Biological Sex Determination in Cadavers Using Deep Learning Algorithms from Computed Tomography Images of Pelvis and Skull

Sexual identification of decomposed cadavers challenges traditional methods dependent on visual anthropological analysis. This study evaluates state-of-the-art deep learning (including YOLO26, YOLO11, ConvNeXt-Tiny, EfficientNetV2, ViT-B16, VGG16, and ResNet50) with transfer learning to automatically determine biological sex from forensic computed tomography (CT) scans. We analyzed 141 autopsied cadavers from the Forensic Medical Institute of Goiania-GO, including a broad age range and varying conditions of preservation. The three-dimensional reconstructions of the pelvis and skull were converted into standardized two-dimensional profile projections, contributing to the study of this new technical approach. Data augmentation techniques compensated for sample limitations. Two scenarios were validated: binary and quaternary classification (one class per sex vs. one class per anatomical region of each sex). The best-performing model achieved highly consistent results on the pelvis region and still satisfactory performance on the skull region, reaching an overall patient-level accuracy of 95.65%, recall of 92.86%, F1- score of 94.36%, and precision of 97.22%, maintaining consistent performance across the evaluated cases, including those with trauma-related artifacts. Results indicate the technical feasibility of the methodology, demonstrating that deep learning models can provide objective, high-speed skeletal analysis. Since the study was conducted using data from a single institution and a single computed tomography scanner, further validation across multiple centers and scanners is required to assess the generalizability of the proposed approach