Autopsy by Imaging: The Last 10 Years

Abstract

Virtual autopsies (VAs) are non-invasive, bypassing many of the challenges posed by traditional autopsies (TAs). This is a literature review about the sensitivity of the main VA techniques: post mortem (PM) computed tomography (PMCT) and PM magnetic resonance (PMMR). This could help to identify the most appropriate uses for VA, and where future research should focus. A review was performed, searching for literature from the last 10 years regarding how sensitive VA is at detecting common lesions that could cause or contribute to death. 33 studies were included. There was strong agreement that PMCT had strengths in detecting: free gas; fractures; large fluid accumulations; and calcifications. PMCT’s weaknesses included missing: pulmonary emboli; myocardial infarctions; and visceral/soft tissue lesions. The strengths of PMMR were less widely agreed, but included detecting: large fluid collections; myocardial infarctions; and visceral/soft tissue lesions. There were no wide agreements on PMMR’s weaknesses due to a lack of literature. Therefore, VA is a useful adjunct to TA; however, its drawbacks in reliably detecting common causes of death restrict its ability to fully replace TA. Novel imaging techniques are being developed in order to bridge the current gaps of VA, and make autopsies even less invasive.

Virtopsy as a Breakthrough in Non-Invasive Autopsy: Its Principles and Potential of Application in Developing Countries During the Covid-19 Pandemic

“…In situations where a full autopsy is necessary, the risk of infection for operators during the dissection of the body is a crucial concern (40). Despite the lack of current data on changes in CA trends during the COVID-19 pandemic, the outbreak of the pandemic in early 2020 enforced the need for safer alternatives to CAs (41). Additionally, the safety concerns stemming from the risk of infection have led to a significant decline in autopsy rates in the US.…”

Improving Traditional Post Mortem Healthcare—The Cross-Sectional Use of Blood-Based Biomarkers

“…Duly, the data known at present on blood biomolecules, which make it possible to determine the cause of death, will be reviewed, and minimally invasive approaches to postmortems will be tackled. Thus, invasive procedures that require the full opening of the body when performing an autopsy may be avoided [18][19][20].…”

“…However, VA has been preferred recently in the COVID-19-related pandemic context, with a satisfying effect [44]. Additionally, it is not invasive procedure, so it does not require the opening of the body when performing an autopsy [18][19][20]. Trained interviewers can use a questionnaire to interview the caregivers of the deceased.…”