The Current Status of Virtual Autopsy Using Combined Imaging Modalities: A Scoping Review

Background/Objectives: Virtual autopsy (virtopsy) is a new domain of research for interdisciplinary teams of radiologists and forensic specialists. This scoping review aims to underline the current state-of-the-art research using combined imaging modalities. Methods: We searched the PubMed database using the term virtopsy for articles that are available in free full text, indexed in the Medline Database, and published in English. The query returned 49 articles on this subject that have been published since 2002. Results: The main imaging modalities used for postmortem imaging were computed tomography (PMCT), angiography (PMCTA), magnetic resonance imaging (PMMRI), and ultrasonography (PMUS). PMCT is highly effective for detecting complex osseous injuries, tracing bullet trajectories, or identifying characteristic findings in drowning cases. PMCTA is valuable for evaluating vascular lesions, particularly in natural death cases. PMMRI is superior in analyzing soft tissues, including brain and spinal structures, cerebrospinal fluid, microbleeds, and laryngohyoid lesions, and identifying cardiomyopathies in young individuals. PMUS serves as an alternative, and its portability also allows for use in forensic settings. One specific situation observed was the increased number of studies published about virtopsy during the COVID-19 pandemic. Another aspect is the increased focus on this alternative to conventional autopsy in the regions where maneuvering of the deceased is limited according to cultural and social customs. Conclusions: We underline the advantages and limitations of each imaging modality used for virtopsy. Further studies need to be developed in order to gather supplementary data regarding the use of these imaging modalities in the new era of artificial intelligence in medicine.