Supplement to Chapter 3:

Medicolegal Death Investigations


Copyright 2006 DH Kaye

Add to note 1 (pp. 41-42)

Add to note 3 (p. 43)

Add to note 4 (pp. 43-44)

Add new note 5.1

"Virtual autopsies." Virtual autopsies are being developed at the University of Bern, Institute of Forensic Medicine in Switzerland under the name Virtopsy. Virtopsy uses noninvasive imaging technologies to generate digital reconstructions of a deceased body. Magnetic resonance imaging (MRI), computed tomography (CT), and photogrammetric scans are combined into two- or three-dimensional digital images to determine cause and time of death.

One of the most recent developments in forensic radiology, virtual autopsies have several advantages over the traditional autopsy. First, virtual autopsies produce clear graphics so that organs and injuries can be viewed without obstruction from blood and other internal matter. The technology is particularly adept at detecting bullet paths, pockets of liquid, hidden fractures, and gasses that are hard to observe with the naked eye. Micro-CT scans can even identify specific toolmarks left in bone. Second, the noninvasive nature of the technique allows autopsies to be performed without offending most personal or religious beliefs. Third, the lack of incisions also protects examiners from toxic agents sealed within the body. Finally, the images are graphic enough to engage and educate jurors but not as gruesome as the traditional autopsy photographs and videotapes. (See infra Chapter 4.)

On the other hand, the high cost of the machinery and need for specially trained x-ray technicians place virtual autopsies out of reach for most coroners. The examination process is not entirely automated which, despite the perceived infallibility of computers, means there is room for error. For example, operators must use complicated protocols to extract images from various kinds of body tissues. Moreover, virtual autopsies are unable to diagnosis natural deaths caused by heart failure or infection, and it is hard to diagnosis poisoning with this technique.FN

FN. The preceding description is adapted from Catherine Guthrie, Research focus, http://www.ncstl.org/news/Focus. See also Christian Jackowski et al., Virtopsy: Postmortem Imaging of the Human Heart In Situ Using MSCT and MRI, 149 Forensic Sci. Int'l 11 (2005); Jack March et al., Three-Dimensional Computer Visualization of Forensic Pathology Data, 25 Am. J. Forensic Med. & Pathology 60 (2004); Michael J. Thali et al., Forensic Microradiology: Micro-computed Tomography (Micro-CT) and Analysis of Patterned Injuries Inside of Bone, 48 J. Forensic Sci. 1336 (2003) Michael J. Thali et al., 3D Surface and Body Documentation in Forensic Medicine: 3-D/CAD Photogrammetry Merged with 3D Radiological Scanning, 48 J. Forensic Sci. 1356 (2003); Michael J. Thali et al., Charred Body: Virtual Autopsy with Multi-slice Computed Tomography and Magnetic Resonance Imaging, 47 J. Forensic Sci. 1326 (2002); Michael J. Thali et al., Is 'Virtual Histology' the Next Step after the 'Virtual Autopsy'?, Magnetic Resonance Microscopy in Forensic Medicine, 22 Magnetic Resonance Imaging 1131 (2004); Michael J. Thali et al., New Horizons in Forensic Radiology: The 60-Second Digital Autopsy: Full-Body Examination of a Gunshot Victim by Multislice Computed Tomography, 24 Am. J. Forensic Med. & Pathology 22 (2003) Michael J. Thali et al., Virtopsy - A New Imaging Horizon in Forensic Pathology: Virtual Autopsy by Postmortem Multislice Computed Tomography (MSCT) and Magnetic Resonance Imaging (MRI) - A Feasibility Study, 48 J. Forensic Sci. 386 (2003); Michael J. Thali et al., Virtopsy - Fatal Motor Vehicle Accident with Head Injury, 49 J. Forensic Sci. 809 (July 2004); Michael J. Thali et al., Virtopsy - Forensic Traumatology of the Subcutaneous Fatty Tissue. Multislice Computed Tomography (MSCT) and Magnetic Resonance Imaging (MRI) as Diagnostic Tools, 49 J. Forensic Sci. 799 (2003); Michael J. Thali et al., Virtopsy: Postmortem Multislice Computed Tomography (MSCT) and Magnetic Resonance Imaging (MRI) in a Fatal Scuba Diving Incident, 48 J. Forensic Sci. 1347 (2003).

Should "virtopsies" be admissible in court? More than one hundred such autopsies have been performed. Suppose that a medical examiner relying on a virtual autopsy simply testifies that the digital images are accurate and have as much diagnostic value as a conventional autopsy. Is tjhis sufficient? See infra chapters 5 & 6. What if the parties disagree about the trustworthiness of the process used to create the computerized images? Federal Rule of Evidence 901(a) simply provides that "[t]he requirement of authentication or identification as a condition precedent to admissibility is satisfied by evidence sufficient to support a finding that the matter in question is what its proponent claims." Rule 901(b)(9) offers the following illustration of proof of authenticity: "Evidence describing a process or system used to produce a result and showing that the process or system produces an accurate result."

Add to note 6 (p. 46)

Add to note 7 (pp. 46-47)




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