THE VIRTOPSY PROJECT NOVEL APPROACHES IN POST MORTEM IMAGING

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THE VIRTOPSY PROJECTNOVEL APPROACHES IN POST
MORTEM IMAGING

• Stephan Bolliger, MD
• Steffen Ross, MD
• Centre for Forensic Imaging and Virtopsy
• Institute of Forensic Medicine
• University of Bern
• Switzerland

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Definition
Virtopsy Virtual virtualis better,
capable Aut-opsy autos self (with own
eyes) opsomei will see
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AIM OF THE PROJECT

• Implementation of modern imaging techniques into
  forensic medicine and pathology
• Augmentation or alternative to classic methods
• Observer-independent documentation
• Improvement of forensic medicine and pathology

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TOOLS

• SURFACE
• -gt3D Optical Surface Scanning / Photogrammetry
• INTERNAL FINDINGS
• -gtMSCT, MRI
• VASCULAR SYSTEM -gtp.m. CT
  Angiography
• HISTOPATHOLOGY/TOXICOLOGY
• -gtImage guided biopsy

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Autopsy Room 2.0
Surfacescan
Biopsy
MSCT
MRI (remote site)
Angiography
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Update
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Image Guided Biopsy
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Image Guided Biopsy
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Image Guided Biopsy
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Fractures
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Idendification of body parts
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Dental ID
ante mortem
post mortem
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Reconstruction of bullet path direction
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Reconstruction of bullet path direction
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Reconstruction of bullet path direction
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Decompostion
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ID of foreign bodies
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ID of foreign bodies
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ID of foreign bodies
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Gas embolism
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Pulmonary Pathologies


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Documentation of malpractice
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Whole body MRI (TIM)
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Whole body MRI (TIM)
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Whole body MRI (TIM)
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Ante mortem MRI in strangulation
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Accident reconstruction
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Accident reconstruction
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Accident reconstruction
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Accident reconstruction
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Accident reconstruction
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Accident reconstruction
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Bite mark analysis
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Bite mark analysis
Digitized plaster casts of the dentitions from
the suspected perpetrators
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Comparison of the bite mark with the dentition of
the assumed perpetrator
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3D documentation of living persons

• Photograph of the injury

3D model of the injury
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3D scanning of the shoes of the suspected persons
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Matching the shoe with the injury
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Problems to solve in pm CT
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PM CT Angiography -Project Information-

• n63 (53 m,10 f), age median 55y(15 83y)
• Inclusion criterium -gtsuspected vascular
  pathology
• Scan pm median 22,6h (6h-55h)
• Whole body MSCT (unenhanced, arterial, venous)
• Unilateral femoral contrast injection
• Harvesting of body fluids (blood/urine) before
  CTA
• CT-guided core needle biopsy (14G TruCut) after
  CTA

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PM CT Angiography -Setup-
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PM CT Angiography -Contrast Medium-

PEG 200
Iopentol
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PM CT Angiography
Main advantages of PEG
Iopentol 1. No tissue edema 2. Enhancement
of parenchymal tissue (brain, heart, upper
abdominal organs, intestines) 3. Imaging of
arteries and veins without superposition
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PM CT Angiography
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PM CT Angiography
R
unenhanced
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PM CT Angiography
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PM CT Angiography
ante mortem B-Dissection
post mortem A-Dissection pericardial tamponade
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PM CT Angiography
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PM CT Angiography
R
R
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PM CT Angiography
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PM CT Angiography
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PM CT Angiography
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PM CT Angiography
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PM CT Angiography
arterial
venous
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PM CT Angiography
.
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PM CT Angiography
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PM CT Angiography
unenhanced
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PM CT Angiography
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Conclusion
Post mortem imaging opens new windows in
forensic and clinical pathology.