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Since the beginning of science, humans have always marveled around the human body. They have especially been interested in the human body and how it works. One such marvel is that of the autopsy. Post-mortem bodies have been examined and discovered ever since the Egyptian period when mummification practices led to organs being removed and studied. Since then autopsies have been performed as a means of diagnosing and determining causes of death. They have also been used as court evidence, as autopsies are performed to determine cause of death and other ailments that may have occurred. Recently, a method proposed to aid in the modern technological advancement of surgery has been Virtual Autopsy. A virtual autopsy is a minimally invasive, Imaging-guided tour of the deceased human body. It is becoming more widely used as a method to replace traditional “body-opening” autopsies. It is a method of imaging called Full Body MSCT (multi-sliced computer topography) and MRI (Magnetic Resonance Imaging) that creates 2-D and 3-D reconstructions of the post-mortem body (Dedouit et al 2007). The method that uses these types of 2-D Scans and reconstructs the body into 3D Imaging is called 3D Shade Surface Display (SSD). This is a great technical marvel that has proven to be successful for autopsies and for corroborating testimonies in court.Although there are some disadvantages of Virtual Autopsies as it is a relatively new technology, they developing to become a credible way to diagnose injuries and determine cause of death without using a knife.
A forensic pathologist uses computer-imaging methods that include a combination of Multi-Slice Computer Topography (MSCT) and Magnetic Resonance Imaging (MRI) to conduct a virtual autopsy. The MSCT is good at discovering foreign objects; bone or air distribution throughout the body and an MRI is good at imaging details within organs and tissues. Using a combination of these types of images, doctors are able to create 3D reconstructions of an entire body post-mortem, without having to use a knife at all. They scan the body through a CT scanner and an MRI scanner to produce images that can detect and diagnose the cause of death. It can do this by producing images that would not disturb a body that has just been found and a forensic pathologist can look at the 3-D rendered images and evaluate the irregularities in the picture to determine the cause of death. For example, Thali et al in 2003 used a virtual autopsy to evaluate a homicide victim that had gone through putrefaction. Before performing a classic autopsy, they performed a virtual one that had shown them “Gaseous distention of the decomposed organs and tissues in detail as well as a complex fracture of the calvarium” (Thali et al 2003). Not only that, but particular features of tissue and bone lesions, such as the earlobe and the skull fracture pattern were documented with great precision (Thali et al 2003). Another example was that of a woman’s body who was found trapped in a floodgate. The MSCT and MRI scanning revealed that the victim had died by drowning because there was fluid visible in the esophagus, trachea, and bronchii (Dedouit et al 2007). The scan of the MSCT can determine fluid and air distribution and in this case it found fluid in these parts and the diagnosis because apparent that she had died from drowning. There was also a discovery that there were very many fractures of the posterior segment of the first left and second rightribs, the left occipital condyle, the anterior part of the first cervicalvertebra (Dedouit et al 2007). Another example of the usefulness of virtual autopsies is in the documentation and analysis of gunshot wounds (Thali et al 2003). Using the techniques of the MSCT and MRI scans, they were able to accurately reconstruct the bullet wound skull fractures and brain damage by the subsequent gunshot wound. The CT and MRI machines were also able to document vital reactions to the gunshot wounds such as air emboli in the heart and blood vessels, and the classic pattern of blood articulation in the lungs (Thali et al 2003). As you can see, the CT and MRI scans as well as the SSD (3D Shade Surface Display) were able to accurately describe gunshot wounds in post mortem victims with great detail.Although there are many advantages of virtual autopsies, there are also some disadvantages. One drawback is the need for a powerfulreconstruction station, including a variety of software for specificreconstructions (bone, soft tissue, metal, dental reconstruction, etc.)(Dedouit et al 2007).It is also evident that analysis of the articular surfaces to determinephases used in anthropology is better in dynamic evaluation, whichallows vision from many angles, than on static and printed images (Dedouit et al 2007). At the current time that the imaging processes are being conducted, the machinery and software may be expensive and extensive. Another drawback is that some organs and some bone techniques are better used by classic autopsy techniques. For example, the examination of dry bones is better analyzed by touching and rotating them than by photographs (Dedouit et al 2007). Palpating the bones post mortem is necessary to assess the damage to bones and finding out if the injuries had happened before or after death. This is a technique that cannot be fully done by computer imaging alone as of yet. In additionto the bones, the colors of the organs cannot be determined by MSCT or MRI imaging. This technique only proves to be a useful tool of a classic autopsy (Thali et al 2003). The reason for this is that currently; the images and scans of the body are not able to replicate the colors of the individual organs or bones. The colors of the organs are important because it can tell multiple things about how the person died or which organs failed at which time.There are also some processes and determination that a MSCT or MRI scan cannot do that must be done by the classic method of performing autopsies. The MSCT and MRI imaging does take time and money to complete, but the results may outweigh the costs especially if they family wants to have the body remain intact. Even through their best efforts, sometimes the Forensic Pathologists may not make the body what it was before an autopsy was performed on it. Although there are some drawbacks, there is still a tremendous amount of usefulness in virtual autopsies.
The outlook of virtual autopsies is very positive. MSCT and MRI scans are both becoming more apparent in the field of Forensics and Forensic Pathology. Scans are now being conducted in minutes rather than hours and are being conducted with more accuracy. They have the ability to become more useable in the future. Thali et al state that the “MSCT and MRI scans are tools for the future. Bullets and relevant histological samples form specific sites then might be won in image-guided minimally invasive fashion via percutaneous biopsy.” These tools along with the SSD may give rise to future forensic documentation practices and a greater, minimally invasive postmortem examination.
After virtual autopsy, virtual anthropology will most likely expand,making possible a new type of collection: the virtual bone collection.The images and reconstructions obtained can be transferredthrough the Internet. This opens new horizons for anthropology interms of worldwide diffusion of bone collections that cannot betransported physically (Dedouit et al 2007). For example at the current time that this research is at, we cannot fully image the bone with every little fragment or contusion, which is very useful information for autopsies. Also, the color of organs cannot be identified by virtual methods. If there was a way to add dye to body that could develop the color of organs, then the imaging would be useful in that respect. The expansion of virtual autopsies is increasing dramatically and more tools are being used to identify things that used to have to be done by the classic autopsy method. What is exciting is this method is investigator independent, objective, and noninvasive and will lead to qualitative improvements in forensic pathologic investigation, since the digitally stored data may be recalled at any time to provide fresh, intacttopographic and anatomic-clinical information (Dirnhofer et al 2006). The digitally stored data will be available for an extremely long time and it reduces the amount of human error that may be involved in the classic method of performing autopsies.
Overall, Virtual autopsies can be useful in many ways although they do have their disadvantages such as space and money as these machines that they use are bigger and they are very expensive. However, just like how computers started out, as the machines get smaller the material will become more viable making the process cheaper. With the expansion of data acquisition, the data and the resulting information can be used asan epidemiologic basis for assessing morbidityand mortality in the general population, therebyaiding in the planning of further research projects.A virtual autopsy screening procedure prior to burial isconceivable. Traditional autopsy rates are decreasing for several reasons, so that autopsy provides only limited data. Virtual autopsy providesan alternative means of acquiring relevant postmortem data for further research (Dirnhorfer et al 2006). Virtual autopsy is on the way to becoming more useful in the future for postmortem autopsies and this may be also prove to be useful for full body scans on alive people as well. Using these scans they may be able to diagnose many different types of diseases on people who are still alive. They could use the images to make a 3D representation of their bodies. Forensic Pathologists are paving the way to create better techniques to determine, diagnose, and examine postmortem bodies with the advancement of virtual autopsies. The future looks bright for Virtual Autopsies.
SOURCES
Dedouit F, Telmon N, Guilbeau-Frugier C, Gainza D, Otal P, Francis J, Rouge D. Virtual Autopsy and Forensic Identification- Practical Application: A Report of One Case. Journal of Forensic Science. 2007;4:960-964.
Dirnhofer, Richard, et al. "VIRTOPSY: minimally invasive, imaging-guided virtual autopsy." Radiographics 26.5 (2006): 1305-1333.
Thali M, Yen K, Schweitzer W, Vock P, Ozdoba C, Dirnhofer R. Into the decomposed body- forensic digital autopsy using multislice-computed tomography. Forensic Science International. 2003;134:109-114.
Thali M, Yen K, Vock P, Ozoba C, Kneubuehl B, Sonnenschien M, Dirnhofer R. Image-guided virtual autopsy findings of gunshot victims performed with multi-slice computed tomography (MSCT) and magnetic resonance imaging (MRI) and subsequent correlation between radiology and autopsy findings. Forensic Science International. 2003;138:8-16.
