 Hello everyone. My name is Dr. Ritesh Gupta. I am a junior resident in the department of video diagnosis in Pundit BD Sharma, Vijay M.S. Ruttak. I will be presenting my paper for CTBus 2021 conference and my topic is age determination by MRI of risk in adolescent sports persons. Introduction. First of all, why MRI? For age determination, analyzing the maturity of bones, that is the fusion of growth plates enables us to determine an individual's age. From the beginning radiologists have used radiographs of various bones to determine the age. With the advent of age related tournaments in various sports, determination of age became crucial to ensure fair play and guarantee equal chances within the game for each player. So for this study at an institution that is department of radio diagnosis, Vijay M.S. Ruttak 30 adolescent sports persons competing in under 17 tournaments were examined using MRI. The examination protocol, the part examined was left wrist of each player. The wrist was positioned above the head or at the side of the body. The 1.5 Tesla MR scanner wrist coil were used and the parameters as described were used. So we have a grading system for age determination by MRI. The grades are grade 1, completely unfused. Grade 2, early fusion where we can see minimal hyper intensity within the phases. Grade 3, terbecular fusion of less than 50% of the cross-sectional area. Grade 4, terbecular fusion of more than 50% of radial cross-sectional area. Grade 5, residual phases, less than 5 mm on any one section. And grade 6, which is complete fusion. As we can see all the grades, so repeating grade 1, completely unfused. Grade 2, early fusion that is minimal hyper intensity within the phases. Grade 3, terbecular fusion less than 50% of the radial cross-sectional area. Grade 4, terbecular fusion of more than 50% of the radial cross-sectional area. Grade 5, residual phases, less than 5 mm on any one section. And grade 6, complete fusion. So as per the study, the average age found with each grade is given this graph. So for grade 1, the average age found out was 15.6. Grade 2, 16.2. Grade 3, 16.7. Grade 4, 17. And for grade 5, it was 17.98. So the advantages of using MRI for age determination as follows. 99% accuracy till 17 years of age. Higher observer reliability with reciprocation of similar results. Premature fissile fusion. Seen in players taking anabolic steroids can be picked up. Also, unlike radiographs where we can only specify age ranges, MRI grading can help pinpoint the exact age. Number 4, standard protocols are available so there is less ambiguity and more clarity. And also the image quality is superior. There are certain disadvantages. The current studies available have focused only on sports persons. Physical maturity of players is higher than the normative population. Hence the results are limited to a small set of population. As of now, it is available for certain ages only. That is 14 to 18 years of age. So why use MRI? A number of international and pancontinent studies have established the accuracy and reliability of MRI of left wrist for age estimation between 14 to 18 years of age. So the take home message. In place of radiographs, MRI needs to be used in age estimation where proper documentation is not available. We require only one sequence that is T1 weighted coronal and the process hardly takes two to three minutes. We get better image quality and more accuracy without any exposure to radiation. Also further research is required to establish MRI as the standard for age estimation across all age groups. We need to widen its scope for use in other sports as well as medical legal purposes. These are the references. Thank you.