The Efficacy of Deep Learning Model on Sex Estimation in Patellae for A Thai Population

Authors

  • Saranya Honghimaphan Siriraj Anatomical Anthropology Bone Research Center (Virapan Davivongs), Department of Anatomy, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • Patara Rattanachet Siriraj Anatomical Anthropology Bone Research Center (Virapan Davivongs), Department of Anatomy, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • Natipong Chatthai Siriraj Anatomical Anthropology Bone Research Center (Virapan Davivongs), Department of Anatomy, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • Parawee Jitrabeab Siriraj Anatomical Anthropology Bone Research Center (Virapan Davivongs), Department of Anatomy, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • Sittiporn Ruengdit Department of Forensic Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  • Robert W. Mann John A. Burns School of Medicine, University of Hawai‘i, Honolulu, Hawai‘i, USA
  • Napakorn Sangchay Siriraj Anatomical Anthropology Bone Research Center (Virapan Davivongs), Department of Anatomy, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

DOI:

https://doi.org/10.33192/smj.v77i12.277048

Keywords:

Patallae, Sexual Dimorphism, Logistic Regression, Machine Learning, Deep Learning, Thai population

Abstract

Objective: This study investigates the sexual dimorphism in the patellae to develop sex estimation equations and determine the accuracy using machine learning (ML) and deep learning (DL) classification models.

Materials and Methods: The sample of 250 pairs of patellae from the Siriraj Anatomical and Anthropological Bone Research Center (Si-AABRC) were measured for eight parameters. The data were statistically analysed using logistic regression model alongside, ML and DL were used to predict the best classifiers in sex classification. Rather than traditional radiographic images, this paper tries a novel integration of photographic images.

Results: The average values for each parameter were significantly larger in males than females (p < 0.05), suggesting the presence of sexual dimorphism within the patellae between each sex. The most dimorphic parameter was Transverse Diameter of Articular Facet (TDAF). The parameters in females showed no significant difference between left and right except for Breadth of the Medial Articular Facet (BMAF). However, in males a significant difference was observed for Maximum Height (MAXH), Transverse Diameter of Articular Facet (TDAF) and Breadth of the Lateral Articular Facet (BLAF). The logistic regression equation generated included the following parameters: MAXH (R), BLAF (L), and TDAF (L). The overall accuracy obtained for different sex estimation models ranged from 80%, 80% to 86% and 49.7% to 79.2% using logistic regression, ML and DL, respectively.

Conclusion: The patellae can be utilized by forensic anthropologists in determining the sex of an unknown individual.

References

Kahana T, Hiss J. Identification of human remains: forensic radiology. J Clin Forensic Med. 1997;4(1):7–15.

de Boer HH, Blau S, Delabarde T, Hackman L. The role of forensic anthropology in disaster victim identification (DVI): recent developments and future prospects. Forensic Sci Res. 2018;4(4):303-15.

Austin D, King RE. The Biological Profile of Unidentified Human Remains in a Forensic Context. Acad Forensic Pathol. 2016;6(3):370–90.

Krishan K, Chatterjee PM, Kanchan T, Kaur S, Baryah N, Singh RK. A review of sex estimation techniques during examination of skeletal remains in forensic anthropology casework. Forensic Sci Int. 2016;261:165.e1–8.

Ahmed AA. Estimation of sex from the lower limb measurements of Sudanese adults. Forensic Sci Int. 2013;229(1-3):169.e1–7.

Phenice TW. A Newly Developed Visual Method of Sexing the Os Pubis. Am J Phys Anthropol. 1969;30(2):297–301.

Bidmos MA, Olateju OI, Latiff S, Rahman T, Chowdhury MEH. Machine learning and discriminant function analysis in the formulation of generic models for sex prediction using patella measurements. Int J Legal Med. 2023;137(2):471–85.

Memarian A, Aghakhani K, Mehrpisheh S, Fares F. Gender determination from diagnostic factors on anteroposterior pelvic radiographs. J Chin Med Assoc. 2017;80(3):161–8.

Wangdee A, Thipdet W, Prasitwattanaseree S, Singsuwan P, Mahakkanukrauh P. Efficiency of sex determination by using external morphology of the pelvis in Thai population. BSCM. 2014;53(4):175–9.

Srinak N, Sukvitchai P. Sex estimation from patella using discriminant analysis in Central Thai population. Journal/Journal - Canadian Society of Forensic Science. 2023;56(4):231–47.

Fox A, Wanivenhaus F, Rodeo S. The Basic Science of the Patella: Structure, Composition, and Function. J Knee Surg. 2012;25(2):127–41.

Knecht S, Morandini P, Biehler-Gomez L, Nogueira L, Adalian P, Cattaneo C. Sex estimation from patellar measurements in a contemporary Italian population: a machine learning approach. Int J Legal Med. 2024;139(3):1371–80.

Peckmann TR, Meek S, Dilkie N, Rozendaal A. Determination of sex from the patella in a contemporary Spanish population. J Forensic Leg Med. 2016;44:84–91.

Silva RF, Franco A, Santos D, Picoli FF, Marinho DE de A. Human identification through the patella—Report of two cases. Forensic Sci Int. 2014;238:e11–4.

Chompoophuen H, Tipmala J, Duangto P, Mahakknukrauh P. Sex Determination from the Patella in a Thai Population. Int J Morphol. 2024;42(4):891–7.

Maio C, Cunha E, Navega D. Metric analysis of the patella for sex estimation in a Portuguese sample. Forensic Sci Res. 2024;9(2):owae015.

Nagarjuna K, Mamatha K, Venkateswarlu B. Patellar Anthropometry in Sex Differentiation - A Study in the Southern Part of Andhra Pradesh, India. Indian Journal of Forensic Medicine and Toxicology. 2021;15(2):3113–8.

Olateju OI, Philander I, Bidmos MA. Morphometric analysis of the patella and patellar ligament of South Africans of European ancestry. South African Journal of Science. 2013;109(9/10):1–6.

Bidmos MA, Steinberg N, Kuykendall KL. Patella measurements of South African whites as sex assessors. Homo. 2005;56(1):69–74.

Cavlak N, Çınarer G, Erkoç MF, Kılıç K. Sex estimation with convolutional neural networks using the patella magnetic resonance image slices. Forensic Sci Med Pathol. 2025;21(2):628–39.

Dayal MR, Bidmos MA. Discriminating Sex in South African Blacks Using Patella Dimensions. J Forensic Sci. 2005;50(6):1294-7.

The jamovi project (2024). jamovi (Version 2.5) [Computer Software]. Available from: https://www.jamovi.org

Govindaram D, Bharanidharan R, Ramya R, Rameshkumar A, Priyadharsini N, Rajkumar K. Root Length: As a determinant tool of sexual dimorphism in an ethnic Tamil population. J Forensic Dent Sci. 2018;10(2):96-100.

Bobak CA, Barr PJ, O’Malley AJ. Estimation of an inter-rater intra-class correlation coefficient that overcomes common assumption violations in the assessment of health measurement scales. BMC Med Res Methodol. 2018;18(1):93.

Koo TK, Li MY. A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research. J Chiropr Med. 2016;15(2):155–63.

Shrout PE, Fleiss JL. Intraclass correlations: uses in assessing rater reliability. Psychol Bull. 1979;86(2):420–8.

RStudio Team (2020). RStudio: Integrated Development for R. RStudio, PBC, Boston, MA, USA. Available from: http://www.rstudio.com

Verma R, Krishan K, Rani D, Kumar A, Sharma V, Shrestha R, et al. Estimation of sex in forensic examinations using logistic regression and likelihood ratios. Forensic Science International: Reports. 2020;2:100118.

Dietrichkeit Pereira JG, Fróes Lima K, Alves da Silva RH. Mandibular Measurements for Sex and Age Estimation in Brazilian Sampling. Acta Stomatologica Croatica. 2020;54(3):294–301.

The MathWorks Inc. MATLAB version: 9.14 (R2023a), Natick, Massachusetts: The MathWorks Inc., 2023. Available from: https://www.mathworks.com

Frank E, Hall MA, Witten IH. The WEKA Workbench. Online Appendix for "Data Mining: Practical Machine Learning Tools and Techniques", Morgan Kaufmann, Fourth Edition, 2016.

Sangchay N, Dzetkuličová V, Zuppello M, Chetsawang J. Consideration of Accuracy and Observational Error Analysis in Pelvic Sex Assessment: A Study in a Thai Cadaveric Human Population. Siriraj Med J. 2022;74(5):330–9.

Abdelaziz S, Khattab HM, AbdelHaq NA. Prediction of Sex from Patellar Parameters Obtained by Magnetic Resonance Imaging in a Sample of Adult Egyptians. Zagazig Journal of Forensic Medicine and Toxicology. 2024;22(2):1–16.

Kim Y-M, Joo Y-B. Patellofemoral Osteoarthritis. Knee Surg Relat Res. 2012;24(4):193–200.

Nieves JW, Formica C, Ruffing J, Zion M, Garrett P, Lindsay R, et al. Males Have Larger Skeletal Size and Bone Mass Than Females, Despite Comparable Body Size. J Bone Miner Res. 2004;20(3):529–35.

Introna F, Di Vella G, Campobasso CP. Sex determination by discriminant analysis of patella measurements. Forensic Sci Int. 1998;95(1):39–45.

Shang P, Zhang L, Hou Z, Bai X, Ye X, Xu Z, et al. Morphometric measurement of the patella on 3D model reconstructed from CT scan images for the southern Chinese population. Chin Med J (Engl). 2014;127(1):96–101.

Kim MH, Yoo MJ, Seo JB, Park HG, Shim SH. Statistical Analysis of the Patellar Thickness in Adults by MRI. J Korean Orthop Assoc. 2005;40(6):646-51.

Pontoh LA, Dilogo IH, Rahyussalim AJ, Widodo W, Edwin R, Fiolin J. Evaluation of patellar dimension and Bristol Index in Asian population: An MRI study. Ann Med Surg (Lond). 2021;72:103072–2.

Kanchan T, Menezes RG, Moudgil R, Kaur R, Kotian MS, Garg RK. Stature estimation from foot dimensions. Forensic Sci Int. 2008;179(2-3):241.e1–5.

Bartholdy BP, Sandoval E, Hoogland MLP, Schrader SA. Getting Rid of Dichotomous Sex Estimations: Why Logistic Regression Should be Preferred Over Discriminant Function Analysis. J Forensic Sci. 2020;65(5):1685–91.

Antonogeorgos G, Panagiotakos DB, Priftis KN, Tzonou A. Logistic Regression and Linear Discriminant Analyses in Evaluating Factors Associated with Asthma Prevalence among 10- to 12-Years-Old Children: Divergence and Similarity of the Two Statistical Methods. Int J Pediatr. 2009;2009:952042.

Kc K, Yin Z, Li D, Wu Z. Impacts of Background Removal on Convolutional Neural Networks for Plant Disease Classification In-Situ. Agriculture. 2021;11(9):827–7.

Adedigba AP, Adeshina SA, Aina OE, Aibinu AM. Optimal hyperparameter selection of deep learning models for COVID-19 chest X-ray classification. Intell Based Med. 2021;5:100034.

Kalaiselvi K, Kasthuri M. Tuning VGG19 hyperparameters for improved pneumonia classification. The Scientific Temper. 2024;15(02):2231–7.

Ukwandu O, Hindy H, Ukwandu E. An evaluation of lightweight deep learning techniques in medical imaging for high precision COVID-19 diagnostics. Healthc Anal (N Y). 2022;2:100096.

Kim HE, Cosa-Linan A, Santhanam N, Jannesari M, Maros ME, Ganslandt T. Transfer learning for medical image classification: a literature review. BMC Med Imaging. 2022;22(1):69.

Yoo JH, Yi SR, Kim JH. The geometry of patella and patellar tendon measured on Knee MRI. Surg Radiol Anat. 2007;29(8):623–8.

Oura P, Junno JA, Hunt DR, Lehenkari P, Tuukkanen J, Maijanen H. Deep learning in sex estimation from knee radiographs – A proof-of-concept study utilizing the Terry Anatomical Collection. Leg Med (Tokyo). 2023;61:102211.

Published

02-12-2025

How to Cite

Honghimaphan, S., Rattanachet, P. ., Chatthai, N. ., Jitrabeab, P., Ruengdit, S. ., Mann, R. W., & Sangchay, N. (2025). The Efficacy of Deep Learning Model on Sex Estimation in Patellae for A Thai Population. Siriraj Medical Journal, 77(12), 829–846. https://doi.org/10.33192/smj.v77i12.277048