Checklist and Scoring System for the Assessment of Soft Tissue Preservation in CT Examinations of Human Mummies: Application to the Tyrolean Iceman

Abstract

Purpose Soft tissues make a skeleton into a mummy and they allow for a diagnosis beyond osteology. Following the approach of structured reporting in clinical radiology, a recently developed checklist was used to evaluate the soft tissue preservation status of the Tyrolean Iceman using computed tomography (CT). The purpose of this study was to apply the “Checklist and Scoring System for the Assessment of Soft Tissue Preservation in CT Examinations of Human Mummies” to the Tyrolean Iceman, and to compare the Iceman’s soft tissue preservation score to the scores calculated for other mummies. Materials and Methods A whole-body (CT) (SOMATOM Definition Flash, Siemens, Forchheim, Germany) consisting of five scans, performed in January 2013 in the Department of Radiodiagnostics, Central Hospital, Bolzano, was used (slice thickness 0.6 mm; kilovolt ranging from 80 to 140). For standardized evaluation the “CT Checklist and Scoring System for the Assessment of Soft Tissue Preservation in Human Mummies” was used. Results All checkpoints under category “A. Soft Tissues of Head and Musculoskeletal System” and more than half in category “B. Organs and Organ Systems” were observed. The scoring system accounted for a total score of 153 (out of 200). The comparison of the scores between the Iceman and three mummy collections from Vilnius, Lithuania, and Palermo, Sicily, as well as one Egyptian mummy resulted in overall higher soft tissue preservation scores for the Iceman. Conclusion Application of the checklist allowed for standardized assessment and documentation of the Iceman’s soft tissue preservation status. The scoring system allowed for a quantitative comparison between the Iceman and other mummies. The Iceman showed remarkable soft tissue preservation. Key Points Citation Format

Discover the anatomy of the mummies: how imaging techniques contribute to understanding disease in the past

“…Paleoradiography has been widely acknowledged as a crucial non-invasive method for studying ancient human remains (Lynnerup, 2007(Lynnerup, , 2009(Lynnerup, , 2010O'Brien et al, 2009;Beckett, 2014;Cox, 2015;Lynnerup and Rühli, 2015;Moissidou et al, 2015;Rühli, 2015Rühli, , 2015Garvin and Stock, 2016;Giovannetti et al, 2016Giovannetti et al, , 2022Habicht et al, 2016;Licata et al, 2019;Nystrom, 2020), and several guidelines have been issued on its use (Panzer et al, 2015(Panzer et al, , 2017(Panzer et al, , 2018(Panzer et al, , 2019Tanti et al, 2021). Moreover, Cramer and coworkers (Cramer et al, 2018) performed a systematic review to summarize artificial changes and detectable paleopathologies diagnosed by CT scans.…”