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CT of the medial clavicular epiphysis for forensic age estimation: hands up?
PURPOSE: The aim of this study was to assess the impact of arm position in computed tomography (CT) of the clavicle performed for forensic age estimation on clavicular position, image noise, and radiation dose. METHODS AND MATERIALS: Forty-seven CT scans of the medial clavicular epiphysis performed...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8206049/ https://www.ncbi.nlm.nih.gov/pubmed/33625576 http://dx.doi.org/10.1007/s00414-021-02516-z |
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author | Tozakidou, Magdalini Meister, Rieke L. Well, Lennart Petersen, Kay U. Schindera, Sebastian Jopp-van Well, Eilin Püschel, Klaus Herrmann, Jochen |
author_facet | Tozakidou, Magdalini Meister, Rieke L. Well, Lennart Petersen, Kay U. Schindera, Sebastian Jopp-van Well, Eilin Püschel, Klaus Herrmann, Jochen |
author_sort | Tozakidou, Magdalini |
collection | PubMed |
description | PURPOSE: The aim of this study was to assess the impact of arm position in computed tomography (CT) of the clavicle performed for forensic age estimation on clavicular position, image noise, and radiation dose. METHODS AND MATERIALS: Forty-seven CT scans of the medial clavicular epiphysis performed for forensic age estimation were conducted with either hands and arms held upwards (CT(HU,) 28 persons) or positioned at the body (CT(HD), 19 persons). Presets were identical for both positions (70 mAs/140 kVp; Brilliance iCT, Philips). Each CT scan was reconstructed with an iterative algorithm (i-Dose 4) and evaluated at the middle of the sternoclavicular joint. Clavicular angle was measured on a.p. topograms in relation to a horizontal line. Quantitative image noise was measured in air at the level of medial clavicular epiphysis. Effective dose and scan length were recorded. RESULTS: Hands-up position compared with hands-down position resulted in a lower lateral body diameter (CT(HU) 41.1 ± 3.6 cm vs. CT(HD) 44.6 ± 3.1 cm; P = 0.03), a reduced quantitative image noise (CT(HU): 39.5 ± 9.2; CT(HD): 46.2 ± 8.3; P = 0.02), and lower CTDI(vol) (5.1 ± 1.4 mGy vs. 6.7 ± 1.8 mGy; P = 0.001). Scan length was longer in patients examined with hands up (HU: 8.5 ± 3.4 cm; HD: 6.2 ± 2.1 cm; P = 0.006). Mean effective dose for CT(HU) was 0.79 ± 0.32 mSv compared with 0.95 ± 0.38 mSv in CT(HD) (P = 0.12). Clavicular angle was 17° ± 6° in patients with hands down and 32° ± 7° in patients with hands up (P < 0.001). CONCLUSION: By elevated arm positioning, the image quality of clavicular CT scans can be improved while maintaining radiation dose compared with hands down. Clavicular position differs according to the hand position. Thus, positioning patients with elevated hands is advisable for forensic clavicular CT examinations, but multiplanar CT reconstructions should be adjusted to clavicular position and scan length should be reduced to a minimum. |
format | Online Article Text |
id | pubmed-8206049 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-82060492021-07-01 CT of the medial clavicular epiphysis for forensic age estimation: hands up? Tozakidou, Magdalini Meister, Rieke L. Well, Lennart Petersen, Kay U. Schindera, Sebastian Jopp-van Well, Eilin Püschel, Klaus Herrmann, Jochen Int J Legal Med Original Article PURPOSE: The aim of this study was to assess the impact of arm position in computed tomography (CT) of the clavicle performed for forensic age estimation on clavicular position, image noise, and radiation dose. METHODS AND MATERIALS: Forty-seven CT scans of the medial clavicular epiphysis performed for forensic age estimation were conducted with either hands and arms held upwards (CT(HU,) 28 persons) or positioned at the body (CT(HD), 19 persons). Presets were identical for both positions (70 mAs/140 kVp; Brilliance iCT, Philips). Each CT scan was reconstructed with an iterative algorithm (i-Dose 4) and evaluated at the middle of the sternoclavicular joint. Clavicular angle was measured on a.p. topograms in relation to a horizontal line. Quantitative image noise was measured in air at the level of medial clavicular epiphysis. Effective dose and scan length were recorded. RESULTS: Hands-up position compared with hands-down position resulted in a lower lateral body diameter (CT(HU) 41.1 ± 3.6 cm vs. CT(HD) 44.6 ± 3.1 cm; P = 0.03), a reduced quantitative image noise (CT(HU): 39.5 ± 9.2; CT(HD): 46.2 ± 8.3; P = 0.02), and lower CTDI(vol) (5.1 ± 1.4 mGy vs. 6.7 ± 1.8 mGy; P = 0.001). Scan length was longer in patients examined with hands up (HU: 8.5 ± 3.4 cm; HD: 6.2 ± 2.1 cm; P = 0.006). Mean effective dose for CT(HU) was 0.79 ± 0.32 mSv compared with 0.95 ± 0.38 mSv in CT(HD) (P = 0.12). Clavicular angle was 17° ± 6° in patients with hands down and 32° ± 7° in patients with hands up (P < 0.001). CONCLUSION: By elevated arm positioning, the image quality of clavicular CT scans can be improved while maintaining radiation dose compared with hands down. Clavicular position differs according to the hand position. Thus, positioning patients with elevated hands is advisable for forensic clavicular CT examinations, but multiplanar CT reconstructions should be adjusted to clavicular position and scan length should be reduced to a minimum. Springer Berlin Heidelberg 2021-02-24 2021 /pmc/articles/PMC8206049/ /pubmed/33625576 http://dx.doi.org/10.1007/s00414-021-02516-z Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Tozakidou, Magdalini Meister, Rieke L. Well, Lennart Petersen, Kay U. Schindera, Sebastian Jopp-van Well, Eilin Püschel, Klaus Herrmann, Jochen CT of the medial clavicular epiphysis for forensic age estimation: hands up? |
title | CT of the medial clavicular epiphysis for forensic age estimation: hands up? |
title_full | CT of the medial clavicular epiphysis for forensic age estimation: hands up? |
title_fullStr | CT of the medial clavicular epiphysis for forensic age estimation: hands up? |
title_full_unstemmed | CT of the medial clavicular epiphysis for forensic age estimation: hands up? |
title_short | CT of the medial clavicular epiphysis for forensic age estimation: hands up? |
title_sort | ct of the medial clavicular epiphysis for forensic age estimation: hands up? |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8206049/ https://www.ncbi.nlm.nih.gov/pubmed/33625576 http://dx.doi.org/10.1007/s00414-021-02516-z |
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