{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T13:32:01Z","timestamp":1787146321535,"version":"build-2736575974"},"reference-count":24,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"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\/Objectives: Forensic age estimation increasingly relies on non-ionizing magnetic resonance imaging (MRI) evaluation of the knee growth plates. The original five-stage classification proposed by Dedouit et al. was developed using spin-echo proton-density-weighted imaging, and its applicability to gradient-echo sequences with different contrast mechanisms has not been fully established. This study aimed to apply the original, unmodified Dedouit classification to a volumetric three-dimensional Multiple Echo Data Image Combination (3D MEDIC) sequence and to generate corresponding age thresholds in a Turkish sample. Methods: Knee MRI examinations of 309 individuals (153 males, 156 females; age range 9.18\u201325.97 years) were retrospectively evaluated at a 3-Tesla field strength. Two experienced observers independently staged the distal femoral and proximal tibial epiphyses; intra- and inter-observer agreement were assessed using Cohen\u2019s kappa. Spearman\u2019s correlation and the Mann\u2013Whitney U test, with rank-biserial effect sizes and Bonferroni correction, were used to assess the relationship between age and stage and between-sex differences, respectively. To provide forensically applicable thresholds, we additionally modeled the age at which the probability of complete fusion (Stage V) reached 50%, with 95% bootstrap confidence intervals, and calculated the sensitivity, specificity, and area under the curve (AUC) of Stage V for identifying individuals \u226518 years. Results: Agreement was very good for both epiphyses (kappa = 0.808\u20130.833). Age correlated strongly with stage for both the femur (rho = 0.70\u20130.76) and tibia (rho = 0.68\u20130.74). The 50%-probability age for complete fusion ranged from 15.23 years (tibia, females) to 17.43 years (femur, males). Stage V showed high sensitivity (0.96\u20130.98) but markedly lower and sex-dependent specificity for the 18-year threshold (0.48\u20130.58 in females versus 0.77\u20130.85 in males), indicating that Stage V alone is a poor sole criterion for confirming adult status in females. The youngest age at which Stage V was observed was 14.67 years in females and 16.07\u201316.16 years in males, markedly younger than thresholds reported using spin-echo imaging in the original Dedouit cohort. However, as an extreme-value statistic based on a single individual, this minimum should not be used as a forensic threshold in isolation. Conclusions: The Dedouit classification remains reproducible when applied to a 3D gradient-echo sequence, but the resulting age thresholds may be influenced by acquisition technique, population-specific factors such as socioeconomic status, or both. Consequently, thresholds derived from different MRI sequences or populations should not be assumed to be interchangeable without local validation.<\/jats:p>","DOI":"10.3390\/diagnostics16162641","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T13:14:01Z","timestamp":1787145241000},"page":"2641","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Forensic Age Estimation of the Knee with 3D MEDIC MRI"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0156-0056","authenticated-orcid":false,"given":"Fatma Celik","family":"Yabul","sequence":"first","affiliation":[{"name":"Department of Radiology, Bak\u0131rkoy Dr. Sadi Konuk Training and Research Hospital, Health Sciences University, Istanbul 35000, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2506-4794","authenticated-orcid":false,"given":"Elif","family":"Hocaoglu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Bak\u0131rkoy Dr. Sadi Konuk Training and Research Hospital, Health Sciences University, Istanbul 35000, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5211-0402","authenticated-orcid":false,"given":"Claire","family":"Villard","sequence":"additional","affiliation":[{"name":"Department of Legal Medicine, CHU Montpellier, University of Montpellier, 34000 Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Baccino","sequence":"additional","affiliation":[{"name":"Department of Legal Medicine, CHU Montpellier, University of Montpellier, 34000 Montpellier, France"},{"name":"L\u2019\u00c9quipe de Droit P\u00e9nal et de Sciences Forensiques de Montpellier (EDPFM), University of Montpellier, 34000 Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6948-120X","authenticated-orcid":false,"given":"Sophie","family":"Colomb","sequence":"additional","affiliation":[{"name":"Department of Legal Medicine, CHU Montpellier, University of Montpellier, 34000 Montpellier, France"},{"name":"L\u2019\u00c9quipe de Droit P\u00e9nal et de Sciences Forensiques de Montpellier (EDPFM), University of Montpellier, 34000 Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7390-8947","authenticated-orcid":false,"given":"Laurent","family":"Martrille","sequence":"additional","affiliation":[{"name":"Department of Legal Medicine, CHU Montpellier, University of Montpellier, 34000 Montpellier, France"},{"name":"ADES, UMR 7268, Aix-Marseille Universit\u00e9, Bloc A, 13344 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"ref_1","unstructured":"Frontex (2022). 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