuracy for hemothorax, with correlation coefficients of 0.859 and 0.794 on the left and right sides, respectively. However, the mean absolute percentage error (MAPE) for volume estimation was relatively high, suggesting caution when relying solely on PMCT for volume estimation.

Conclusion

PMCT is a reliable tool for diagnosing hemothorax; however, its accuracy in volume estimation remains limited for manual segmentation methods. Further refinement of the imaging techniques is required for more precise volume measurements.
通过死后计算机断层扫描(PMCT)估计胸血容量仍然具有挑战性,因为死后的伪影会影响解释和准确性。本研究旨在评估PMCT与标准尸检相比在估计胸血容量方面的准确性。方法对40例同时进行PMCT和尸检的死者进行分析。人工分割PMCT体积,并将结果与尸检结果进行比较。使用Spearman秩相关和配对t检验来评估准确性。结果spmct对血胸的诊断准确率较高,左右两侧的相关系数分别为0.859和0.794。然而,体积估计的平均绝对百分比误差(MAPE)相对较高,建议仅依靠PMCT进行体积估计时要谨慎。结论pmct是诊断血胸的可靠工具;然而,对于人工分割方法,其体积估计的准确性仍然有限。为了更精确地测量体积,需要进一步改进成像技术。
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引用次数: 0
Dental age estimation based on imaging of lower third molars in Western Indian population 基于西印度人口下三磨牙影像的牙龄估计
IF 0.8 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-06-01 Epub Date: 2025-04-17 DOI: 10.1016/j.fri.2025.200624
Deepa Jatti Patil, Chandramani B. More, Rashmi Venkatesh
The study aimed to determine age by assessing the discernibility of the periodontal ligament (PDL) and root canal (RC) on panoramic radiographs of mandibular third molars. In this retrospective study, 2000 panoramic radiographs of individuals aged between 16 to 40 were analysed, including both males and females. The radiographic discernibility of PDL and RC in mandibular third molars was assessed according to the study by Olze et al. which was categorised into four stages. At each stage, the minimum, maximum, and standard deviation were assessed. Statistical analysis was conducted to examine the relationship between age, sex, and PDL/RC stage. There was a notable disparity in the average age of individuals at different stages of PDL and RC. There was a considerable increase in the average age from PDL & RC stage 0 to stage 3. By considering the minimum and maximum values for each stage, individuals can be classified as being older than 17 years if they are in stage 1, and older than 20 years if they are in stages 2 and 3. These classifications are determined based on the combined results of the PDL and RC stages. The radiographic discernibility of PDL and RC can be utilised as a promising method to determine age in the western Indian population.
本研究旨在通过评估下颌第三磨牙全景x线片牙周韧带(PDL)和根管(RC)的可分辨性来确定年龄。在这项回顾性研究中,分析了2000张年龄在16至40岁之间的个体的全景x线片,包括男性和女性。根据Olze等人的研究,评估下颌第三磨牙PDL和RC的x线片可分辨性,并将其分为四个阶段。在每个阶段,评估最小值、最大值和标准差。统计分析年龄、性别与PDL/RC分期的关系。PDL和RC不同阶段个体的平均年龄存在显著差异。从PDL &;RC阶段0到阶段3。通过考虑每个阶段的最小值和最大值,可以将处于阶段1的个体划分为年龄大于17岁,处于阶段2和阶段3的个体划分为年龄大于20岁。这些分类是根据PDL和RC阶段的综合结果确定的。放射学上PDL和RC的区别可以作为一种有前途的方法来确定西印度人口的年龄。
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引用次数: 0
Unlocking sexual dimorphism: geometric morphometrics analysis of the Atlas (C1) bone in Malaysian populations 解开两性二态性:马来西亚人群阿特拉斯(C1)骨的几何形态计量学分析
IF 0.8 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-06-01 Epub Date: 2025-04-29 DOI: 10.1016/j.fri.2025.200637
Muhammad Faiz Mohd Fauad , Aspalilah Alias , Ker Woon Choy , Helmi Mohd Hadi Pritam , Eric Chung , Arofi Kurniawan , Khalid Ayidh Alqahtani
Sexual identification is the most crucial step in the forensic anthropology field. Traditional morphometric techniques, involving caliper-based measurements, are often labor-intensive and time-consuming. In contrast, the geometric morphometric method (GMM) offers a more efficient approach, integrating qualitative and quantitative assessments of biological forms based on precise geometric characterizations of their shape. This study aimed to assess sexual dimorphism of the Atlas (C1) bone on lateral cervical radiographs using GMM. A cross-sectional design was employed, utilizinglateral cervical radiographs from a sample of 413 individuals, including 208 males and 205 females, age ranged between 35 and 45 years old. Six 2D landmarks were identified and marked on the digitalized radiographs using TPSDig2 (Version 2.31) software. GMM analysis conducted by MorphoJ software. Eight principal components (PC) accounted for 100 % of the shape variability produced. Procrustes ANOVA showed that centroid size and shape were significantly different between different sexes. Discriminant function analysis (DFA) revealed a correct classification rate for 87.9 % of cases, with an identification accuracy of 87.0 % for males and 88.8 % for females. There were significant differences among males and females in the height of the C1 vertebral body with p < 0.05 via independent t-test. In conclusion, there was a significant sexual dimorphism of the C1 vertebra by GMM, which could serve as an alternative method in physical anthropology and forensic medicine.
性别鉴定是法医人类学领域最关键的一步。传统的形态测量技术,包括基于卡尺的测量,通常是劳动密集型和耗时的。相比之下,几何形态测量法(GMM)提供了一种更有效的方法,基于生物形态的精确几何特征,将生物形态的定性和定量评估整合在一起。本研究旨在利用GMM评估颈椎侧位片上寰椎(C1)骨的性别二态性。采用横断面设计,利用413人的侧位颈椎x线片样本,包括208名男性和205名女性,年龄在35至45岁之间。使用TPSDig2 (Version 2.31)软件在数字化x线片上识别并标记6个二维地标。采用MorphoJ软件进行GMM分析。8个主成分(PC)占产生的形状变异性的100%。Procrustes方差分析显示,不同性别间质心大小和形状存在显著差异。判别函数分析(Discriminant function analysis, DFA)的分类正确率为87.9%,其中男性的识别正确率为87.0%,女性为88.8%。男性和女性在C1椎体高度p <上有显著差异;经独立t检验0.05。综上所述,GMM对C1椎体有明显的性别二态性,可作为体质人类学和法医学的替代方法。
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引用次数: 0
Stature estimation and craniometry–a computed tomography scan based study in South Indian adult population 身高估计和颅部测量-一项基于南印度成年人的计算机断层扫描研究
IF 0.8 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-06-01 Epub Date: 2025-04-17 DOI: 10.1016/j.fri.2025.200627
Kirthika Ravi , Siddhartha Das , Ambika Prasad Patra , Deepak Barathi Subramania , Harichandrakumar Kottyen Thazhath

Background

Stature estimation contributes to the identification of an individual which is one of the objectives of a medicolegal autopsy. Stature can be estimated by measuring various landmarks of the cranium. Owing to the geographical variations, the regression formula used for one population may not be applicable to other populations. This CT scan study was conducted with an aim to develop regression formulas for the different cranial parameters in a South Indian adult population.

Methodology

511 patients scheduled for elective CT scans of the head and neck were recruited. Twenty-nine cranial variables were studied in each of these patients. Simple and multivariate linear regression was performed to establish a predictive stature estimation model. Pearson correlation and the predictive stature estimation model were considered significant if the P value was ≤ 0.05.

Results

All the cranial measurements showed a statistically significant correlation with stature in the overall population except for right orbital height, left orbital height and minimum distance between the condyles. The proportion of variance of stature explained by the model was found to be 27 % for the overall population, whereas it was 20 % and 21 % respectively for the males and females.

Conclusion

Our results suggest that the studied cranial measurements have a positive correlation with stature and can be used to estimate the stature, but the R2 values are not so encouraging.
身高估计有助于识别个体,这是法医尸检的目标之一。身高可以通过测量头盖骨的各种标志来估计。由于地理上的差异,用于一个人口的回归公式可能不适用于其他人口。本CT扫描研究进行的目的是开发回归公式的不同颅参数在印度南部的成年人人口。方法招募511例计划择期进行头部和颈部CT扫描的患者。在这些患者中研究了29个颅变量。采用简单线性回归和多元线性回归建立了预测身高的模型。如果P值≤0.05,则认为Pearson相关性和预测身高估计模型显著。结果除右眼眶高度、左眼眶高度和髁间最小距离外,所有颅骨测量值与总体人群身高均有统计学意义。该模型解释的身高差异比例在总人口中为27%,而在男性和女性中分别为20%和21%。结论颅骨尺寸与身高呈正相关,可用于身高的估计,但R2值并不理想。
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引用次数: 0
Stature estimation based on vertical measurements of the skull using three-dimensional images from postmortem computed tomography in a Japanese population 基于日本人群死后计算机断层扫描三维图像的头骨垂直测量的身高估计
IF 0.8 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-06-01 Epub Date: 2025-04-18 DOI: 10.1016/j.fri.2025.200628
Shoken Suzuki , Maki Ohtani , Yuhei Matsuo , Masayuki Fukuda , Sohtaro Mimasaka
We aimed to evaluate the correlation between stature and vertical skull measurements based on three-dimensional (3D) computed tomography (CT) images, develop a stature estimation formula, and validate it in a Japanese population. The “training” and “validation” datasets consisted of 275 and 49 identified individuals who underwent postmortem CT. Two skull measurements, the linear distances from the basion to the bregma (Basion–Bregma) and the posterior nasal spine to the bregma (PNS–Bregma), were obtained from 3D CT images that solely extracted cranial data. Pearson product-moment correlation coefficients assessed stature-skull correlations. Multiple regression analysis was performed to assess whether stature was dependent on sex. A stature estimation formula was developed based on the regression analysis. Validation tests were performed for each formula. Significant correlations were observed between stature and skull measurements. The correlation coefficients were 0.790 for stature and Basion–Bregma, and 0.782 for stature and PNS–Bregma. Sex status was statistically significant as an independent variable in regression analysis and influences the estimation of stature. For the stature estimation formula, the coefficient of determination adjusted for the degree of freedom (R*2) was 0.730, and the standard error of estimation (SEE) was 5.55 cm when using three variables: sex status, Basion–Bregma, and PNS–Bregma. The validation test exhibited high reliability; mean error (MA) = 0.10 cm and mean absolute error (MAE) = 4.64 cm. Vertical skull measurements from 3D CT images may be helpful for stature estimation in Japanese individuals, particularly in cases where better predictors are unavailable.
我们的目的是评估基于三维计算机断层扫描(CT)图像的身材与垂直头骨测量值之间的相关性,开发一种身材估算公式,并在日本人群中进行验证。训练 "和 "验证 "数据集分别由 275 人和 49 人组成,他们都接受了尸检 CT。两个头骨测量值,即从基底到前囟的线性距离(Basion-Bregma)和从后鼻骨脊到前囟的线性距离(PNS-Bregma),都是从仅提取头骨数据的三维 CT 图像中获得的。皮尔逊积矩相关系数评估了身材与头骨的相关性。进行多元回归分析以评估身材是否取决于性别。在回归分析的基础上制定了一个身材估算公式。每个公式都进行了验证测试。结果表明,身材与头骨测量值之间存在显著的相关性。身材与 Basion-Bregma 的相关系数为 0.790,身材与 PNS-Bregma 的相关系数为 0.782。在回归分析中,性别状况作为一个自变量对身材的估计有显著的统计学影响。使用性别状况、Basion-Bregma 和 PNS-Bregma 这三个变量估算身材时,经自由度调整的决定系数(R*2)为 0.730,估算标准误差(SEE)为 5.55 厘米。验证测试显示出较高的可靠性;平均误差 (MA) = 0.10 厘米,平均绝对误差 (MAE) = 4.64 厘米。通过三维 CT 图像进行头骨垂直测量可能有助于估计日本人的身材,尤其是在没有更好的预测指标的情况下。
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引用次数: 0
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Forensic Imaging
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