{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T05:09:47Z","timestamp":1778303387544,"version":"3.51.4"},"reference-count":71,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Sex estimation represents a pivotal element of forensic anthropological investigation, conventionally dependent on highly dimorphic skeletal components such as the pelvis and skull. The purpose of the current study was to systematically evaluate the diagnostic accuracy of sternal measurements for sex estimation and to identify methodological- or population-based moderators that influence classification performance. Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA 2020 guidelines. R programming software was used to perform statistical meta-analysis. Pooled sensitivity, specificity, diagnostic odds ratio (DOR), likelihood ratios (LR\u00b1), and overall accuracy were calculated using random-effects meta-analysis. Subgroup analyses and meta-regression were performed based on population origin, study design, statistical approach, and measurement protocol. Results: Forty-one studies comprising 293 predictive models were included. The overall pooled sensitivity and specificity were 80.9% (95% CI: 79.7\u201382.1) and 74.0% (95% CI: 72.4\u201375.5), respectively, with a mean accuracy of 77.3%. Subgroup analysis revealed that studies involving African populations and imaging-based methods achieved the highest accuracy. Machine learning- and ROC-based methods outperformed traditional discriminant analysis. Combined sternal measurements (manubrium and body) yielded the most robust diagnostic performance (accuracy: 87.3%). Significant heterogeneity (I2 &gt; 85%) was observed. Conclusions: Sternal morphometry exhibits a moderate to high degree of diagnostic accuracy in sex estimation and possesses significant forensic importance, especially in situations where more sexually dimorphic features are inaccessible. Nonetheless, variations across populations, the absence of standardized protocols, and methodological heterogeneity constrain its universal applicability.<\/jats:p>","DOI":"10.3390\/diagnostics16091255","type":"journal-article","created":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T12:54:08Z","timestamp":1776862448000},"page":"1255","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic Accuracy of Sternum Measurements for Sex Estimation: A Systematic Review with Meta-Analysis"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-0122-2436","authenticated-orcid":false,"given":"George","family":"Triantafyllou","sequence":"first","affiliation":[{"name":"Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4945-7062","authenticated-orcid":false,"given":"Daniel","family":"Gondorf","sequence":"additional","affiliation":[{"name":"Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6221-7537","authenticated-orcid":false,"given":"Ioannis","family":"Paschopoulos","sequence":"additional","affiliation":[{"name":"Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Baccino","sequence":"additional","affiliation":[{"name":"EDPFM, Department of Legal Medicine CHU Montpellier, University of Montpellier, 34000 Montpellier, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7390-8947","authenticated-orcid":false,"given":"Laurent","family":"Martrille","sequence":"additional","affiliation":[{"name":"EDPFM, Department of Legal Medicine CHU Montpellier, University of Montpellier, 34000 Montpellier, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stavroula","family":"Papadodima","sequence":"additional","affiliation":[{"name":"Department of Forensic Medicine and Toxicology, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4831-8005","authenticated-orcid":false,"given":"Maria","family":"Piagkou","sequence":"additional","affiliation":[{"name":"Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2617","DOI":"10.1007\/s00414-024-03268-2","article-title":"Sex Estimation from Coxal Bones Using Deep Learning in a Population Balanced by Sex and Age","volume":"138","author":"Epain","year":"2024","journal-title":"Int. J. Leg. Med."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Baca, K., Bridge, B., and Snow, M. (2022). Three-Dimensional Geometric Morphometric Sex Determination of the Whole and Modeled Fragmentary Human Pubic Bone. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0265754"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2603","DOI":"10.1007\/s00414-021-02700-1","article-title":"Sex Estimation from the Greater Sciatic Notch: A Comparison of Classical Statistical Models and Machine Learning Algorithms","volume":"135","author":"Knecht","year":"2021","journal-title":"Int. J. Leg. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"407.e1","DOI":"10.1016\/j.forsciint.2017.06.012","article-title":"Population Variation in Skeletal Sexual Dimorphism","volume":"278","author":"Ubelaker","year":"2017","journal-title":"Forensic Sci. Int."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1002\/ajpa.23282","article-title":"Validation and Reliability of the Sex Estimation of the Human Os Coxae Using Freely Available DSP2 Software for Bioarchaeology and Forensic Anthropology","volume":"164","author":"Santos","year":"2017","journal-title":"Am. J. Phys. Anthropol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1002\/ajpa.10012","article-title":"A Method for Visual Determination of Sex, Using the Human Hip Bone","volume":"117","author":"Bruzek","year":"2002","journal-title":"Am. J. Phys. Anthropol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1887","DOI":"10.1007\/s00414-023-03072-4","article-title":"Sex Estimation from Long Bones: A Machine Learning Approach","volume":"137","author":"Knecht","year":"2023","journal-title":"Int. J. Leg. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1007\/s12024-023-00613-6","article-title":"Accuracy of Sex Estimation by Morphometric Evaluation of Foramen Magnum Using Computed Tomography\u2014A Systematic Review and Meta-Analysis","volume":"20","author":"Fernandes","year":"2023","journal-title":"Forensic Sci. Med. Pathol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"owad046","DOI":"10.1093\/fsr\/owad046","article-title":"Potential Role of the Sella Turcica X-Ray Imaging Aspects for Sex Estimation in the Field of Forensic Anthropology: A Systematic Review and Meta-Analysis","volume":"9","author":"Ribeiro","year":"2024","journal-title":"Forensic Sci. Res."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Triantafyllou, G., Botis, G.G., Piagkou, M., Papanastasiou, K., Tsakotos, G., Paschopoulos, I., Matsopoulos, G.K., and Papadodima, S. (2024). Sex Estimation Through Orbital Measurements: A Machine Learning Approach for Forensic Science. Diagnostics, 14.","DOI":"10.3390\/diagnostics14242773"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Uabundit, N., Chaiyamoon, A., Iamsaard, S., Yurasakpong, L., Nantasenamat, C., Suwannakhan, A., and Phunchago, N. (2021). Classification and Morphometric Features of Pterion in Thai Population with Potential Sex Prediction. Medicina, 57.","DOI":"10.3390\/medicina57111282"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"112143","DOI":"10.1016\/j.forsciint.2024.112143","article-title":"Reliability of Predictive Models Based on the Mesiodistal and Buccolingual Diameters of Permanent Canine Teeth for Sex Estimation in Forensic Contexts: A Systematic Review and Meta-Analysis","volume":"361","author":"Tanga","year":"2024","journal-title":"Forensic Sci. Int."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Vatzia, K., Fanariotis, M., Bugajski, M., Fezoulidis, I.V., Piagkou, M., Vlychou, M., Triantafyllou, G., Vezakis, I., Botis, G., and Papadodima, S. (2025). Assessing Sternal Dimensions for Sex Classification: Insights from a Greek Computed Tomography-Based Study. Diagnostics, 15.","DOI":"10.3390\/diagnostics15131649"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 Statement: An Updated Guideline for Reporting Systematic Reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Campbell, J. (2020). Chapter 9: Diagnostic Test Accuracy Systematic Reviews. JBI Manual for Evidence Synthesis, JBI.","DOI":"10.46658\/JBIRM-17-07"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"103","DOI":"10.21608\/ajfm.2014.18679","article-title":"Determination of Sex from Sternal Dimensions in Upper Egypt Population by Using Multislice Computed Axial Tomography","volume":"23","author":"Yossef","year":"2014","journal-title":"Ain Shams J. Forensic Med. Clin. Toxicol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1016\/j.jchb.2017.11.001","article-title":"Estimation of Sex in a Contemporary Saudi Population Based on Sternal Measurements Using Multidetector Computed Tomography","volume":"68","author":"Ahmed","year":"2017","journal-title":"HOMO"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"100244","DOI":"10.1016\/j.fsir.2021.100244","article-title":"Multi-Detector Computed Tomography for the Estimation of Sex from Sternal Medullary Cavity Measurements in Sudanese Individuals","volume":"4","author":"Ahmed","year":"2021","journal-title":"Forensic Sci. Int. Rep."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"200457","DOI":"10.1016\/j.fri.2021.200457","article-title":"Sternum as an Indicator for Sex and Age Estimation Using Multidetector Computed Tomography in an Egyptian Population","volume":"26","author":"Ali","year":"2021","journal-title":"Forensic Imaging"},{"key":"ref_20","first-page":"577","article-title":"A Study of Sexual Dimorphism in Human Sterna","volume":"2","author":"Adhvaryu","year":"2013","journal-title":"Int. J. Med. Res. Health Sci."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Arag\u00e3o, J.A., Matos, \u00cd.Q., Carvalho, H.D.G., Arag\u00e3o, I.C.S., Arag\u00e3o, F.M.S., Feitosa, V.L.C., and Reis, F.P. (2022, September 21). Sexual Dimorphism Based on the Sternum Bone Morphometry in Human Fetuses. Available online: https:\/\/www.researchsquare.com\/article\/rs-2076534\/v1.","DOI":"10.21203\/rs.3.rs-2076534\/v1"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1177\/0971097320080405","article-title":"Gender Differentiation from Sternal Width","volume":"30","author":"Atal","year":"2008","journal-title":"J. Indian Acad. Forensic Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"100368","DOI":"10.1016\/j.fsir.2024.100368","article-title":"Assessing the Reliability and Accuracy of Sex Estimation Models Utilizing Sternal Morphometry Derived from Computed Tomography in the Ghanaian Population","volume":"9","author":"Banyeh","year":"2024","journal-title":"Forensic Sci. Int. Rep."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"83","DOI":"10.5958\/0974-0848.2017.00018.5","article-title":"Width of Sternum at Suprasternal Notch and at the Level of Fourth Rib for Determination of Sex in the Population of Delhi: A New & Reliable Tool for Sex Prediction","volume":"39","author":"Baraw","year":"2017","journal-title":"J. Indian Acad. Forensic Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"237","DOI":"10.3325\/cmj.2019.60.237","article-title":"Sex Estimation of the Sternum by Automatic Image Processing of Multi-Slice Computed Tomography Images in a Croatian Population Sample: A Retrospective Study","volume":"60","author":"Bedalov","year":"2019","journal-title":"Croat. Med. J."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"290.e1","DOI":"10.1016\/j.forsciint.2011.11.034","article-title":"Estimating Sex of the Human Skeleton Based on Metrics of the Sternum","volume":"219","author":"Bongiovanni","year":"2012","journal-title":"Forensic Sci. Int."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1016\/j.legalmed.2014.07.007","article-title":"Osteometric Analysis for Sexing of Modern Sternum\u2014An Autopsy Study from South India","volume":"16","author":"Chandrakanth","year":"2014","journal-title":"Leg. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1444","DOI":"10.26735\/16586794.2019.035","article-title":"A Study for Determination of Sex by Multidetector Computed Tomography of Sternum Using Discriminant Function and Logistic Regression","volume":"1","author":"Chowdhuri","year":"2019","journal-title":"Arab J. Forensic Sci. Forensic Med."},{"key":"ref_29","first-page":"117","article-title":"An Autopsy Based Study of Sexual Dimorphism of Adult Human Sterna","volume":"14","author":"Darade","year":"2020","journal-title":"Indian J. Forensic Med. Toxicol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/j.jflm.2017.09.006","article-title":"Sex Determination from Chest Measurements in a Sample of Egyptian Adults Using Multislice Computed Tomography","volume":"52","author":"Darwish","year":"2017","journal-title":"J. Forensic Leg. Med."},{"key":"ref_31","first-page":"1","article-title":"Radiological Age & Sex Determination from Sternum","volume":"3","author":"Dhkar","year":"2014","journal-title":"Int. J. Sci. Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"96","DOI":"10.4323\/rjlm.2021.96","article-title":"The Sternum as a Sex Discriminator in a Contemporary Spanish Population","volume":"29","year":"2021","journal-title":"Rom. J. Leg. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e240","DOI":"10.1097\/MD.0000000000000240","article-title":"Sex Estimation from Sternal Measurements Using Multidetector Computed Tomography","volume":"93","author":"Ekizoglu","year":"2014","journal-title":"Medicine"},{"key":"ref_34","first-page":"1","article-title":"Sex Identification Using Sternal Measurements by Multi-Slice Computed Tomography in a Sample of the Egyptian Population","volume":"24","author":"Elmansy","year":"2024","journal-title":"Egypt. J. Forensic Sci. Appl. Toxicol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"90","DOI":"10.21608\/zjfm.2022.127310.1109","article-title":"Determination of Gender from Sternal Measurements Using Computed Tomography Imaging in a Sample of Sohag Governorate Population","volume":"20","author":"Elsayed","year":"2022","journal-title":"Zagazig J. Forensic Med. Toxicol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"230.e1","DOI":"10.1016\/j.forsciint.2011.11.008","article-title":"Estimation of Sex from Sternal Measurements in a Western Australian Population","volume":"217","author":"Franklin","year":"2012","journal-title":"Forensic Sci. Int."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"313.e1","DOI":"10.1016\/j.forsciint.2014.06.019","article-title":"Sexual Dimorphism of Human Sternum in a Contemporary Spanish Population","volume":"244","author":"Djorojevic","year":"2014","journal-title":"Forensic Sci. Int."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"200501","DOI":"10.1016\/j.fri.2022.200501","article-title":"Morphometric Study of Sternum by Computed Tomography in an Iranian Population: A Method to Discriminate between Male and Female","volume":"28","author":"Ghorbanlou","year":"2022","journal-title":"Forensic Imaging"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1177\/0971097320140304","article-title":"Determination of Sex from Sternal Bone in Central Delhi Population","volume":"36","author":"Gupta","year":"2014","journal-title":"J. Indian Acad. Forensic Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.legalmed.2007.05.011","article-title":"Sexual Dimorphism of the Human Sternum in a Maharashtrian Population of India: A Morphometric Analysis","volume":"10","author":"Hunnargi","year":"2008","journal-title":"Leg. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.jflm.2008.08.004","article-title":"Sternal Index: Is It a Reliable Indicator of Sex in the Maharashtrian Population of India?","volume":"16","author":"Hunnargi","year":"2009","journal-title":"J. Forensic Leg. Med."},{"key":"ref_42","first-page":"200","article-title":"Sex Determination from Measurements of the Sternum Using Multislice Computed Tomography of the Chest in Pashtun Population of Swat","volume":"4","author":"Iqbal","year":"2021","journal-title":"Pak Euro J. Med. Life Sci."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"7070","DOI":"10.16965\/ijar.2019.307","article-title":"Sternum as an Index for Determination of Sex","volume":"7","author":"Jaiswal","year":"2019","journal-title":"Int. J. Anat. Res."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1002\/ajpa.1330530206","article-title":"Sexing the Human Sternum","volume":"53","author":"Jit","year":"1980","journal-title":"Am. J. Phys. Anthropol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e28169","DOI":"10.1097\/MD.0000000000028169","article-title":"Estimation of Sex Based on Metrics of the Sternum in a Contemporary Jordanian Population","volume":"100","author":"Kalbouneh","year":"2021","journal-title":"Medicine"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"104","DOI":"10.3126\/jgmcn.v13i2.30729","article-title":"Sex- Related Morphometric Difference in Sternal Index and Dimensions amongst Nepalese Adults","volume":"13","author":"Karki","year":"2020","journal-title":"J. Gandaki Med. Coll. Nepal"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"200495","DOI":"10.1016\/j.fri.2022.200495","article-title":"Sex and Stature Estimation Based on Multidetector Computed Tomography Imaging Measurements of the Sternum in Turkish Population","volume":"28","author":"Tetiker","year":"2022","journal-title":"Forensic Imaging"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"111.e1","DOI":"10.1016\/j.forsciint.2010.07.019","article-title":"The Efficacy of Sternal Measurements for Sex Estimation in South African Blacks","volume":"202","author":"Macaluso","year":"2010","journal-title":"Forensic Sci. Int."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1007\/s00414-013-0910-z","article-title":"Estimation of Sex from Sternal Dimensions Derived from Chest Plate Radiographs in Contemporary Spaniards","volume":"128","author":"Macaluso","year":"2014","journal-title":"Int. J. Leg. Med."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"60","DOI":"10.5958\/2394-6776.2016.00009.6","article-title":"Is Human Sternum a Tool for Determination of Sex?","volume":"3","author":"Manoharan","year":"2016","journal-title":"Indian J. Forensic Community Med."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1002\/ajpa.1330680205","article-title":"Sex Determination from Chest Plate Roentgenograms","volume":"68","author":"McCormick","year":"1985","journal-title":"Am. J. Phys. Anthropol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1177\/0971097320100413","article-title":"Determination of Sex from Adult Sternum by Discriminant Function Analysis on Autopsy Sample of Indian Bengali Population: A New Approach","volume":"32","author":"Mukhopadhyay","year":"2010","journal-title":"J. Indian Acad. Forensic Med."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"13","DOI":"10.61091\/jpms2024130603","article-title":"Sex Determination and Length and Stature Estimation from The Sternum Bone","volume":"13","author":"Nasab","year":"2024","journal-title":"J. Pioneer. Med. Sci."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1007\/s00414-024-03349-2","article-title":"Sex Estimation by CT Image Analysis of the Rib Cage in a Mediterranean Population","volume":"139","year":"2025","journal-title":"Int. J. Leg. Med."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.forsciint.2019.05.011","article-title":"Sex Estimation Using Sternum Part Lengths by Means of Artificial Neural Networks","volume":"301","author":"Oner","year":"2019","journal-title":"Forensic Sci. Int."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1519","DOI":"10.1007\/s00414-020-02266-4","article-title":"New Methods for Sex Estimation Using Sternum and Rib Morphology","volume":"134","author":"Peleg","year":"2020","journal-title":"Int. J. Leg. Med."},{"key":"ref_57","first-page":"1516","article-title":"Sexing of Unknown Adult Human Sterna by Metrical Analysis","volume":"3","author":"Puttabanthi","year":"2012","journal-title":"Int. J. Biol. Med. Res."},{"key":"ref_58","first-page":"120.e1","article-title":"Sex Determination from Measurements of the Sternum and Fourth Rib Using Multislice Computed Tomography of the Chest","volume":"197","author":"Dolgun","year":"2010","journal-title":"Forensic Sci. Int."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"118","DOI":"10.18231\/2581-5229.2018.0031","article-title":"Study of Gender Determination in Living Adult Male and Female Subjects by Evaluating the Size of Sternum about North Indian Population","volume":"4","author":"VSharma","year":"2020","journal-title":"IP Indian J. Anat. Surg. Head Neck Brain"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"181.e1","DOI":"10.1016\/j.forsciint.2013.02.002","article-title":"Sex and Age Related Non-Metric Variation of the Human Sternum in a Northwest Indian Postmortem Sample: A Pilot Study","volume":"228","author":"Singh","year":"2013","journal-title":"Forensic Sci. Int."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"26740","DOI":"10.32598\/ijmtfm.v10i1.26740","article-title":"Gender Identification Based on the Parameters of the Sternum Bone in the Cadavers","volume":"10","author":"Soltani","year":"2020","journal-title":"Int. J. Med. Toxicol. Forensic Med."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"32","DOI":"10.4103\/ijabmr.ijabmr_150_24","article-title":"Determination of Sex from Morphometry of Sternum Using Multidetector Computed Tomography in Central Indian Population","volume":"15","author":"Sravan","year":"2025","journal-title":"Int. J. Appl. Basic Med. Res."},{"key":"ref_63","first-page":"27","article-title":"Determination of Sex from the Sternum and Fourth Rib Measurements (A Cross-Sectional Study (Using Thoracic Computed Tomography (CT) Images","volume":"17","author":"Sweilum","year":"2017","journal-title":"Egypt. J. Forensic Sci. Appl. Toxicol."},{"key":"ref_64","unstructured":"Toneva, D. (2014). Reliability of the Sternal Index as a Sex Indicator in Medieval Skeletal Remains from Northeastern Bulgaria. J. BioSci. Biotech., 149\u2013152."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.legalmed.2015.01.003","article-title":"Estimation of Sex in Japanese Cadavers Based on Sternal Measurements Using Multidetector Computed Tomography","volume":"17","author":"Torimitsu","year":"2015","journal-title":"Leg. Med."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.jasi.2015.10.004","article-title":"Sex Determination from Different Sternal Measurements: A Study in a Thai Population","volume":"64","author":"Das","year":"2015","journal-title":"J. Anat. Soc. India"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1111\/1556-4029.12111","article-title":"Discrete Traits of the Sternum and Ribs: A Useful Contribution to Identification in Forensic Anthropology and Medicine","volume":"58","author":"Verna","year":"2013","journal-title":"J. Forensic Sci."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1007\/s12565-014-0235-0","article-title":"Estimation of Stature and Sex from Sternal Lengths: An Autopsy Study","volume":"90","author":"Yonguc","year":"2015","journal-title":"Anat. Sci. Int."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.legalmed.2018.07.003","article-title":"Estimation of Stature and Sex from Sacrum and Coccyx Measurements by Multidetector Computed Tomography in Chinese","volume":"34","author":"Zhan","year":"2018","journal-title":"Leg. Med."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1080\/00450618.2015.1060523","article-title":"Sexual Dimorphism of Sternum Using Computed Tomography\u2014Volume Rendering Technique Images of Western Chinese","volume":"48","author":"Zhang","year":"2016","journal-title":"Aust. J. Forensic Sci."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1127\/anthranz\/2019\/0887","article-title":"Stature Estimation from the Combination of Clavicle, Scapula, and Sternum from 3D-VRT Images in Chinese Population","volume":"76","author":"Zhang","year":"2019","journal-title":"Anthropol. Anz."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/9\/1255\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T04:12:35Z","timestamp":1778299955000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/9\/1255"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,22]]},"references-count":71,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["diagnostics16091255"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16091255","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,22]]}}}