Virtual computed tomography morphometry of the patella for estimation of sex using postmortem Japanese adult data in forensic identification

In forensic anthropological identification of human remains and single bones, computed tomography (CT) data analysis facilitates volumetric and radiographic density analyses, and a recently developed automated analysis system markedly improved the performance, accuracy, and reproducibility of three-dimensional (3-D) reconstruction. The present study aimed to investigate virtual CT morphometry of the patella for the estimation of sex using postmortem CT data of forensic autopsy cases of Japanese individuals aged ≥18 years (total n = 220; 110 males and 110 females; estimated postmortem interval <88 h), especially with regard to the efficacy of 3-D bone volumetry. Sex-related differences were detected for all parameters (males > females; p < 0.0001), but the differences were the most notable for bone mass volume; the estimated cut-off values (cm3) for discriminating males and females were 20.35 with a sensitivity and specificity of 0.85 and 0.91 for the left side and 19.96 with a sensitivity and specificity of 0.83 and 0.92 for the right side, respectively. The mean CT value showed an age-dependent decrease and was particularly low in females aged >60 years. These findings indicate the efficacy of virtual CT morphometry of the patella using an automated analyzer for sex estimation.