Sex and stature estimation from adult lumbar vertebrae in a Thai population based on image analysis / Estimación de sexo y estatura de vértebras lumbares adultas en una población Tailandesa basada en análisis de imagen

SUMMARY: Although molecular techniques evolved considerably in last years, anthropological methods of assessing skeletal remains, continues to be an important tool in the identification process in medico legal investigations. The objective of this study was to develop a discriminant function equation for estimating sex and stature using several measurements of lumbar vertebrae in a Thai population. We studied 150 lumbar columns (75 male and 75 female) age range of 22 to 89 years from the Forensic Osteology Research Center, Chiang Mai University, Thailand. The quantitative variables with sex were analyzed by the discriminant function analysis and that with stature were calculated using linear regression. The pixel density of the major axis of the trabecular surface of superior endplate of the first lumbar vertebra had the most accuracy in sex determination. The regression equation with quantitative variables in stature estimation described 32.3 % of the total variance with standard error of estimate of 7.736 cm. Lumbar vertebrae can be used as part of the stature and sex quantitatively and qualitatively estimating in Thais incomplete skeletal remains.

RESUMEN: Los métodos antropológicos de evaluación del esqueleto siguen siendo una herramienta importante en el proceso de identificación en las investigaciones médico-legales. El objetivo de este estudio fue desarrollar una ecuación de función discriminante para estimar el sexo y la estatura utilizando varias medidas de las vértebras lumbares en una población tailandesa. Se estudiaron 150 columnas lumbares (75 hombres y 75 mujeres) con un rango etario de 22 a 89 años del Centro de Investigación de Osteología Forense, Universidad de Chiang Mai, Tailandia. Las variables cuantitativas de sexo se analizaron mediante el análisis de función discriminante y la estatura fue calculada mediante regresión lineal. En cuanto a la determinación de sexo, la densidad de píxeles del eje mayor de superficie trabecular de la placa terminal superior de la primera vértebra lumbar fue de mayor precisión. La ecuación de regresión con variables cuantitativas en la estimación de la estatura describió el 32,3 % de la varianza total con el error estándar de estimación de 7,736 cm. Las vértebras lumbares se pueden utilizar como parte de la estatura y el sexo, estimando cuantitativa y cualitativamente los restos esqueléticos incompletos en sujetos tailandeses.

Radiation protection in non-ionizing and ionizing body composition assessment procedures.

Body composition assessment (BCA) represents a valid instrument to evaluate nutritional status through the quantification of lean and fat tissue, in healthy subjects and sick patients. According to the clinical indication, body composition (BC) can be assessed by different modalities. To better analyze radiation risks for patients involved, BCA procedures can be divided into two main groups: the first based on the use of ionizing radiation (IR), involving dual energy X-ray absorptiometry (DXA) and computed tomography (CT), and others based on non-ionizing radiation (NIR) [magnetic resonance imaging (MRI)]. Ultrasound (US) techniques using mechanical waves represent a separate group. The purpose of our study was to analyze publications about IR and NIR effects in order to make physicians aware about the risks for patients undergoing medical procedures to assess BCA providing to guide them towards choosing the most suitable method. To this end we reported the biological effects of IR and NIR and their associated risks, with a special regard to the excess risk of death from radio-induced cancer. Furthermore, we reported and compared doses obtained from different IR techniques, giving practical indications on the optimization process. We also summarized current recommendations and limits for techniques employing NIR and US. The authors conclude that IR imaging procedures carry relatively small individual risks that are usually justified by the medical need of patients, especially when the optimization principle is applied. As regards NIR imaging procedures, a few studies have been conducted on interactions between electromagnetic fields involved in MR exam and biological tissue. To date, no clear link exists between MRI or associated magnetic and pulsed radio frequency (RF) fields and subsequent health risks, whereas acute effects such as tissue burns and phosphenes are well-known; as regards the DNA damage and the capability of NIR to break chemical bonds, they are not yet robustly demonstrated. MRI is thus considered to be very safe for BCA as well US procedures.

Intravoxel incoherent motion MR imaging for differentiating malignant lesions in spine: A pilot study.

PURPOSE: To determine the diagnostic potential of Intravoxel Incoherent Motion (IVIM) MRI for differentiating malignant spinal tumours from acute vertebral compression fractures and tuberculous spondylitis, and to compare IVIM with diffusion-weighted imaging (DWI) and chemical shift imaging (CSI). METHODS: The Institutional Review Board approved this prospective study, and informed consent was obtained. IVIM MRI, DWI, and CSI at 1.5 T were performed in 25 patients with 12 acute compression fractures, 14 tuberculous spondylitis, and 18 malignant spinal tumours. The parameters of these techniques were assessed using the Kruskal-Wallis test. The diagnostic performance of the parameters was evaluated using receiver operating characteristic (ROC) analysis. RESULTS: ADC, SIR, Dslow, Dfast, and f values of malignant tumours were significantly different from those of acute compression fracture (for all, p < 0.05). The mean Dslow and Dfast values of malignant spinal tumours had significant differences compared with those of tuberculous spondylitis (for all, p < 0.05). However, no significant differences were observed in any quantitative parameters between the acute compression fracture and the tuberculous spondylitis (p > 0.05). Dslow•f showed the highest AUC value of 0.980 (95%CI: 0.942-1.000) in differentiating acute compression fracture and malignant spinal tumours. Dslow showed the highest AUC value of 0.877 (95%CI: 0.713-0.966) in differentiating tuberculous spondylitis and malignant spinal tumours. CONCLUSIONS: IVIM MR imaging may be helpful for differentiating malignant spinal tumours from acute vertebral compression fractures and tuberculous spondylitis.

The Association between Dietary Magnesium Intake and Magnetic Resonance Parameters for Knee Osteoarthritis.

The aim of the study was to evaluate the relationship between dietary magnesium (Mg) intake and prevalence of knee osteoarthritis (OA), a topic poorly explored in the literature. Overall, 783 people participating in the Osteoarthritis Initiative (59.8% females; mean age: 62.3 years) and having an MRI assessment were enrolled in this cross-sectional study. Mg intake was measured with a semi-quantitative food frequency questionnaire, and its association with knee OA was evaluated for an increased intake of 100 mg/day. Using an adjusted linear regression analysis, a higher Mg intake (i.e., increase of 100 mg/day) corresponded to a significant increase in mean cartilage thickness, cartilage volume at medial tibia, cartilage volume and mean cartilage thickness at central medial femur, and cartilage volume and mean cartilage thickness in the central medial tibiofemoral compartment. In conclusion, an increased Mg dietary intake is associated with a better knee cartilage architecture, also when adjusting for potential confounders, suggesting a potential role of Mg in the prevention and treatment of knee OA.

The new lens dose limit: implication for occupational radiation protection.

AIM AND OBJECTIVES: The aim of this article was to explore the implications of the new Euratom dose limit for occupational radiation protection in the context of medical occupational radiation exposures. The European Directive 2013/59/Euratom takes into account the new recommendations on reduction in the dose limit for the lens of the eye for planned occupational exposures released in 2012 by the International Commission on Radiological Protection (ICRP 118). MATERIALS AND METHODS: Different dose-monitoring procedures and devices were considered. Occupational eye lens doses reported by previous studies were analyzed, mainly considering workers involved in interventional procedures with X-rays. The current status of eye lens radiation protection and the main methods for dose reduction were investigated. RESULTS: The analysis showed that the workers, potentially exceeding the new limit, are clinical staff performing interventional procedures with a relatively high X-ray dose. Regarding radiological protection issues, the considered literature reports that the proper use of personal protective equipment may reduce the eye lens absorbed dose. CONCLUSION: The evaluation of the occupational eye lens dose is essential to establish which method of personal dose monitoring should be preferred. Furthermore, education and training about the right use of personal protective equipment are important for medical staff working with ionizing radiation.

Parosteal osteosarcoma with focal fatty metaplasia: A case report.

Parosteal osteosarcoma originates on the surface of long bones. The juxtacortical variety is one of the most common ones and accounts for about 5% of all osteosarcomas. We report the case of a 34-year-old female patient with a rare variant of parosteal osteosarcoma. Because of the less aggressive biological behavior, it is important to know it, in order to recognize and differentiate it from benign osseous lesions.

Vitamin D Intake and Magnetic Resonance Parameters for Knee Osteoarthritis: Data from the Osteoarthritis Initiative.

PURPOSE: There is evidence that vitamin D may play a role in the osteoarthritis (OA) pathogenesis, but the few data available are limited to X-rays and clinical findings. The aim of this study was to investigate whether a higher intake of vitamin D was associated with a better architecture of the cartilage of the knee, assessed with magnetic resonance (MRI), in a large cohort from North America. METHODS: 783 participants (59.8% females; mean age: 62.3 years) with an MRI assessment from the Osteoarthritis Initiative were included. Vitamin D dietary intake was calculated as the sum of food and oral supplementation. A coronal 3D FLASH with Water Excitation MR sequence of the right knees was used. The strength of the association between dietary vitamin D intake and knee MRI parameters was investigated through an adjusted linear regression analysis, reported as standardized betas with 95% confidence intervals (CIs). RESULTS: Using a linear regression analysis, adjusted for ten potential confounders, higher vitamin D intake (reported as an increase in one standard deviation, = 250 IU) corresponded to significantly higher values of mean cartilage thickness and volume of cartilage at medial tibia, volume of cartilage and mean cartilage thickness at central lateral femur, volume of cartilage and mean cartilage thickness at central medial femur, and volume of cartilage and mean cartilage thickness at central medial tibial-femoral compartment. CONCLUSIONS: Higher vitamin D intake is associated with a significantly better architecture of the cartilage of the knee, also independently taking in account from several potential confounders.

The association between the Mediterranean diet and magnetic resonance parameters for knee osteoarthritis: data from the Osteoarthritis Initiative.

The Mediterranean diet appears to be beneficial for osteoarthritis (OA), but the few data available regarding the association between the diet and the condition are limited to X-ray and clinical findings. The current study aimed to investigate the association between adherence to the Mediterranean diet and knee cartilage morphology, assessed using magnetic resonance (MRI) in a cohort of North American participants. Seven hundred eighty-three participants in the Osteoarthritis Initiative (59.8% females; mean age 62.3 years) in possession of a MRI assessment (a coronal 3D FLASH with Water Excitation MR sequence of the right knee) were enrolled in our cross-sectional study. Adherence to the Mediterranean diet was evaluated using a validated Mediterranean diet score (aMED). The strength of the association between aMED and knee MRI parameters was gauged using an adjusted linear regression analysis, expressed as standardized betas with 95% confidence intervals (CIs). Using an adjusted linear regression analysis, each increase of one standard deviation (SD) in the aMED corresponded to a significant increase in the central medial femoral cartilage volume (beta = 0.12; 95%CI 0.09 to 0.15), in the mean central medial femoral cartilage thickness (beta = 0.13; 95%CI 0.01 to 0.17), in the cartilage thickness of the mean central medial tibiofemoral compartment (beta = 0.12; 95%CI 0.09 to 0.15), and in the cartilage volume of the medial tibiofemoral compartment (beta = 0.09; 95%CI 0.06 to 0.12). Higher adherence to a Mediterranean diet was found to be associated with a significant improvement in knee cartilage as assessed by MRI, even after adjusting for potential confounding factors.

Forensic Radiology: An Update.

Forensic radiology is a specialized area of medical imaging using radiological techniques to assist physicians and pathologists in matters related to the law. The forensic application of diagnostic medical radiology can be applied in many fields; the prime target of evaluation is the osseous skeleton, but soft tissues and abdominal and thoracic viscera may offer key findings. The technological progress in clinical radiology provides a lot of potential tools to forensic radiology, allowing wider fields of applications in this matter.