I'm writing a protocol for a systematic review. I want to use available studies/literature to show whether there is a rationale for for cross sectional or even just CT imaging over plain radiography as a complement to invasive autopsy. There is a lack of definitive papers pertaining to forensic radiography. Are you aware of any guidelines /studies that could be included?

Thank you I will do that immediately. Thanks for the info.

You can write to Dr. BG Brogdon in the University of South Alabama, USA. I know for sure that he has decades of experience in this field and has also written a book.

Thank you for the info.

Are you aware of any guidelines /studies that could be included?

Just wait a little bit longer. I am writing an article about postmortem radiography combining the radiolgy and forensic aspect. I am a forensic pathologist and on my way to become a radiologist, too.

You are right. I have searched the internet as well as printed books and there are only a few publications about this subject.

Virtopsy team has published over 200 papers so far. See http://www.ncbi.nlm.nih.gov/pubmed/?term=Thali[All%20Fields]&cmd=DetailsSearch for more details.

Well, I can say that as for example in the study of my collegues and I ("Role of virtopsy in the postmortem diagnosis of drowning" which was presented as poster at the European Congress of Radiology at the beginning of this month (6th-10th March 2014) and it has been already accepted as article by the journal "La Radiologia Medica"), virtopsy through CT proved to be helpful in case of drowning to understand if the victim was alive or dead when he entered the water and if the cause of death was drowning; in the cases we reported this issue was solved by postmortem-CT since there are no autopsy findings pathognomic of drowning.

Hi

Sarah Heinze - International guidelines have not been developed yet which seems to be an issue that may be resolved in the near future. I believe that a working party will be assembled in May at the Society of Forensic Radiology 3rd Congress in Marseille. Several individual geographic regions have their own protocols being developed e.g. Switzerland, Victoria - Australia, Denmark etc. In the UK CT is sometimes used for medico-legal cases but there are no guidelines for forensic investigative cases yet. I would really appreciate the chance to read your work soon and will look for it being published.

Peter Kovac - Thank you for the link. I had already browsed Prof. Michael Thali's studies via the Swiss Virtopsy program website which also led me to the Virtobot development studies. I have decided to refine my systematic review specifically to diagnostic accuracy of CT/MR angiography compared to conventional autopsy of vascular systems.

Federica Vernuccio - Thanks for the information. I will watch out for your study in La Radiologia Medica. I haven't found many studies relating to Virtopsy and drowning so this is very interesting to me.

thank you Jane. I am pleased of your interest in the study of my group.

It also depends on the population you would like to investigate. In children under the age of four years a full skeletal survey according to the Royal College of Radiology should be obtained. There is insufficient evidence for the detection of especially metaphyseal corner fractures on CT. In all cases irrespective of the age I would perform CT, the cross sectional data not only gives additional information but the 3-D reconstructions are very helpfull for laymen (e.g. lawyers and judges).

In neonates and young children the MARIAS study group have shown that MRI is superior, related to publications on CT in adults.

This indeed is an issue that needs to be addressed by the ISFRI.

@Deepak Takhtani - I was very saddened to read about the death of Dr. BG Brogdon on 28th March. He was very knowledgeable and influential - an expert in his field. R.I.P.

I just want to share with you Jane my experience in postmortem cross sectional imaging as part of my research work and clinical practice of fetal medicine. We do MRI and CT for aborted fetuses. These studies replaced invasive autopsies for many cases (especially when parents refused autopsies). When the parents permitted us, we did both postmortem cross sectional imaging and invasive autopsies. We were able to compare the results of both methods. There were findings detected better in cross sectional imaging than in invasive autopsy despite that we were aware of the imaging findings at the time of autopsy. In all of these cases, the results of postmortem cross sectional imaging directed well the invasive autopsy.

Thanks Sahar. I've decided to focus my systematic review on post-mortem CT angiography as an addition to other virtual autopsy procedures. It's an interesting development using modified heart-lung machines and contrast media. I'm basing the review on diagnostic accuracy and have found that, as you say, there is often more information gained from the imaging procedure than the invasive autopsy. It has the potential to replace invasive examinations, but possibly the best scenario will be as a first-line test to triage and guide only those cases that need invasive examination for clarification.

Hi Jane... I am writing you to let you know I uploaded my article on the role of virtopsy in the diagnosis of drowning that has been accepted and published by La Radiologia Medica, as I had told you in a previous post... Good luck with your review!!!

Thank you Federica, I will look for it and read it.

The review is more difficult than I anticipated but I will work hard to complete it!

It will take years in India to develop.

Personally I feel autopsy is far better than Virtopsy.