Accuracy of forensic pathologists in incorporating post‐mortem <scp>CT</scp> (<scp>PMCT</scp>) in forensic death investigation

Makino, Yohsuke; Unuma, Kana; Nolte, Kurt B.; Adolphi, Natalie L.

doi:10.1111/1556-4029.15131

Cited by 6 publications

(2 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our office, after training, the forensic pathologists currently interpret the PMCT scans for most of their cases and have a backup radiologist consultant for only 2.3% of cases [27]. A recent study confirmed that forensic pathologists can reliably interpret the findings on PMCT scans and use them to accurately certify deaths [34]. Similarly, another recent study showed that novice forensic anthropologists with brief training in basic radiologic imaging interpretation can accurately interpret skeletal trauma and find more skeletal injuries, and that CT scans are more easily interpreted than plain radiographs [35].…”

Section: Ta B L Ementioning

confidence: 99%

Can computed tomography replace or supplement autopsy?

Lathrop

Wiest

Andrews

et al. 2023

Journal of Forensic Sciences

View full text Add to dashboard Cite

Postmortem computed tomography (PMCT) has been integrated into the practice of many forensic pathologists. To evaluate the utility of PMCT in supplementing and/or supplanting medicolegal autopsy, we conducted a prospective double‐blind comparison of abnormal findings reported by the autopsy pathologist with those reported by a radiologist reviewing the PMCT. We reviewed 890 cases: 167 with blunt force injury (BFI), 63 with pediatric trauma (under 5 years), 203 firearm injuries, and 457 drug poisoning deaths. Autopsy and radiology reports were coded using the Abbreviated Injury Scale and abnormal findings and cause of death (COD) were compared for congruence in consensus conferences with novel pathologists and radiologists. Overall sensitivity for recognizing abnormal findings was 71% for PMCT and 74.6% for autopsy. Sensitivities for PMCT/autopsy were 74%/73.1% for BFI, 61.5%/71.4% for pediatric trauma, 84.9%/83.7% for firearm injuries, and 56.5%/66.4% for drug poisoning deaths. COD assigned by reviewing PMCT/autopsy was correct in 88%/95.8% of BFI cases, 99%/99.5% of firearm fatalities, 82.5%/98.5% of pediatric trauma deaths, and 84%/100% of drug poisoning deaths of individuals younger than 50. Both autopsy and PMCT were imperfect in recognizing injuries. However, both methods identified the most important findings and are sufficient to establish COD in cases of BFI, pediatric trauma, firearm injuries and drug poisoning in individuals younger than 50. Ideally, all forensic pathologists would have access to a CT scanner and a consulting radiologist. This would allow a flexible approach that meets the diagnostic needs of each case and best serves decedents' families and other stakeholders.

show abstract

Section: Ta B L Ementioning

confidence: 99%

Can computed tomography replace or supplement autopsy?

Lathrop

Wiest

Andrews

et al. 2023

Journal of Forensic Sciences

View full text Add to dashboard Cite

show abstract

“…On the other hand, postmortem computed tomography (PMCT) has been increasingly used in forensic pathology as a tool to assess the cause of death. Currently, some forensic centres routinely perform PMCT scans before the autopsy [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

The value of PMCTA in the diagnosis of coronary atherosclerosis in isolated human hearts

Wan,

Chen,

Zhou

et al. 2023

Forensic Sciences Research

View full text Add to dashboard Cite

Postmortem computed tomography (PMCT) has a limited value in investigating coronary artery disease, despite several obvious advantages over the conventional autopsy. To address this issue, postmortem computed tomography angiography (PMCTA) has been introduced into various studies, where it has been used to investigate natural and unnatural deaths involving vascular damage, occlusion, or other pathologies of the vascular system. To investigate the application value of PMCTA in the diagnosis of coronary artery stenosis in ex situ hearts, the water-based contrast media were injected into isolated hearts, scaned, and finally compared with gold standards (autopsy and histology findings of the coronary artery). This study involved 16 subjects from the Academy of Forensic Science who were suspected to have died of sudden death without traumatic injuries. Unenhanced PMCT was performed first, followed by PMCTA using a water-based contrast agent, injected into the coronary arteries of isolated hearts using a self-designed angiography device. The image data were reconstructed into three-dimensional (3D) angiography images using software in the angiography facility. The 3D images were recorded and evaluated by two radiologists and then statistically analysed. The results of PMCTA were consistent with the gold standards for the diagnosis of coronary artery stenosis (P > 0.05). However, water-based contrast media can only be used to examine the pathological changes of blood vessels, which may have limitations in the diagnosis of causes of death such as myocardial oedema. PMCTA can be used as a new method to evaluate the degree of coronary atherosclerosis in addition to traditional autopsy. The 3D reconstruction technique reveals the coronary artery lesions more objectively and vividly and provides the opportunity to re-read the data at any time. Key points

show abstract