VIRTOPSY: Minimally Invasive, Imaging-guided Virtual Autopsy

Abstract

Invasive "body-opening" autopsy represents the traditional means of postmortem investigation in humans. However, modern cross-sectional imaging techniques can supplement and may even partially replace traditional autopsy. Computed tomography (CT) is the imaging modality of choice for two- and three-dimensional documentation and analysis of autopsy findings including fracture systems, pathologic gas collections (eg, air embolism, subcutaneous emphysema after trauma, hyperbaric trauma, decomposition effects), and gross tissue injury. Various postprocessing techniques can provide strong forensic evidence for use in legal proceedings. Magnetic resonance (MR) imaging has had a greater impact in demonstrating soft-tissue injury, organ trauma, and nontraumatic conditions. However, the differences in morphologic features and signal intensity characteristics seen at antemortem versus postmortem MR imaging have not yet been studied systematically. The documentation and analysis of postmortem findings with CT and MR imaging and postprocessing techniques ("virtopsy") is investigator independent, objective, and noninvasive and will lead to qualitative improvements in forensic pathologic investigation. Future applications of this approach include the assessment of morbidity and mortality in the general population and, perhaps, routine screening of bodies prior to burial.

Magnetic resonance imaging goes postmortem: noninvasive detection and assessment of myocardial infarction by postmortem MRI

“…6 Within these research efforts it was also experienced that natural causes of death can be visualized in a noninvasive manner. A variety of natural causes of death were exemplarily published by predominantly forensic-radiological research groups.…”

Evaluation of postmortem MDCT and MDCT-angiography for the investigation of sudden cardiac death related to atherosclerotic coronary artery disease

“…In recent years, as a result of the increased availability of computed tomography and magnetic resonance imaging in forensic practice, postmortem radiology is more frequently used [6,7]. Authors are currently debating if postmortem radiology should be a complementary examination or if it can be considered as a good replacement for conventional autopsy [8][9][10].…”

Postmortem CT Angiography Compared with Autopsy: A Forensic Multicenter Study

“…ith the introduction of modern cross-sectional imaging techniques such as multi-detector row computed tomography (CT) and magnetic resonance (MR) imaging to postmortem investigations, forensic pathology has taken an important step forward (1,2). Relatively low maintenance costs, short examination times, and ease of operation make CT a widely used cross-sectional imaging technique in modern postmortem imaging (3).…”