Development of an open-source 3D imaging method for forensic age estimation based on medial clavicular ossification: assessing area and volume ratios of epiphyses and metaphyses

Forensic age estimation is essential for legal and social decision-making when reliable documentation is lacking. Traditionally, ossification of the medial clavicular epiphysis (MCE) is assessed by visual staging, but norm variants frequently limit classic systems and introduce error and irreproducibility. High-resolution computed tomography (CT) allows for quantitative morphometric assessment, potentially offering support - especially in such cases. Based on the approach of Hua et al. (2014) an open-source workflow for metric age estimation of the medial clavicles using semi-automatic three-dimensional (3D) CT segmentation was developed. Clinical CT scans were pseudonymized, archived in XNAT (Extensible Neuroimaging Archive Toolkit), and 3D models were generated in 3D Slicer. Expert-guided segmentation and alignment enabled extraction of quantitative parameters including planar areas and volumes of epiphyses and metaphyses; area and volume ratios were calculated as dimensionless metrics. It was concluded that morphometric assessment of the medial clavicles via 3D imaging is a promising approach for forensic age estimation. The workflow's open-source architecture supports transparency and collaborative validation. Future research should validate metric markers and pursue workflow automation, particularly to address anatomically complex cases.