Purpose In acute irreducible inguinal hernias, the presence of bowel strangulation is the most critical determinant of clinical urgency and prognosis. Preoperative identification of strangulation can prompt urgent surgical intervention and potentially prevent bowel resection and its associated complications. This study aimed to identify preoperative risk factors associated with bowel resection in these patients. Methods This retrospective observational study included patients who underwent emergency surgery for acutely irreducible inguinal hernia at our institution between 2017 and 2024. Patients were categorized into two groups based on whether bowel resection was performed. Clinical, laboratory, and radiological variables were compared between the groups. Results A total of 182 patients met the inclusion criteria. Bowel resection was performed in 45 cases (24.7%). These patients had significantly older age, female predominance, ASA and Charlson Comorbidity Index (CCI) scores, longer symptom and operative durations, and higher rates of femoral hernia, peritonitis signs, elevated CRP, leukocytosis, and increased neutrophil-to-lymphocyte ratio (NLR). CT findings associated with resection included smaller defect and hernia diameters, reduced sac volume and bowel enhancement, increased bowel wall thickness, and a higher incidence of ileus. Multivariate logistic regression identified CCI, NLR, peritonitis signs, intraoperative bowel obstruction, bowel wall thickness, defect diameter, and lack of enhancement as independent predictors of resection. Conclusion This study identified specific preoperative clinical, laboratory, and CT features that may help identify patients at increased risk of bowel resection in acute irreducible inguinal hernias. These findings may support early risk stratification and assist operative planning in emergency settings.

Appendiceal diverticular disease (ADD) is an uncommon condition that may clinically and radiologically mimic acute appendicitis and it is associated with a high risk of perforation. Limited awareness and diagnostic challenges frequently result in a diagnosis only after histopathological examination. Among 6,853 emergency appendectomies performed between January 2015 and June 2024, 153 patients with histopathologically confirmed ADD were retrospectively analyzed in this study. The demographic data, clinical presentation, imaging findings, operative outcomes, and pathological characteristics were reviewed. All CT scans and pathology slides were re-evaluated by gastrointestinal radiologists and a gastrointestinal pathologist. The diverticula were classified according to the Lipton system. The frequency of ADD detection in histopathological reports was 2.23

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 9.18–25.97 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’s kappa. Spearman’s correlation and the Mann–Whitney 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 ≥18 years. Results: Agreement was very good for both epiphyses (kappa = 0.808–0.833). Age correlated strongly with stage for both the femur (rho = 0.70–0.76) and tibia (rho = 0.68–0.74). 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 (0.96–0.98) but markedly lower and sex-dependent specificity for the 18-year threshold (0.48–0.58 in females versus 0.77–0.85 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 16.07–16.16 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.

The primary question in forensic age assessment is whether an individual has reached a legally defined age threshold. Cervical ring apophysis maturation has been proposed as a potential age indicator; however, it has previously been studied only with ionizing imaging. This study aimed to evaluate cervical ring apophysis maturation using magnetic resonance imaging (MRI) and to determine stage-specific probabilities for legally relevant age thresholds. This retrospective cross-sectional study included 1000 individuals (552 females, 448 males) aged 9.64–26.67 years. Maturation of the ring apophysis at C2–C4 was assessed using a five-stage MRI-adapted system. Sex-specific descriptive statistics were calculated. Age-related stage transitions were modeled using multinomial logistic regression, and conditional probabilities were estimated for the 15-, 16-, 18-, and 21-year thresholds. Observer agreement was assessed using weighted kappa. Maturation progressed sequentially from C2 to C4 in both sexes, with a broad transitional zone between stages 3 and 4. In females, median age at stage 4 ranged from 18.5 to 20.2 years in males, approximately 22 years. However, minimal ages for stage 4 were markedly lower (12.5 years in females, 13.1 years in males), and stage 3 persisted into the third decade. At stage 4, the probability of being ≥ 18 years reached 0.96–0.98 in males but only 0.54–0.61 in females. For the ≥ 21-year threshold, probabilities at stage 4 were approximately 0.65–0.70 in males and 0.34–0.40 in females. Cervical ring apophysis maturation on MRI represents a continuous and overlapping biological process. It should therefore be interpreted as a probabilistic indicator for legal thresholds rather than a definitive test of adulthood.

Background: This study aimed to establish normal regional Magnetization Transfer Ratio (MTR) values in white and grey matter using 3-Tesla MRI in healthy adult subjects, with a particular focus on cortical and deep brain structures. It also aims to assess the variability of these values and provide a baseline for further pathological studies. Materials and Methods: Seventy healthy volunteers (28 females, 42 males, mean age 28 years) were included. MRI scans were performed using a 3.0 Tesla MRI scanner. Conventional cranial MRI sequences were acquired, followed by Magnetization Transfer Imaging (MTI) with off-resonance pulses. MTR maps were generated from proton density-weighted images obtained with and without magnetization transfer pre-pulses. Measurements were performed in 31 white matter and 9 grey matter regions, with additional assessments of CSF for noise control. Statistical analysis was carried out to compare MTR values across different brain regions. Results: The mean MTR value was significantly higher in white matter (23.9 ± 0.21) compared to grey matter (17.3 ± 0.77). The corpus callosum had the highest MTR values within the white matter, particularly in the splenium, while the thalamus exhibited the highest MTR values in the grey matter. Regional variations were observed, with higher MTR values in the occipital and temporal lobes and lower values in the frontal and parietal lobes. MTR measurements showed excellent intra-observer (ICC > 0.9) and good inter-observer reliability (ICC 0.80–0.90). Conclusions: This study provides detailed MTR mapping of normal brain tissue, highlighting significant regional dif-ferences between white and grey matter. The findings offer valuable baseline data for assessing structural changes in CNS diseases and for evaluating the efficacy of therapeutic interventions. MTR measurements demonstrate high reproducibility, making this technique a reliable tool in clinical and research applications for monitoring pathological alterations in the central nervous system.

The timing of growth plate fusion is a key indicator for age estimation and is primarily used in forensic investigations. On the other hand, non-ionizing techniques such as MRI are being developed to provide safer and more ethical evaluations in forensic casework. This study aims to evaluate the closure process of growth plates in the distal femoral and proximal tibial epiphyses using Multiple Echo Recombined Gradient Echo (MERGE) MRI sequences and provide age estimation data based on staging methods for forensic purposes. We retrospectively analyzed 559 patients (294 males, 265 females, aged 8–25 years) diagnosed with trauma and knee pain at Tepecik Training and Research Hospital from 2016 to 2019. MRI scans were performed using a 1.5-T system with MERGE sequences and evaluated by two observers using a new staging system. Observer agreement was assessed using Cohen’s κ test, yielding high agreement values (κ > 0.8). Positive correlations were found between age and ossification stages (p < 0.001). Minimum age thresholds for stages 5a and 5b of the distal femoral epiphysis were 16 and 18 years for females and 17 and 19 years for males, respectively. For the proximal tibial epiphysis, the minimum ages for stages 5a and 5b were 15 years for females and 17 years for males. The MERGE sequence provides a viable method for assessing skeletal maturity in living individuals with significant ethical advantages due to non-ionizing radiation. This study supports the potential application of the MERGE sequence in forensic age estimation, demonstrating high observer agreement and consistency. Future research should focus on comparing different sequences and populations to enhance the methodology’s applicability.

Introduction: It is essential to detect sacroiliitis earlier to decrease morbidity and unwanted complications such as ankylosing of sacroiliac joints. In recent studies, magnetic resonance imaging (MRI) serves as a key diagnostic tool for identifying sacroiliitis and is now included in the diagnostic criteria. We aim to detect the utility of diffusion-weighted imaging on the MRI in diagnosing sacroiliitis and measure ADC values for the response to treatment in future studies. Materials -methods: There were 39 patients (16 male, 20 female). A 1.5 Tesla MR device with a pelvic coil was used. The sequences were T1 (before and after intravenous contrast administration of gadolinium), T2-weighted fast field echo, short tau inversion recovery (STIR), diffusion-weighted (DW) images, and apparent diffusion coefficient (ADC) mapping. Sacroiliac joints were divided into four quadrants, and two radiologists interpreted all the sequences by giving scores from 0 to 3 depending on bone marrow edema from none to severe. The concordance of scores assigned to STIR, T1-weighted gadolinium-enhanced images, ADC mapping, and diffusion-weighted MR images was evaluated by calculating intraclass correlation coefficients. Results: A statistically significant positive correlation was observed between the activity scores derived from short tau inversion recovery (STIR) and other magnetic resonance (MR) sequences, namely T1-weighted gadolinium-enhanced images, apparent diffusion coefficient (ADC) mapping, and diffusion-weighted MR images. Conclusion: Active bone marrow abnormalities were identified with comparable efficacy using STIR imaging and other MR sequences (T1W-Gad, ADC mapping, DW-MR). In our study, we tried to emphasize the role of the diffusion-weighted images near the other sequences. Diffusion is a fast, easy-applied sequence. After increased experience in the diffusion-weighted images, routine application of this sequence will increase, and even becoming one of the diagnostic criteria will be inevitable. The difference in DWI from the other sequences is that it is measurable. The response to treatment may be followed up by ADC values.

Objective: To determine the value of hypointense pericholedocal ring sign in magnetic resonance imaging (MRI) T2W sequence images in the diagnosis of pancreatic ductal adenocarcinoma (PDA). Study design: Retrospective observational study. Place and Duration of the Study: Department of Radiology, Bakirkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkiye, from January 2016 and March 2022. Methodology: Retrospective analysis of MRI scans was performed on 70 patients with postoperative histopathological confirmation of a diagnosis of periampullary cancer. The patients' demographic information, the results of their histopathological examinations, and the findings of their MRIs were recorded. The results of the MRI were statistically analysed and compared between the PDA and the non-PDA groups. Results: The study included 43 (61.4%) male and 27 (38.5%) female patients, with a mean age of 62.2 +/- 8.4 years. The means of Wirsung diameter and tumour diameter were significantly higher in PDA group (p = 0.034, p = 0.010, respectively). A progressive contrast enhancement pattern of 95.3% was observed in PDA group, while 40.7% rapid contrast enhancement pattern was observed in the non-PDA group. Hypointense pericholedochal ring sign, observed in T2W sequences, was detected in 74.2% (n = 32) of the PDA group and 11.1% (n = 3) of the non-PDA group, and the findings were statistically significant (p <0.001). Conclusion: Hypointense pericholedochal ring sign in axial T2W sequences in periampullary tumours is a complementary MRI finding in the distinction between the PDA and the non-PDA groups.

Rationale and Objectives: Magnetic resonance imaging plays an important role in the evaluation of patients with known or suspected periampullary masses. The utilization of volumetric apparent diffusion coefficient (ADC) histogram evaluation for the entire lesion eradicates the potential for subjectivity in the region of interest placement, thus guaranteeing the accuracy of computation and repeatability. Purpose: To investigate the value of volumetric ADC histogram analysis in the differentiation of intestinal-type (IPAC) and pancreatobiliary-type periampullary adenocarcinomas (PPAC). Materials and Methods: This retrospective study included 69 patients with histopathologically confirmed periampullary adenocarcinoma (54 PPAC and 15 IPAC). Diffusion-weighted imaging was obtained at b values of 1000 mm(2)/s. The histogram parameters of ADC values, comprising the mean, minimum, maximum, 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles, as well as skewness, kurtosis, and variance, were calculated independently by two radiologists. Using the interclass correlation coefficient, the interobserver agreement was evaluated. Results: The ADC parameters for the PPAC group were all lower than those of the IPAC group. The PPAC group had higher variance, skewness, and kurtosis than the IPAC group. However, the difference between the kurtosis (P =.003), the 5th (P =.032), 10th (P =.043), and 25th (P =.037) percentiles of ADC values was statistically significant. The area under the curve (AUC) of the kurtosis was the highest (AUC = 0.752; cut-off value = - 0.235; sensitivity = 61.1%; specificity = 80.0%). Conclusion: Volumetric ADC histogram analysis with b values of 1000 mm(2)/s can discriminate subtypes noninvasively before surgery.

OBJECTIVE:To evaluate the association of body composition parameters with outcomes in Covid-19.METHODS:173 patients hospitalized for Covid-19 infection in 6 European centers were included in this retrospective study. Measurements were performed at L3-level and comprised skeletal muscle index (SMI), muscle density (MD), and adipose tissue measurements [visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), intramuscular adipose tissue (IMAT), visceral-to-subcutaneous-adipose-tissue-area-ratio (VSR)]. The association with mortality, the need for intubation (MV), and the need for admission to ICU within 30 days were evaluated.RESULTS:Higher SAT density was associated with a greater risk of MV (OR = 1.071, 95%CI=(1.034;1.110), p < 0.001). Higher VAT density was associated with admission to ICU (OR = 1.068, 95%CI=(1.029;1.109), p < 0.001). Higher MD was a protective factor for MV and ICU admission (OR = 0.914, 95%CI=(0.870;0.960), p < 0.001; OR = 0.882, 95%CI=(0.832;0.934), p = 0.028). Higher VSR was associated with mortality (OR = 2.147, 95%CI=(1.022;4.512), p = 0.044). Male sex showed the strongest influence on the risk of ICU admission and MV. SMI was not associated with either parameter.CONCLUSION:In patients hospitalized for Covid-19 infection, higher VSR seems to be a strong prognostic factor of short-term mortality. Weak associations with clinical course were found for MD and adipose tissue measurements. Male sex was the strongest prognostic factor of adverse clinical course.ADVANCES IN KNOWLEDGE:VSR is a prognostic biomarker for 30-day mortality in patients hospitalized for Covid-19 disease.

Rationale and Objectives: To evaluate the impact of low skeletal muscle mass in patients with COVID-19 on relevant outcomes like 30-day mortality, need for intubation and need for intensive care unit admission.Materials and Methods: For this study, data from six centers were acquired. The acquired sample comprises 1138 patients. There were 547 women (48.1%) and 591 men (51.9%) with a mean age of 54.5 +/- 18.8 years; median age, 55 years; range, 18-84 years). In every case, thoracic CT without intravenous application of contrast medium was performed. The following parameters of the pectoralis muscles were estimated: muscle area as a sum of the bilateral areas of the pectoralis major and minor muscles, muscle density, muscle index (PMI) (pectoralis muscle area divided by the patient's body height square) as a ratio pectoralis major and minor muscles divided by the patient's body height2, and muscle gauge as PMI x muscle density. Results: Overall, 220 patients (19.33%) were admitted to the intensive care unit. In 171 patients (15.03%), mechanical lung ventilation was performed. Finally, 154 patients (13.53%) died within the observation time of 30-day. All investigated parameters of pectoralis muscle were lower in the patients with unfavorable courses of Covid-19. All pectoralis muscle parameters were associated with 30-day mortality in multivariate analyses adjusted for age and sex: pectoralis muscle area, HR = 0.93 CI 95% (0.91-0.95) p < 0.001; pectoralis muscle den-sity, HR = 0.94 CI 95% (0.93-0.96) p < 0.001; pectoralis muscle index, HR = 0.79 CI 95% (0.75-0.85) p < 0.001, pectoralis muscle gauge, HR = 0.995 CI 95% (0.99-0.996) p < 0.001.Conclusion: in COVID-19, survivors have larger areas and higher index, gauge and density of the pectoralis muscles in comparison to nonsurvivors. However, the analyzed muscle parameters cannot be used for prediction of disease courses.

time in COVID-19 patients (6).There are numerous case reviews of individuals providing nothing but neurological symptoms, including confusion, headaches, diminished feeling of odor and taste, strokes, and seizures with encephalitis-like symptoms (3).

BACKGROUND:Dual-energy X-ray absorptiometry (DEXA) scanning has several disadvantages determining osteoporosis, especially for the degenerative spine.INTRODUCTION:This study aims to determine spinal osteoporosis in patients suffering from lumbar degenerative disease using computed tomography (CT).METHODS:A total of 547 subjects that underwent DEXA and abdominal CT within a period of three months were examined retrospectively and separated into groups based on lumbar degenerative alteration on the CT scan. The subjects that showed degenerative severity at L1-L4, in at least two levels, were graded and placed in the degenerative group (Group D, n=350). In contrast, the other subjects constituted the control group (Group C, n=197). The Hounsfield unit (HU) of the vertebral body trabecular bone, the T-score, and bone mineral density (BMD) of L1-L4 and hips were determined from the CT images. CT-HU parameters for osteoporosis acquired from the control group were used to ascertain undiagnosed osteoporosis.RESULTS:The CT-HU was positively correlated with T-score and lumbar BMD for both groups (P<0.001), while the L1-L4 correlation was higher in Group C than in Group D. Based on linear regression, the T-score and CT-HU for L1-L4 osteoporosis were 129, 136, 129 and 120 HU, respectively in Group C. Undiagnosed spinal osteoporosis was greater in Group D compared to the controls (44.2% vs. 9.6%, respectively) based on the CT-HU thresholds.CONCLUSION:Lumbar spine degeneration can augment BMD and T-score, resulting in the underestimation of lumbar osteoporosis. The osteoporosis threshold determined by CT-HU may be a valuable technique to determine undiagnosed spinal osteoporosis.

Sex estimation from skeletal remains is crucial for the estimation of the biological profile of an individual. Although the most commonly used bones for means of sex estimation are the pelvis and the skull, research has shown that acceptable accuracy rates might be achieved by using other skeletal elements such as vertebrae. This study aims to contribute to the development of sex estimation standards from a Turkish population through the examination of CT scans from the seven cervical vertebrae. A total of 294 individuals were included in this study. The CT scans were obtained from patients attending the Bakirkoy Training and Research Hospital (Turkey) and the data was collected retrospectively by virtually taking measurements from each cervical vertebrae. The full database was divided into a training set (N = 210) and a validation set (N = 84) to test the fit of the models. Observer error was assessed through technical error of measurement and sex differences were explored using parametric and non-parametric approaches. Logistic regression was applied in order to explore different combinations of vertebral parameters. The results showed low intra- and inter-observer errors. All parameters presented statistically significant differences between the sexes and a total of 15 univariate and multivariate models were generated producing accuracies ranging from a minimum of 83.30% to a maximum of 91.40% for a model including three parameters collected from four vertebrae. This study presents a virtual method using cervical vertebrae for sex estimation on the Turkish population providing error rates comparable to other metric studies conducted on the postcranial skeleton. The presented results contribute not only to the development of population-specific standards but also to the generation of virtual methods that can be tested, validated, and further examined in future forensic cases.

Rationale and Objectives: The aim of our study was to evaluate whether there is any correlation between a histogram analysis of the pectoralis muscle derived from chest computed tomography (CT) and the mortality rate for COVID-19 pneumonia in the adult population. Method: Chest CT derived measurements were evaluated retrospectively for 217 patients with a diagnosis of COVID-19 pneumonia. Using a CT histogram analysis, we measured pectoralis muscle volume (PV) and pectoralis muscle density (PD). Patients were divided into groups first according to gender and then subgroups, which are age and outcome. Results: The COVID-19 diagnoses were confirmed by RT-PCR testing, chest CT and clinical findings in 217 patients (108 men, 109 women), aged 21-92 years (mean 61 years). PD measurements were lower in the exitus group (p = 0.001) and in patients aged >= 65 than in those aged <65 years (p < 0.05). There was a significant difference between PD measurements of outpatient and inpatient under 65 years age (p < 0.05). Additionally, there was a statistically significant difference between fatty volume measurements according to the exitus status of cases (p < 0.05). Conclusion: CT-derived measurements of the pectoralis muscle can be useful in predicting disease severity and mortality rate of COVID-19 pneumonia in adult patients.

Background: Breast density is an important variable that can change the sensitivity of mammography. It can be analyzed with using the 4th and 5th editions of the Breast Imaging and Reporting Data System (BI-RADS) recommendations from the American College of Radiology (ACR). Purpose: To define the intra- and inter-reader agreement levels of breast density assignments performed by readers with different experience levels using two versions of BI-RADS. Material and Methods: The breast density assessments of 330 women were conducted by two readers with different levels of experience (one breast radiologist and one resident). Each reader independently defined the breast density four times-twice using the 4th edition and twice using the 5th edition. Assessments were analyzed on four- and two-category scales. Results: The intra-reader agreement of the breast radiologist for the 4th and 5th editions of BI-RADS was almost perfect (k = 0.90 and k = 0.87, respectively.) The resident had similar results (k = 0.88 and k = 0.87, respectively). The agreement between the breast radiologist and resident for the 4th and 5th edition of BI-RADS was substantial (k = 0.70 and k = 0.63, respectively). There was a statistically significant difference with the two-category scale analysis between the dense and non-dense for both readers and versions of BI-RADS (McNemar's test, P < 0.001). Conclusion: Although there were high intra- and inter-reader agreement levels when using both versions, the percentage of women having dense breasts increased when using the 5th edition, and the difference was statistically significant. There were no differences found with regard to the readers' level of experience in all analyses.

Objective:The aim of this study was to determine the information and practices related to breast cancer screening performed in women who presented to the mammography unit of a university hospital in Istanbul.Method: A questionnaire was prepared using the literature.It was performed with a face-to-face interview method in the patients who were referred to the mammography (MG) unit of our hospital.It consisted of questions about sociodemographic characteristics, breast selfexamination (BSE), clinical breast examination (CBE) and information about MG and performing these methods.Results: In 260 women with a mean age of 52.5 (36-81) years; while the rate of BSE was 69.2%, the rate of CBE was 77.7% and the rate of MG was 78.5%, these were higher than the literature.The mean level of knowledge of patients about breast cancer was 6.2/10 (62%) and it was higher than the literature.Breast cancer risk factors knowledge level scores were significantly higher in patients who underwent MG procedure and BSE (p=0.031;p=0.001; p<0.05).Contrary to the literature, no significant effect of income and education level on the rates of BSE, CBE, undergoing MG procedure was determined.There was a statistically significant difference between the level of knowledge of the patients according to the family history of breast cancer (p=0.004;p<0.01).However, there was no statistically significant difference in the rates of MG, CBE, and BSE in those (p>0.05). Conclusion:The knowledge and practices about breast cancer screening are good in the women who presented to our hospital.However, in women who have a positive family history, although there is a high level of knowledge, it has been determined that there is no increase in participation in screening.In addition to the entire female population, this susceptible group needs health workers' support.

With increases in migration across borders, age estimation in living individuals of not (reliably) documented identity becomes all the more important. Unfortunately, there are not many age indicators that can be used for this purpose, and human variation requires specific methodical approaches. In this paper, a recently proposed age marker to assess the age around the critical age limit of 18 completed years is tested. The method uses apophyseal development of cervical vertebrae 2, 3 and 4. Here CT scans of a large sample of Turkish individuals (n = 1276) were assessed, and likelihoods of being 18 years at a given stage were calculated. The likelihood of being at least 18 years for stages 0, 1 and 2 were zero or close to zero in both males and females. By the time that stage 4 was reached, the likelihood to be 18 years were between 65 and 70% (depending on the vertebra) in females and 81 and 90% in males. In comparison to South Africans, the Turkish individuals developed earlier, but the likelihoods of being 18 years were lower at stage 4 as some individuals were still judged to be in stage 3 well into their twenties. Although fairly variable, this method is a valuable new addition to the modalities that can be used for age assessment in the living. CT scans seemed to provide good visualization of the structures in question, although in actual forensic cases the high radiation dose may be problematic.