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Estimation liver radiomics from postmortem CT: Development of interpretable models for postmortem interval

Fabio De-Giorgio¹, Davide Cusumano², Luca Vellini²

¹Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Department of Healthcare Surveillance and Bioethics, Section of Legal Medicine, Università Cattolica del Sacro Cuore, Rome, Italy.

Physica Medica : PM : an International Journal Devoted to the Applications of Physics to Medicine and Biology : Official Journal of the Italian Association of Biomedical Physics (AIFB)

|September 29, 2025

Summary

This summary is machine-generated.

Liver skewness from postmortem CT scans can help estimate time since death. This radiomic feature reliably identifies deaths occurring more than 24 hours prior, aiding forensic investigations.

Keywords:

Computed tomography Post-mortem interval Radiomics

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Area of Science:

Forensic Radiology
Medical Imaging Analysis
Radiomics

Background:

Postmortem computed tomography (PMCT) is a valuable non-invasive tool for forensic investigations.
Estimating the postmortem interval (PMI) is crucial in determining the time since death.
Radiomic analysis of PMCT scans offers objective data for PMI estimation.

Purpose of the Study:

To develop and validate radiomic models using liver features from PMCT scans.
To differentiate between deaths occurring within versus beyond 24 hours.
To identify robust radiomic biomarkers for postmortem interval estimation.

Main Methods:

Retrospective analysis of 173 PMCT scans for model development and 80 for external validation.
Manual liver segmentation and extraction of 40 statistical, morphological, and fractal radiomic features.
Logistic regression modeling and ROC curve analysis to evaluate feature performance for PMI estimation.

Main Results:

Liver skewness was the most predictive and robust radiomic feature (p=9.13×10⁻⁴, ICC=0.75).
A model based on liver skewness achieved an AUC of 0.75 and 100% specificity for deaths >24 hours.
External validation confirmed the specificity of the skewness model.

Conclusions:

Liver skewness extracted from PMCT is a promising biomarker for identifying deaths beyond 24 hours.
The model demonstrates reliable performance in an independent cohort.
Radiomic analysis of PMCT liver images can enhance forensic PMI determination.