Early Experience With Postmortem CT Imaging.

Area of Science:

• Forensic Radiology
• Medical Examiner Systems
• Radiological Imaging

Background:

• Postmortem computed tomography (PMCT) is an underutilized imaging modality in the United States.
• Collaboration between radiology departments and medical examiner offices (MEO) can integrate PMCT into autopsy workflows.
• PMCT assists forensic pathologists in determining the necessity of autopsy and cause of death.

Purpose of the Study:

• To introduce PMCT into the autopsy workflow.
• To support forensic pathologist decision-making regarding autopsy necessity.
• To evaluate the impact of PMCT on autopsy rates.

Main Methods:

• PMCT performed on MEO-requested cases over two years.
• Double-read reports by emergency radiologists detailing PMCT findings.
• MEO reports included external examination and, when performed, autopsy findings.
• Shared documentation integrated decedent information, radiology impressions, and pathology results.

Main Results:

• 116 PMCT examinations completed; 50 (43.1%) cases did not require subsequent autopsy.
• PMCT findings were conclusive for cause of death in cases where autopsy was not performed.
• Indications for PMCT included ruling out/assessing trauma and addressing family/religious objections.
• Manner of death varied, including accident, homicide, natural, suicide, traffic-related, and undetermined.

Conclusions:

• PMCT is a valuable service for decedent families and forensic pathologists, especially in resource-limited settings.
• PMCT can reduce the need for traditional autopsies, respecting cultural and religious sentiments.
• Implementation requires multi-stakeholder cooperation and offers collaborative research and educational opportunities.
• Lessons learned can guide other jurisdictions in establishing PMCT services.