The third dimension in palaeopathology: How can three-dimensional imaging by computed tomography bring an added value to retrospective diagnosis?

Abstract Three-dimensional (3D) imaging is now extensively used for studying ancient human and animal bones. This method has been consensually adopted by palaeoanthropologists, but its interest in palaeopathology has been challenged. The aim of this paper is to illustrate the contribution of 3D reconstructions to retrospective diagnosis in palaeopathology. We selected six palaeopathological cases among our research corpus representing three nosographic categories (trauma, infection and neoplasia) from various periods ranging from the Middle Palaeolithic to the beginning of the Modern Era. For each case, we compared the diagnostic value of plain X-ray, computed tomography (CT) slices, and 3D reconstructions. The latter were performed using TIVMI program, a free software for research use developed by one of us. Reconstructions are obtained by surface extraction that follows a segmentation process. We showed that this 3D method allowed reconstructing/quantifying pathological processes on ancient bones, usefully supplementing conventional radiological analyses and clearly bringing an added value to retrospective diagnosis in palaeopathology

Nouvelles données sur l'édification des molaires et l'estimation de l'âge dentaire des enfants par imagerie médicale et 3D : apports et perspectives = New data on the development and age estimations of molars in children, using medical and 3D imaging

International audienceLes méthodes d’estimation de l’âge des enfants se fondent sur des référentiels pouvant être biaisés. L’évolution technologique aidant, l’imagerie médicale et 3D peuvent être utilisées pour améliorer ou développer des méthodes moins subjectives. Ces nouvelles approches conduisent également à identifier de nouveaux critères d’estimation de l’âge au décès. Aussi, pour en proposer, il est essentiel de s’appuyer sur un échantillon de référence, dont il faut connaître les caractéristiques et qui offre un aperçu de la variabilité populationnelle. Cette variabilité, comparée à celle des taxons fossiles, permet d’apporter de nouvelles informations sur le développement dentaire de ces derniers et d’approfondir la réflexion sur l’estimation de l’âge des sujets immatures en général et des fossiles en particulier. En effet, à travers cette étude, nous nous proposons de fournir des améliorations méthodologiques aux méthodes de Moorrees et al. 1963a, b et de proposer de nouvelles pistes dans l’estimation de l’âge des enfants grâce à l’imagerie médicale et 3D à travers les volumes dentaires. Une première application de ces propositions à l’enfant néanderthalien Châteauneuf 2 a été effectuée. Elle rend compte de l’importance des critères sélectionnés pour l’estimation de l’âge, produisant des écarts plus importants que pour des enfants modernes. De plus, elle met en avant le développement différentiel des premières molaires permanentes entre les deux arcades dentaire

Assessing biases in the analysis of trabecular bone microarchitecture of non-adult individuals

International audienceMicro-computed tomography (µCT) is a non-destructive x-ray technique that can provide high-resolution images of skeletal material, making it an attractive option for analysing archaeological human remains. However, µCT data acquisition, image segmentation and 3D reconstruction may bias the quantification of trabecular bone microarchitecture (TBMA) parameters. Some biases have been evaluated in previous studies, but never in non-adult individuals at different stages of development. Five non-pathological humeral metaphyses from known-age individuals of various developmental stages were µCT-scanned at a high resolution based on bone size. First, repeatability and reproducibility of the volume of interest selection protocol (VOI, trabecular bone region analysed) have been evaluated and found to produce nonsignificant variations of the TBMA parameters. Then, each bone was assessed for biasing effects related to image resolution and segmentation, as well as the size and position of the VOI. According to the bias tested, individuals of different developmental stages and parameters are differentially affected. By progressing through the stages of development, the TBMA parameters seem less sensitive to the variation introduced by the bias tests. Perinatal stage and mature adolescent stage distinctly differ from others depending on the tests and parameters measured. Bone volume fraction, trabecular thickness and trabecular number are the most sensitive and correlated parameters to the biases tested. We therefore propose specific recommendations to assure homologous VOI selection and reliable and comparable results for non-adult TBMA analyses

La mandibule de l’adulte Qafzeh 25 (Paléolithique moyen, Basse Galilée). Reconstruction virtuelle 3D et analyse morphométrique

International audienceAu sein de l’échantillon d’individus de Qafzeh (Basse Galilée), datés du Paléolithique moyen, Qafzeh 25 est représenté pardes composants du squelette ayant été sérieusement altérés pendant la fossilisation, et tout particulièrement le bloc crânio-facial etla mandibule compressés bilatéralement. Grâce aux avancées méthodologiques de l’imagerie 3D, nous proposons dans cette étudeune reconstitution virtuelle de la mandibule à partir de CT-scans du fossile original. Cette restauration virtuelle réalisée à l’aide dulogiciel TIVMI permet de mener une première analyse morphométrique comparative avec les autres mandibules connues au Levantméditerranéen pour le Paléolithique et l’Épipaléolithique

Complex mortuary dynamics in the Upper Paleolithic of the decorated Grotte de Cussac, France

The Mid-Upper Paleolithic (Gravettian) karstic Grotte de Cussac (France) contains two areas of human remains in the context of abundant (and spectacular) parietal engravings. The first area (loci 1 and 2) includes the skeleton of a young adult male in a bear nest, rearranged by postdecomposition inundation, and the variably fragmentary remains of at least two individuals distributed across two bear nests, sorted anatomically and with most of the elements constrained to one side of one nest. The second area (locus 3) retains remains of two adults and an adolescent, in upper hollows and variably distributed down the slope, largely segregated into upper versus lower body groups. The only decoration associated with the human remains is red pigment on some of the bones or underlying sediment. The human remains indicate variable non-natural deposition and manipulation of human bodies, body portions, and skeletal elements of at least six individuals. Moreover, Cussac is unusual in the association of these remains with exceptional parietal art. The complex Cussac mortuary pattern joins growing evidence from other Gravettian sites of variable treatment of individuals after death, within and across sites, in terms of formal deposition of the body versus postmortem manipulation versus surface abandonment. It provides a window onto the social diversity and the complex interactions of the living and the dead among these successful Late Pleistocene foragers

Supplementary Material for: Recombinant Human Growth Hormone Plus Recombinant Human Insulin-Like Growth Factor-1 Coadministration Therapy in Short Children with Low Insulin-Like Growth Factor-1 and Growth Hormone Sufficiency: Results from a Randomized, Multicenter, Open-Label, Parallel-Group, Active Treatment-Controlled Trial

<b><i>Background/Aims:</i></b> Growth hormone (GH) and insulin-like growth factor-1 (IGF-1) both contribute to growth. To determine if recombinant human (rh)GH + rhIGF-1 therapy is more effective than rhGH alone to treat short stature, we assessed the efficacy and safety of coadministered rhGH + rhIGF-1 in short children with GH sufficiency and low IGF-1. <b><i>Methods:</i></b> In a 3-year, randomized, multicenter, open-label trial, patients with height SD score ≤−2.0 and IGF-1 SD score ≤−1.0 for age and sex, and with stimulated GH ≥10 ng/ml for age and sex, were randomized to receive (all doses in µg/kg/day): 45 rhGH alone (group A), 45 rhGH + 50 rhIGF-1 (group B), 45 rhGH + 100 rhIGF-1 (group C) or 45 rhGH + 150 rhIGF-1 (group D). Height velocity (HV) and Δ height SD score were measured. <b><i>Results:</i></b> The first-year HV (modified intention-to-treat population) was 9.3 ± 1.7 cm/year (group A), 10.1 ± 1.3 cm/year (group B), 9.7 ± 2.5 cm/year (group C) and 11.2 ± 2.1 cm/year (group D) (p = 0.001 for groups A vs. D). This effect was sustained, resulting in a height SD score improvement during the second and third years. Most treatment-emergent adverse events were mild and transient. <b><i>Conclusion:</i></b> In children with short stature, GH sufficiency and low IGF-1, coadministration of rhGH/rhIGF-1 (45/150 µg/kg) significantly accelerated linear growth compared with rhGH alone, with a safety profile similar to the individual monotherapies