# Sex Estimation from Computed Tomography of Os
## 4 Discussion
Even though the percentage of undetermined cases was higher among males, it is essential to recognize that even a minor misclassification rate could lead to significant consequences, particularly in forensic settings where precision is crucial. These findings emphasize the critical role of accuracy in forensic sex identification, as even a single misclassification could potentially lead to erroneous conclusions in legal proceedings. While the use of CT scans and the DSP tool for sex estimation appear promising and comparable to traditional techniques utilizing dry pelvic bones, several potential limitations and areas for further research should be considered. Studies validating the DSP tool against traditional techniques may have been conducted on specific skeletal collections or populations, potentially limiting the generalizability of their findings [6; 38; 39]. All of these studies' findings--which are compared with those of the present study--indicate that the DSP tool is appropriate for use with measurements from CT scans [17; 21]. While CT scanning offers advantages such as non-invasiveness and the ability to capture measurements that cannot be taken directly on the bone, the accuracy of CT imaging may be influenced by factors such as imaging resolution, artifacts, and soft tissue effects. Understanding the limitations and potential sources of error in CT imaging is crucial for interpreting results accurately [40]. Sex estimation techniques may vary in their accuracy across different populations due to variations in skeletal morphology and demographic characteristics. Furtherresearch should investigate the performance of the DSP method in diverse populations, including individuals with varying ancestry, age, and geographic origins. In conclusion, while the DSP tool shows promise as a reliable method for sex estimation using CT scans, further research is needed to address potential limitations, validate its accuracy across diverse populations, and ensure its applicability in various clinical and forensic settings. Standardization of protocols, consideration of ethical considerations, and interdisciplinary collaboration are essential for advancing the field of skeletal sex estimation. To the best of our knowledge, this study stands as the pioneering investigation into applying the DSP tool for sex estimation among the adult population of Romania. This unique endeavor fills a crucial gap in research, as previous studies in Romania have primarily relied on traditional techniques for sex estimation, overlooking the potential of modern imaging technologies like CT scans and the DSP tool. Despite the inherent limitations of our study's relatively small sample size, our results demonstrate comparable accuracy and sex estimation rates to those observed in similar studies conducted across European populations. Building upon these initial findings, future research endeavors will prioritize including a more significant number of measurements per individual and a more extensive sample size to enhance the sex estimation and accuracy. Moreover, we recognize the importance of expanding the geographical scope of our study to encompass multiple regions within Romania. Such an expansion is vital for providing a more comprehensive understanding of the applicability and generalizability of the DSP method across the diverse population demographics present within the country. By incorporating data from various regions, we can ensure the robustness and reliability of the DSP tool for sex estimation in the context of the contemporary Romanian population.