{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T08:53:17Z","timestamp":1781686397841,"version":"3.54.5"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T00:00:00Z","timestamp":1772236800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T00:00:00Z","timestamp":1772236800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Legal Med"],"published-print":{"date-parts":[[2026,7]]},"DOI":"10.1007\/s00414-026-03746-9","type":"journal-article","created":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T06:26:44Z","timestamp":1772260004000},"page":"2183-2191","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Radiation dose reduction through short scan protocols and arms-out positioning in clavicular CT for forensic age estimation"],"prefix":"10.1007","volume":"140","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3110-9143","authenticated-orcid":false,"given":"Thomas D.","family":"Ruder","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolf-Dieter","family":"Zech","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc Alexander","family":"Schmid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Schmeling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Straessle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Lombardo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rainer J.","family":"Egli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"M\u00fcller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,28]]},"reference":[{"key":"3746_CR1","unstructured":"Asylum applicants by (2025) type, citizenship, age and sex - annual aggregated data. https:\/\/ec.europa.eu\/eurostat\/databrowser\/view\/migr_asyappctza\/default\/table?lang=en. Accessed 22 Oct"},{"key":"3746_CR2","doi-asserted-by":"publisher","first-page":"1581","DOI":"10.1007\/s00414-021-02516-z","volume":"135","author":"M Tozakidou","year":"2021","unstructured":"Tozakidou M, Meister RL, Well L et al (2021) CT of the medial clavicular epiphysis for forensic age estimation: hands up? Int J Legal Med 135:1581\u20131587. https:\/\/doi.org\/10.1007\/s00414-021-02516-z","journal-title":"Int J Legal Med"},{"key":"3746_CR3","doi-asserted-by":"publisher","unstructured":"Schmeling A, Dettmeyer R, Rudolf E et al (2016) Forensic Age Estimation: Methods, Certainty, and the Law. Deutsches \u00c4rzteblatt international. https:\/\/doi.org\/10.3238\/arztebl.2016.0044","DOI":"10.3238\/arztebl.2016.0044"},{"key":"3746_CR4","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1007\/s00414-014-1067-0","volume":"129","author":"D Wittschieber","year":"2015","unstructured":"Wittschieber D, Ottow C, Vieth V et al (2015) Projection radiography of the clavicle: still recommendable for forensic age diagnostics in living individuals? Int J Legal Med 129:187\u2013193. https:\/\/doi.org\/10.1007\/s00414-014-1067-0","journal-title":"Int J Legal Med"},{"key":"3746_CR5","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1007\/s00414-005-0010-9","volume":"120","author":"M M\u00fchler","year":"2006","unstructured":"M\u00fchler M, Schulz R, Schmidt S et al (2006) The influence of slice thickness on assessment of clavicle ossification in forensic age diagnostics. Int J Legal Med 120:15\u201317. https:\/\/doi.org\/10.1007\/s00414-005-0010-9","journal-title":"Int J Legal Med"},{"key":"3746_CR6","doi-asserted-by":"publisher","first-page":"1757","DOI":"10.1007\/s00414-023-03061-7","volume":"137","author":"TD Ruder","year":"2023","unstructured":"Ruder TD, Kuhnen SC, Zech W-D et al (2023) Standards of practice in forensic age estimation with CT of the medial clavicular epiphysis\u2014a systematic review. Int J Legal Med 137:1757\u20131766. https:\/\/doi.org\/10.1007\/s00414-023-03061-7","journal-title":"Int J Legal Med"},{"key":"3746_CR7","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1007\/s00414-008-0254-2","volume":"122","author":"A Schmeling","year":"2008","unstructured":"Schmeling A, Grundmann C, Fuhrmann A et al (2008) Criteria for age estimation in living individuals. Int J Legal Med 122:457\u2013460. https:\/\/doi.org\/10.1007\/s00414-008-0254-2","journal-title":"Int J Legal Med"},{"key":"3746_CR8","doi-asserted-by":"publisher","first-page":"6645","DOI":"10.1007\/s00330-020-07079-y","volume":"30","author":"S Gassenmaier","year":"2020","unstructured":"Gassenmaier S, Schaefer JF, Nikolaou K et al (2020) Forensic age estimation in living adolescents with CT imaging of the clavicula\u2014impact of low-dose scanning on readers\u2019 confidence. Eur Radiol 30:6645\u20136652. https:\/\/doi.org\/10.1007\/s00330-020-07079-y","journal-title":"Eur Radiol"},{"key":"3746_CR9","doi-asserted-by":"publisher","first-page":"2126","DOI":"10.1177\/02841851231164996","volume":"64","author":"S Mehnert","year":"2023","unstructured":"Mehnert S, Berger N, Flach PM et al (2023) How low can we go? CT dose reduction in the assessment of the medial clavicular epiphysis in forensic age estimation: a prospective postmortem CT study. Acta Radiol 64:2126\u20132131. https:\/\/doi.org\/10.1177\/02841851231164996","journal-title":"Acta Radiol"},{"key":"3746_CR10","doi-asserted-by":"publisher","DOI":"10.1007\/s00414-025-03521-2","author":"SC Kuhnen","year":"2025","unstructured":"Kuhnen SC, M\u00fcller M, Schmeling A et al (2025) CT of the medial clavicular epiphysis for forensic age estimation \u2013 raised arms position recommended. Int J Legal Med. https:\/\/doi.org\/10.1007\/s00414-025-03521-2","journal-title":"Int J Legal Med"},{"key":"3746_CR11","doi-asserted-by":"publisher","first-page":"853","DOI":"10.1007\/s00414-022-02813-1","volume":"136","author":"M Lossois","year":"2022","unstructured":"Lossois M, Cyteval C, Baccino E, Peyron P-A (2022) Forensic age assessments of alleged unaccompanied minors at the medicolegal Institute of Montpellier: a 4-year retrospective study. Int J Legal Med 136:853\u2013859. https:\/\/doi.org\/10.1007\/s00414-022-02813-1","journal-title":"Int J Legal Med"},{"key":"3746_CR12","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1016\/j.jtho.2023.07.019","volume":"19","author":"S Lam","year":"2024","unstructured":"Lam S, Bai C, Baldwin DR et al (2024) Current and future perspectives on computed tomography screening for lung cancer: a roadmap from 2023 to 2027 from the International Association for the Study of Lung Cancer. J Thorac Oncol 19:36\u201351. https:\/\/doi.org\/10.1016\/j.jtho.2023.07.019","journal-title":"J Thorac Oncol"},{"key":"3746_CR13","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1007\/s00414-003-0404-5","volume":"118","author":"A Schmeling","year":"2004","unstructured":"Schmeling A, Schulz R, Reisinger W et al (2004) Studies on the time frame for ossification of the medial clavicular epiphyseal cartilage in conventional radiography. Int J Legal Med 118:5\u20138. https:\/\/doi.org\/10.1007\/s00414-003-0404-5","journal-title":"Int J Legal Med"},{"key":"3746_CR14","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1007\/s00414-009-0398-8","volume":"124","author":"M Kellinghaus","year":"2010","unstructured":"Kellinghaus M, Schulz R, Vieth V et al (2010) Forensic age estimation in living subjects based on the ossification status of the medial clavicular epiphysis as revealed by thin-slice multidetector computed tomography. Int J Legal Med 124:149\u2013154. https:\/\/doi.org\/10.1007\/s00414-009-0398-8","journal-title":"Int J Legal Med"},{"key":"3746_CR15","doi-asserted-by":"publisher","first-page":"661","DOI":"10.1148\/radiol.2492080169","volume":"249","author":"M Brink","year":"2008","unstructured":"Brink M, De Lange F, Oostveen LJ et al (2008) Arm raising at exposure-controlled multidetector trauma CT of thoracoabdominal region: higher image quality, lower radiation dose. Radiology 249:661\u2013670. https:\/\/doi.org\/10.1148\/radiol.2492080169","journal-title":"Radiology"},{"key":"3746_CR16","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1055\/s-0034-1365687","volume":"14","author":"A Euler","year":"2014","unstructured":"Euler A, Sz\u00fccs-Farkas Z, Schindera S (2014) M\u00f6glichkeiten der Strahlenreduktion bei der CT des K\u00f6rperstamms. Radiologie up2date 14:163\u2013176. https:\/\/doi.org\/10.1055\/s-0034-1365687","journal-title":"Radiologie up2date"},{"key":"3746_CR17","doi-asserted-by":"publisher","first-page":"900","DOI":"10.1097\/ta.0b013e3181edc80e","volume":"70","author":"J Bayer","year":"2011","unstructured":"Bayer J, Pache G, Strohm PC et al (2011) Influence of arm positioning on radiation dose for whole body computed tomography in trauma patients. J Trauma Injury Infect Crit Care 70:900\u2013905. https:\/\/doi.org\/10.1097\/ta.0b013e3181edc80e","journal-title":"J Trauma Injury Infect Crit Care"},{"key":"3746_CR18","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1007\/s10140-011-0948-5","volume":"18","author":"C Karlo","year":"2011","unstructured":"Karlo C, Gnannt R, Frauenfelder T et al (2011) Whole-body CT in polytrauma patients: effect of arm positioning on thoracic and abdominal image quality. Emerg Radiol 18:285\u2013293. https:\/\/doi.org\/10.1007\/s10140-011-0948-5","journal-title":"Emerg Radiol"},{"key":"3746_CR19","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1007\/s00414-007-0210-6","volume":"122","author":"R Schulz","year":"2008","unstructured":"Schulz R, M\u00fchler M, Reisinger W et al (2008) Radiographic staging of ossification of the medial clavicular epiphysis. Int J Legal Med 122:55\u201358. https:\/\/doi.org\/10.1007\/s00414-007-0210-6","journal-title":"Int J Legal Med"},{"key":"3746_CR20","doi-asserted-by":"publisher","first-page":"1239","DOI":"10.1148\/rg.210107","volume":"42","author":"A Zhao","year":"2022","unstructured":"Zhao A, Fopma S, Agrawal R (2022) Demystifying the CT radiation dose sheet. Radiographics 42:1239\u20131250. https:\/\/doi.org\/10.1148\/rg.210107","journal-title":"Radiographics"},{"key":"3746_CR21","volume-title":"Review of Radiologic Physics","author":"W Huda","year":"2010","unstructured":"Huda W (2010) Review of Radiologic Physics. Lippincott Williams & Wilkins"},{"key":"3746_CR22","doi-asserted-by":"publisher","first-page":"1057","DOI":"10.1148\/rg.304095167","volume":"30","author":"A Schilham","year":"2010","unstructured":"Schilham A, Van Der Molen AJ, Prokop M, De Jong HW (2010) Overranging at multisection CT: an underestimated source of excess radiation exposure. Radiographics 30:1057\u20131067. https:\/\/doi.org\/10.1148\/rg.304095167","journal-title":"Radiographics"},{"key":"3746_CR23","doi-asserted-by":"publisher","first-page":"1857","DOI":"10.1002\/sim.4501","volume":"31","author":"JO Friedrich","year":"2012","unstructured":"Friedrich JO, Adhikari NKJ, Beyene J (2012) Ratio of geometric means to analyze continuous outcomes in meta-analysis: comparison to mean differences and ratio of arithmetic means using empiric data and simulation. Stat Med 31:1857\u20131886. https:\/\/doi.org\/10.1002\/sim.4501","journal-title":"Stat Med"},{"key":"3746_CR24","doi-asserted-by":"publisher","first-page":"1514","DOI":"10.1002\/mp.12137","volume":"44","author":"RM Marsh","year":"2017","unstructured":"Marsh RM, Silosky MS (2017) The effects of patient positioning when interpreting CT dose metrics: a Phantom study. Med Phys 44:1514\u20131524. https:\/\/doi.org\/10.1002\/mp.12137","journal-title":"Med Phys"},{"key":"3746_CR25","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2019.108655","volume":"120","author":"M Tozakidou","year":"2019","unstructured":"Tozakidou M, Yang S-R, Kovacs BK et al (2019) Dose-optimized computed tomography of the cervical spine in patients with shoulder pull-down: is image quality comparable with a standard dose protocol in an emergency setting? Eur J Radiol 120:108655. https:\/\/doi.org\/10.1016\/j.ejrad.2019.108655","journal-title":"Eur J Radiol"},{"key":"3746_CR26","doi-asserted-by":"publisher","DOI":"10.1161\/jaha.123.033566","author":"BW Sperry","year":"2024","unstructured":"Sperry BW, Vamenta MS, Gunta SP et al (2024) Influence of body mass index on radiation exposure across imaging modalities in the evaluation of chest pain. J Am Heart Assoc. https:\/\/doi.org\/10.1161\/jaha.123.033566","journal-title":"J Am Heart Assoc"}],"container-title":["International Journal of Legal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00414-026-03746-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00414-026-03746-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00414-026-03746-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T08:03:13Z","timestamp":1781683393000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00414-026-03746-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,28]]},"references-count":26,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["3746"],"URL":"https:\/\/doi.org\/10.1007\/s00414-026-03746-9","relation":{},"ISSN":["0937-9827","1437-1596"],"issn-type":[{"value":"0937-9827","type":"print"},{"value":"1437-1596","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,28]]},"assertion":[{"value":"3 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 February 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was classified as quality evaluation study by the Ethics Committee of the Canton of Bern (KEK Req-2023-00390) and the need for informed consent was waived.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"<!--Emphasis Type='Bold' removed-->Ethical approval"}},{"value":"not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Clinical trial number"}},{"value":"The authors declare that they have no conflict of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"<!--Emphasis Type='Bold' removed-->Conflict of interest"}}]}}