Evaluation of computed tomography as a screening test for death inquest

Area of Science:

• Forensic Pathology
• Medical Imaging
• Public Health

Background:

• The Japanese method of inquest relies heavily on external examinations, potentially leading to misclassification of death causes.
• Accidental deaths and suicides may be misdiagnosed as death by disease, impacting public health data and justice.

Purpose of the Study:

• To evaluate the utility of computed tomography (CT) scans in determining the cause of death in cases initially classified as disease or natural causes.
• To assess the potential of CT scans in identifying overlooked crimes and accidents.

Main Methods:

• Computed tomography (CT) scans were performed on 80 cases where police investigations concluded death by disease or natural causes.
• Cases with suspicious findings on CT scans were further investigated with autopsy and toxicological tests.

Main Results:

• CT scans clearly determined the cause of death in 17 out of 80 cases.
• Ten cases proceeded to autopsy due to suspected criminality indicated by CT scan results.
• CT scans identified potential misclassifications in death investigations.

Conclusions:

• CT scans show promise as a tool to prevent misdiagnosis of accidental deaths and suicides as natural causes in Japan.
• CT scans are valuable but not a definitive standalone tool; cooperation with investigative agencies and forensic examinations like autopsy are crucial for accurate cause-of-death determination.