Forensic Imaging最新文献

{"title":"Working Together to Protect the Vulnerable: A Radiologic Perspective on the Forensic Evaluation of Child Abuse","authors":"Mária Marosi , Péter A. Gergely , Ervin Berényi , Tamás Papp","doi":"10.1016/j.fri.2026.200765","DOIUrl":"10.1016/j.fri.2026.200765","url":null,"abstract":"<div><h3>Background</h3><div>Child abuse constitutes a persistent public health concern and a serious human rights violation, requiring objective, evidence-based investigative approaches. Radiologic imaging plays a pivotal role in the detection, documentation, and forensic interpretation of non-accidental injuries. By revealing injury patterns often undetectable on clinical examination, medical imaging strengthens both the protection of vulnerable children and the integrity of judicial procedures. The aim of this study is to present a series of radiologic case analyses involving children with suspected or confirmed physical abuse, emphasizing the diagnostic value of multimodal imaging in identifying non-accidental trauma and supporting the protection of children’s rights.</div></div><div>Child abuse constitutes a persistent public health concern and a serious human rights violation, requiring objective, evidence-based investigative approaches. Radiologic imaging plays a pivotal role in the detection, documentation, and forensic interpretation of non-accidental injuries. By revealing injury patterns often undetectable on clinical examination, medical imaging strengthens both the protection of vulnerable children and the integrity of judicial procedures. The aim of this study is to present a series of radiologic case analyses involving children with suspected or confirmed physical abuse, emphasizing the diagnostic value of multimodal imaging in identifying non-accidental trauma and supporting the protection of children’s rights.</div><div><h3>Methods</h3><div>A retrospective review was performed on pediatric cases referred for imaging due to suspected physical abuse. Conventional radiography, computed tomography (CT), and magnetic resonance imaging (MRI) were systematically assessed for radiologic features characteristic of inflicted trauma. Ethical and procedural considerations relevant to maintaining human dignity and ensuring the child’s legal protection were also evaluated.</div></div><div>A retrospective review was performed on pediatric cases referred for imaging due to suspected physical abuse. Conventional radiography, computed tomography (CT), and magnetic resonance imaging (MRI) were systematically assessed for radiologic features characteristic of inflicted trauma. Ethical and procedural considerations relevant to maintaining human dignity and ensuring the child’s legal protection were also evaluated.</div><div><h3>Results</h3><div>Imaging identified multiple forms of injury across the cohort, including acute and healing fractures, subdural hematomas, and patterned soft-tissue contusions. CT proved particularly effective for skeletal and intracranial evaluation, whereas MRI demonstrated superior sensitivity in detecting parenchymal and ligamentous injuries. Correlation of findings across modalities facilitated differentiation between accidental and inflicted trauma. Radiologic documentation served as an essential evidentiary component in","PeriodicalId":40763,"journal":{"name":"Forensic Imaging","volume":"45 ","pages":"Article 200765"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147951968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Competencies and training requirements for reporting and interpretation of adult forensic post-mortem imaging: positional statement of ISFRI","authors":"Chris O'Donnell , Guy Rutty , Yohsuke Makino , Michael Thali","doi":"10.1016/j.fri.2026.200759","DOIUrl":"10.1016/j.fri.2026.200759","url":null,"abstract":"<div><h3>Background</h3><div>There have been no internationally agreed protocols for training and competency of medical partitioners in postmortem imaging interpretation</div></div><div>There have been no internationally agreed protocols for training and competency of medical partitioners in postmortem imaging interpretation</div><div><h3>Methods</h3><div>Following a meeting in 2024 of NRGD in Utrecht where a group of local and international experts in postmortem imaging and the law discussed competencies and training requirements for the Netherlands, members of the ISFRI Education Working Group have produced a document outlining recommendations for international use</div></div><div>Following a meeting in 2024 of NRGD in Utrecht where a group of local and international experts in postmortem imaging and the law discussed competencies and training requirements for the Netherlands, members of the ISFRI Education Working Group have produced a document outlining recommendations for international use</div><div><h3>Results</h3><div>Summary of these recommendations:</div><div>1. In line with current clinical practice, “Forensic Imaging” or “Post-mortem Imaging” should be used to describe medicolegal or forensic use of imaging techniques</div><div>2. A forensic pathologist, radiologist, or forensic physician/legal medicine practitioner who meets training and competency requirements can report and interpret forensic imaging</div><div>3. There are two distinct levels of work focus, competency, and responsibility i.e. level 1 Reader and level 2 Interpreter</div><div>4. A level 1 practitioner can read images and produce a comprehensive and complete list of all forensically relevant findings</div><div>5. A level 2 practitioner can produce a list of forensically relevant findings and provide forensic interpretation of all or some of those findings</div></div><div>Summary of these recommendations:</div><div>1. In line with current clinical practice, “Forensic Imaging” or “Post-mortem Imaging” should be used to describe medicolegal or forensic use of imaging techniques</div><div>2. A forensic pathologist, radiologist, or forensic physician/legal medicine practitioner who meets training and competency requirements can report and interpret forensic imaging</div><div>3. There are two distinct levels of work focus, competency, and responsibility i.e. level 1 Reader and level 2 Interpreter</div><div>4. A level 1 practitioner can read images and produce a comprehensive and complete list of all forensically relevant findings</div><div>5. A level 2 practitioner can produce a list of forensically relevant findings and provide forensic interpretation of all or some of those findings</div><div><h3>Conclusion</h3><div>These recommendations are now published in Forensic Imaging and are non-binding but provide a framework that can be used by local jurisdictions when they are formulating local requirements for training and accreditation</div></div><div>These recommendations are","PeriodicalId":40763,"journal":{"name":"Forensic Imaging","volume":"45 ","pages":"Article 200759"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147952052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-mortem CT interpretation in forensic odontology: introduction of the Hounsfield Units Extended Scale","authors":"Alienor Traissac , Delphine Maret , Candice Giono , Fabrice Dedouit , Geromine Fournier","doi":"10.1016/j.fri.2026.200771","DOIUrl":"10.1016/j.fri.2026.200771","url":null,"abstract":"<div><h3>Background</h3><div>In cases of body decomposition, carbonization, or drowning, dental anatomic and restorative comparison is crucial for forensic identification. However, direct intraoral examination and 2D radiography are often impossible in severely altered or rigid bodies that limit access to the oral cavity. In such conditions, post-mortem computed tomography (PMCT) offers a non-invasive and reproducible exploration of the oral cavity and serves as a key tool for identification. Yet, metallic artifacts and Hounsfield units saturation can degrade image quality and hinder recognition of dental restorations. This study aimed to identify the PMCT filter and reconstruction modality providing the best image quality for post-mortem dental analysis.</div></div><div>In cases of body decomposition, carbonization, or drowning, dental anatomic and restorative comparison is crucial for forensic identification. However, direct intraoral examination and 2D radiography are often impossible in severely altered or rigid bodies that limit access to the oral cavity. In such conditions, post-mortem computed tomography (PMCT) offers a non-invasive and reproducible exploration of the oral cavity and serves as a key tool for identification. Yet, metallic artifacts and Hounsfield units saturation can degrade image quality and hinder recognition of dental restorations. This study aimed to identify the PMCT filter and reconstruction modality providing the best image quality for post-mortem dental analysis.</div><div><h3>Methods</h3><div>Fifty autopsies were performed, including a reference intraoral examination (considered as the gold standard) and a corresponding PMCT scan. Six filters (Bone and Soft Tissue, with or without Iterative Metal Artifact Reduction (IMAR) and Extended Hounsfield Unit (EHU) filters) and four reconstruction modalities (Multiplanar Reconstruction (MPR) and Maximum Intensity Projection (MIP) at 2-, 5-, and 10-mm thickness) were compared. Each dental restoration was evaluated using a decision tree assigning an image quality score from 0 to 4.</div></div><div>Fifty autopsies were performed, including a reference intraoral examination (considered as the gold standard) and a corresponding PMCT scan. Six filters (Bone and Soft Tissue, with or without Iterative Metal Artifact Reduction (IMAR) and Extended Hounsfield Unit (EHU) filters) and four reconstruction modalities (Multiplanar Reconstruction (MPR) and Maximum Intensity Projection (MIP) at 2-, 5-, and 10-mm thickness) were compared. Each dental restoration was evaluated using a decision tree assigning an image quality score from 0 to 4.</div><div><h3>Results</h3><div>Among the six filters, the EHU Bone filter achieved the highest mean score (3.48 vs <2.47 for other filters) and the largest proportion of maximum-quality ratings (76.8%). The 10-mm MIP reconstruction yielded the best results (71.2% of score-4 images), whereas other modalities reached ≤20%. With this filter–modality comb","PeriodicalId":40763,"journal":{"name":"Forensic Imaging","volume":"45 ","pages":"Article 200771"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147951187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiologically Misdiagnosed Medicolegal Cases: Case Series","authors":"Serbülent Kılıç , Mustafa Yığıt , Mustafa Rüşvenlı","doi":"10.1016/j.fri.2026.200745","DOIUrl":"10.1016/j.fri.2026.200745","url":null,"abstract":"<div><h3>Background</h3><div>Preparing medicolegal reports is one of the duties of a physician. The legal procedure is heavily dependent on those reports, which makes them quite significant. it requires expertise and experience to prepare the reports, which essentially describe the severity of the damage. When evaluating radiologic images, physicians may misdiagnose in the absence of these illnesses. This may result to inaccurate medicolegal reports. In order to resolve these conflicts by conducting an entirely new assessment, legal authorities ask for an expert report from a forensic medicine specialist. The presentation aims to demonstrate three cases of individuals who have assessed radiologic images incorrectly. Another goal is to raise forensic medical experts' awareness of these instances.</div></div><div>Preparing medicolegal reports is one of the duties of a physician. The legal procedure is heavily dependent on those reports, which makes them quite significant. it requires expertise and experience to prepare the reports, which essentially describe the severity of the damage. When evaluating radiologic images, physicians may misdiagnose in the absence of these illnesses. This may result to inaccurate medicolegal reports. In order to resolve these conflicts by conducting an entirely new assessment, legal authorities ask for an expert report from a forensic medicine specialist. The presentation aims to demonstrate three cases of individuals who have assessed radiologic images incorrectly. Another goal is to raise forensic medical experts' awareness of these instances.</div><div><h3>Methods</h3><div>The first case involved a skipped fracture line in the ulna's processus styloideus, the second case included a missed pneumothorax on the right, mosaic attenuation of the lung, and fracture lines in the vertebrae's processus transversus, and the third case involved a skipped fracture line in the pelvic bone's acetabulum, pneumothorax, and mosaic attenuation of the lung. A forensic medicine specialist revised and edited all reports following an additional assessment of the computed tomography and x-rays.</div></div><div>The first case involved a skipped fracture line in the ulna's processus styloideus, the second case included a missed pneumothorax on the right, mosaic attenuation of the lung, and fracture lines in the vertebrae's processus transversus, and the third case involved a skipped fracture line in the pelvic bone's acetabulum, pneumothorax, and mosaic attenuation of the lung. A forensic medicine specialist revised and edited all reports following an additional assessment of the computed tomography and x-rays.</div><div><h3>Results</h3><div>The goal of forensic medicine specialists' expert reports is to provide assistance in the conduct of justice.</div></div><div>The goal of forensic medicine specialists' expert reports is to provide assistance in the conduct of justice.</div><div><h3>Conclusions</h3><div>Developing the assessment of rad","PeriodicalId":40763,"journal":{"name":"Forensic Imaging","volume":"45 ","pages":"Article 200745"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147951785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The added value of Post-Mortem Magnetic Resonance Imaging (PMMRI) in a forensic setting: a single institution study in the Netherlands","authors":"Cédrique A.S. Gregoire , Maartje M.A. Eggen , Geneviève A.J.C. Crombag , Alida A. Postma , Martijn J. Nobel","doi":"10.1016/j.fri.2026.200736","DOIUrl":"10.1016/j.fri.2026.200736","url":null,"abstract":"<div><h3>Background</h3><div>In the Netherlands post-mortem radiology is applied to aid the forensic investigation. In adults, this includes a full body Post-Mortem Computed Tomography (PMCT) scan and an additional Post-Mortem Magnetic Resonance Imaging (PMMRI) scan in specific cases. Application of PMMRI varies between countries and institutions in a forensic setting in absence of international guidelines. This study analyses current use and added value of PMMRI in a single forensic imaging institution in the Netherlands to identify indications for application in the forensic post-mortem investigation.</div></div><div>In the Netherlands post-mortem radiology is applied to aid the forensic investigation. In adults, this includes a full body Post-Mortem Computed Tomography (PMCT) scan and an additional Post-Mortem Magnetic Resonance Imaging (PMMRI) scan in specific cases. Application of PMMRI varies between countries and institutions in a forensic setting in absence of international guidelines. This study analyses current use and added value of PMMRI in a single forensic imaging institution in the Netherlands to identify indications for application in the forensic post-mortem investigation.</div><div><h3>Methods</h3><div>All post-mortem cases scanned between July 2024 and July 2025 were included for analysis, except non-accidental injury protocol cases. The individual (contra-)indications for additional PMMRI scanning in adjunct to a PMCT were recorded. On the same day as the evaluation of the images an added value was scored by the forensic radiologist and consultant using the following options: additional finding, exclusion of a finding, confirmation of PMCT and no added value.</div></div><div>All post-mortem cases scanned between July 2024 and July 2025 were included for analysis, except non-accidental injury protocol cases. The individual (contra-)indications for additional PMMRI scanning in adjunct to a PMCT were recorded. On the same day as the evaluation of the images an added value was scored by the forensic radiologist and consultant using the following options: additional finding, exclusion of a finding, confirmation of PMCT and no added value.</div><div><h3>Results</h3><div>PMMRI was conducted in 47.4% of all cases, for which the most common indications consisted of suspected strangulation, blunt force trauma, penetrating injuries or when a suspected lesion was seen on PMCT. When a lesion was seen on PMCT, a PMMRI brain showed additional findings in 10/15 (66.7%) of cases. A PMMRI neck in cases of suspected strangulation showed additional findings or exclusion of findings in 31/46 (67.4%). However, adding PMMRI brain in suspected strangulation cases did not entail additional findings. PMMRI thorax and abdomen showed additional findings in 14/20 (70%) and 4/9 (44.4%) cases of penetrating injuries respectively.</div></div><div>PMMRI was conducted in 47.4% of all cases, for which the most common indications consisted of suspected strangula","PeriodicalId":40763,"journal":{"name":"Forensic Imaging","volume":"45 ","pages":"Article 200736"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147951794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of Post-Mortem CT in an Upper-Middle-Income African Setting: Outcomes of a Three-Month Pilot Audit in a High-Volume Forensic Mortuary","authors":"Janette Verster, Lienke Perold, Elsa Oosthuizen, Liza Clegg, Grace Simon, Marco van der Merwe, Janette Verster","doi":"10.1016/j.fri.2026.200743","DOIUrl":"10.1016/j.fri.2026.200743","url":null,"abstract":"<div><div>Post-mortem computed tomography (PMCT) is increasingly integrated into routine forensic pathology practice in well-resourced settings, where funding supports dedicated scanners and specialist staff. In contrast, low- and upper-middle-income countries face severe budgetary constraints, often viewing PMCT as an unattainable luxury rather than a practical service tool. The Tygerberg Forensic Pathology Service (FPS) Medico-Legal Mortuary in Cape Town, South Africa, manages an exceptionally high caseload, making it a suitable setting to challenge this paradigm. PMCT may offer an opportunity to improve case triage and reduce reliance on full autopsy, potentially yielding long-term operational and cost benefits.</div><div>A three-month pilot programme will utilise an existing clinically dedicated CT scanner at Tygerberg Hospital after hours to avoid disruption to routine patient services. A designated forensic pathology consultant will be assigned to radiology duty throughout the pilot period. All case admissions will be reviewed daily, to select cases for PMCT triage based on available case history. Each case will undergo standard external examination, PMCT, and complete medicolegal autopsy. PMCT findings will be compared directly with autopsy results to evaluate diagnostic concordance and assess the feasibility of PMCT as a triage tool within this high-volume service.</div><div>We hypothesise that PMCT will demonstrate a critical, previously under-recognised value in the African forensic context—not only as a diagnostic modality but as an effective triage instrument to manage overwhelming caseloads in resource-limited settings. Specifically, we anticipate that PMCT will streamline case prioritisation, facilitate certification of selected deaths using external examination and imaging alone, reduce the need for unnecessary autopsies, and generate meaningful workflow efficiencies.</div><div>This pilot aims to demonstrate that integrating PMCT into routine forensic practice in a resource-constrained environment is operationally feasible and beneficial. Rather than a “luxury technology”, PMCT may represent a strategic investment capable of improving efficiency and delivering long-term cost savings in high-volume resource constrained forensic mortuaries.</div></div><div>Post-mortem computed tomography (PMCT) is increasingly integrated into routine forensic pathology practice in well-resourced settings, where funding supports dedicated scanners and specialist staff. In contrast, low- and upper-middle-income countries face severe budgetary constraints, often viewing PMCT as an unattainable luxury rather than a practical service tool. The Tygerberg Forensic Pathology Service (FPS) Medico-Legal Mortuary in Cape Town, South Africa, manages an exceptionally high caseload, making it a suitable setting to challenge this paradigm. PMCT may offer an opportunity to improve case triage and reduce reliance on full autopsy, potentially yielding long-term operat","PeriodicalId":40763,"journal":{"name":"Forensic Imaging","volume":"45 ","pages":"Article 200743"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147951956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analyzing the relationship between postmortem interval estimation and the persisting decomposed intracranial content percentage from PMCT in Thailand","authors":"Chanon Towithelertkul , Koravik Meesilpavikkai , Panuwat Chutivongse , Jeong Benchapathomrong","doi":"10.1016/j.fri.2026.200707","DOIUrl":"10.1016/j.fri.2026.200707","url":null,"abstract":"<div><div>Determining the postmortem interval (PMI) in decomposed cases can be challenging in forensic investigations. Forensic pathologists traditionally rely on external examination, along with history taking and circumstantial evidence, while considering other influencing factors to estimate PMI. With advances in forensic radiology, postmortem computed tomography (PMCT) has become an important tool for providing additional information from the deceased, including PMI estimation. During decomposition, the brain undergoes autolysis and then settles in gravity-dependent areas, while putrefaction gas starts to fill the non-dependent parts. This study aims to analyze relationship between ranges of PMI estimation based on external appearances in decomposed cases in Thailand, between 1 and 7 days, and the persisting decomposed intracranial content percentage (PICP) from the PMCT data. We included the cases requiring further examination inside Forensic Department, Faculty of Medicine, Chulalongkorn University, in which PMCT was performed during May 2022 to February 2025 (N=161). PMI range were categorized into 3 groups: 1-3 days, 3-5 days and 5-7 days by one resident and one board-certified forensic pathologist, with a second board-certified providing consensus in cases of discrepancy. The PMCT data were processed through software (3Dslicer) to calculate PICP from voxels. The Spearman’s rho correlation showed a moderate negative correlation between PICP and PMI range (correlation coefficient = -0.648, p<0.001) while the ordinal logistic regression indicates that sex and age were non-significant parameters (p>0.05) when cooperate with PICP (p<0.001) to predict PMI range. This study highlights the utilization of radioinformatics to attempt answering the questions in the forensic medicine.</div></div><div>Determining the postmortem interval (PMI) in decomposed cases can be challenging in forensic investigations. Forensic pathologists traditionally rely on external examination, along with history taking and circumstantial evidence, while considering other influencing factors to estimate PMI. With advances in forensic radiology, postmortem computed tomography (PMCT) has become an important tool for providing additional information from the deceased, including PMI estimation. During decomposition, the brain undergoes autolysis and then settles in gravity-dependent areas, while putrefaction gas starts to fill the non-dependent parts. This study aims to analyze relationship between ranges of PMI estimation based on external appearances in decomposed cases in Thailand, between 1 and 7 days, and the persisting decomposed intracranial content percentage (PICP) from the PMCT data. We included the cases requiring further examination inside Forensic Department, Faculty of Medicine, Chulalongkorn University, in which PMCT was performed during May 2022 to February 2025 (N=161). PMI range were categorized into 3 groups: 1-3 days, 3-5 days and 5-7 days by one ","PeriodicalId":40763,"journal":{"name":"Forensic Imaging","volume":"45 ","pages":"Article 200707"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147951970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the autopsy: the contribution of post-mortem computed tomography in road traffic fatalities","authors":"Anna Laura Santunione , Micaela Guerra , Giuseppe Mammola , Antonino Lavenia , Sara Corradini , Giovanni Pizzuto , Giovanni Battinelli , Luca Alemanno , Jessika Camatti , Rossana Cecchi","doi":"10.1016/j.fri.2026.200714","DOIUrl":"10.1016/j.fri.2026.200714","url":null,"abstract":"<div><h3>Background</h3><div>Road traffic fatalities remain a major cause of non-natural death, particularly among young individuals. In this setting, the forensic autopsy represents the reference standard for determining the cause of death. However, the multifocal distribution of traumatic injuries and the increasing need for objective, reproducible, and well-documented findings strongly support the integration of complementary imaging techniques. Post-mortem computed tomography (PMCT) has therefore emerged as a cornerstone of forensic radiology in the assessment of fatal trauma.</div></div><div>Road traffic fatalities remain a major cause of non-natural death, particularly among young individuals. In this setting, the forensic autopsy represents the reference standard for determining the cause of death. However, the multifocal distribution of traumatic injuries and the increasing need for objective, reproducible, and well-documented findings strongly support the integration of complementary imaging techniques. Post-mortem computed tomography (PMCT) has therefore emerged as a cornerstone of forensic radiology in the assessment of fatal trauma.</div><div><h3>Materials and Methods</h3><div>All cases of road traffic fatalities examined between 2018 and 2024 at the Institute of Legal Medicine of Modena (Italy), in which a PMCT examination was performed prior to autopsy, were retrospectively collected. Whole-body PMCT findings were systematically compared with conventional autopsy results. The analysis focused on skeletal and visceral injuries, gas and fluid collections, and their correlation with trauma dynamics. Multiplanar reconstructions and three-dimensional volume-rendered images were used to support radiological evaluation and medico-legal reconstruction of injury mechanisms.</div></div><div>All cases of road traffic fatalities examined between 2018 and 2024 at the Institute of Legal Medicine of Modena (Italy), in which a PMCT examination was performed prior to autopsy, were retrospectively collected. Whole-body PMCT findings were systematically compared with conventional autopsy results. The analysis focused on skeletal and visceral injuries, gas and fluid collections, and their correlation with trauma dynamics. Multiplanar reconstructions and three-dimensional volume-rendered images were used to support radiological evaluation and medico-legal reconstruction of injury mechanisms.</div><div><h3>Results</h3><div>PMCT enabled a comprehensive whole-body assessment of traumatic injuries, allowing the identification of injury patterns consistent with specific impact mechanisms and force directions. The technique proved particularly effective in detecting complex skeletal fractures, hemorrhagic and gas collections, and in visualizing spatial relationships between injuries, which may be difficult to fully appreciate at autopsy alone.</div><div>Conversely, PMCT showed intrinsic limitations in the evaluation of parenchymal and soft-tissue injuries. Th","PeriodicalId":40763,"journal":{"name":"Forensic Imaging","volume":"45 ","pages":"Article 200714"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147951957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of forensic radiology and imaging in medicolegal investigation in India","authors":"Raghvendra Kumar Vidua, Niranjan Sahoo, Salu Chandran","doi":"10.1016/j.fri.2026.200742","DOIUrl":"10.1016/j.fri.2026.200742","url":null,"abstract":"<div><div>Forensic radiology and imaging have emerged as indispensable components of modern medicolegal investigations, offering non-invasive, rapid, and highly accurate tools for documenting injuries, identifying remains, and reconstructing events surrounding death. The integration of modalities such as digital radiography, postmortem computed tomography (PMCT), magnetic resonance imaging (MRI), ultrasonography, and advanced 3D reconstruction techniques has significantly enhanced the objectivity, precision, and reproducibility of forensic assessments. These technologies not only complement but, in certain contexts, surpass conventional autopsy techniques by enabling detailed visualization of skeletal trauma, foreign bodies, pathological changes, and soft-tissue injuries without the limitations posed by decomposition or inaccessible anatomical regions.</div><div>Despite these advances, the effective utilization of forensic imaging in India and similar resource-limited settings remains constrained by gaps in awareness, infrastructure, multidisciplinary collaboration, and specialized training. As medicolegal casework increasingly demands technologically sophisticated documentation, the need for structured education and capacity-building programs becomes critical.</div><div>Training initiatives for forensic medicine specialists, radiologists, technicians, and law-enforcement personnel must focus on image acquisition protocols, interpretation standards, chain-of-custody maintenance, and medico-legal reporting tailored to judicial requirements. Incorporating forensic imaging into undergraduate and postgraduate curricula, along with simulation-based learning, hands-on workshops, and virtual reality modules, can strengthen competency and bridge the skill deficit. Furthermore, establishing regional forensic imaging centres, developing national guidelines, and fostering inter-institutional collaborations can streamline quality assurance and enhance evidentiary value in courts. Investment in tele-forensics, digital archiving, and continuous professional development will support the creation of a skilled workforce capable of meeting evolving investigative challenges.</div><div>In conclusion, forensic radiology and imaging hold transformative potential for medicolegal investigations, but their optimal impact depends on systematic education, standardized training, and sustained capacity building. Strengthening these domains will enable efficient, accurate, and scientifically robust forensic outcomes, ultimately contributing to improved justice delivery.</div></div><div>Forensic radiology and imaging have emerged as indispensable components of modern medicolegal investigations, offering non-invasive, rapid, and highly accurate tools for documenting injuries, identifying remains, and reconstructing events surrounding death. The integration of modalities such as digital radiography, postmortem computed tomography (PMCT), magnetic resonance imaging (MRI), ultraso","PeriodicalId":40763,"journal":{"name":"Forensic Imaging","volume":"45 ","pages":"Article 200742"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147951981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postmortem CT Angiography for Diagnosis of Spontaneous Common Carotid Artery Dissection: An Autopsy Case","authors":"Hikaru Kuninaka , Momoka Tanabe , Noriko Ogawa , Moe Mukai , Ayako Nasu , Kazuho Maeda , Hidekazu Mochizuki , Yoshinobu Ishiwata , Keiichi Horie , Yoko Ihama","doi":"10.1016/j.fri.2026.200731","DOIUrl":"10.1016/j.fri.2026.200731","url":null,"abstract":"<div><h3>Background</h3><div>Postmortem computed tomography angiography (PMCTA) has become increasingly valuable in forensic practice for visualizing vascular rupture sites. Spontaneous common carotid artery dissection (sCCAD) is extremely rare. Knowingly, no previous reports have demonstrated its findings on PMCTA. Here, we report a case in which PMCTA was crucial in determining the cause of death in a man with right-sided sCCAD.</div></div><div>Postmortem computed tomography angiography (PMCTA) has become increasingly valuable in forensic practice for visualizing vascular rupture sites. Spontaneous common carotid artery dissection (sCCAD) is extremely rare. Knowingly, no previous reports have demonstrated its findings on PMCTA. Here, we report a case in which PMCTA was crucial in determining the cause of death in a man with right-sided sCCAD.</div><div><h3>Methods</h3><div>A man in his 90s experienced immediate lost consciousness and neck swelling following bathing and was confirmed dead upon hospital arrival owing to cardiopulmonary arrest, with intubation impossible. The patient had no history of neck surgery. Non-contrast CT performed three days postmortem revealed a right-dominant cervical hematoma without airway obstruction. PMCTA was performed during autopsy to identify the bleeding source. After thoracotomy and heart removal, catheters were inserted into the brachiocephalic and left common carotid arteries via the aorta. Gastrografin, a water-soluble contrast agent, was manually injected, followed by helical CT from the head to the upper chest.</div></div><div>A man in his 90s experienced immediate lost consciousness and neck swelling following bathing and was confirmed dead upon hospital arrival owing to cardiopulmonary arrest, with intubation impossible. The patient had no history of neck surgery. Non-contrast CT performed three days postmortem revealed a right-dominant cervical hematoma without airway obstruction. PMCTA was performed during autopsy to identify the bleeding source. After thoracotomy and heart removal, catheters were inserted into the brachiocephalic and left common carotid arteries via the aorta. Gastrografin, a water-soluble contrast agent, was manually injected, followed by helical CT from the head to the upper chest.</div><div><h3>Results</h3><div>PMCTA demonstrated contrast extravasation from the right common carotid artery and vascular compression caused by a hematoma. Autopsy revealed a circumferential hematoma, predominantly on the right anterior neck. The right common carotid artery showed an adventitial rupture 1.5 cm below the bifurcation and an intimal rupture 1.8 cm below it, with a 1.8 cm dissection between them. Histopathology confirmed adventitial disruption and thinning of the tunica media at the dissection site. The cause of death was hematoma formation due to right-sided sCCAD.</div></div><div>PMCTA demonstrated contrast extravasation from the right common carotid artery and vascular compression cause","PeriodicalId":40763,"journal":{"name":"Forensic Imaging","volume":"45 ","pages":"Article 200731"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147951093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}