Forensic Imaging最新文献

{"title":"The Future of Forensic Workfow - from Virtopsy to Virtoxy and AI-opsy!","authors":"Michael Thali, Virtopsy Team","doi":"10.1016/j.fri.2026.200749","DOIUrl":"10.1016/j.fri.2026.200749","url":null,"abstract":"<div><div>The evolution of forensic imaging—from its early experimental stages to its current status as a globally recognised scientific discipline—reflects a remarkable synergy of technological innovation and interdisciplinary collaboration. A significant milestone in the development of cross-sectional imaging technologies such as spiral CT and multislice CT came in the late 1990s with the foundation of the Virtopsy project at University Bern. What began in a modest construction barrack soon laid the foundations for a new era in forensic medicine, characterised by the integration of 3D surface scanning, CT, MRI, and postmortem angiography. The Virtopsy approach rapidly evolved from groundbreaking research into practical forensic application. The relocation of the Virtopsy group to Zurich in 2011—made possible through the generous support of the Emma Louise Kessler Foundation—enabled the development of the Zurich Approach. This included 3D and VR/AR-based digital documentation and analysis, imaging as a triage tool prior to autopsy, postmortem ventilation techniques, and the early adoption of machine learning in forensic workflows.</div><div>The founding of the International Society of Forensic Radiology and Imaging (ISFRI) well as the launch of the dedicated journal Forensic Imaging, helped establish forensic imaging as a distinct and independent field. Global education programmes such as CAS Virtopsy and the integration of imaging into forensic practice in Switzerland and beyond transformed early visions into sustained professional reality. Today, in Zurich alone, over 350 cases per year (means 1/3 of the total case load) are resolved through CT triage imaging alone, demonstrating how forensic imaging has become standard practice. Forensic imaging is no longer a promising innovation—it is a mature, evidence-based, and legally sound discipline set to shape the future of forensic science. Forensic imaging is evolving from classical Virtopsy to an enhanced approach that integrates rapid toxicology (Virtoxy), enabling intoxication cases to be detected within hours alongside imaging. The next step is the “AI-opsy”, which unifies Virtopsy (imaging) and Virtoxy (rapid toxicology). Its aim is for AI to rapidly pre-read and synthesize surface findings, internal imaging results, and toxicology data via modern AI-assisted software, providing structured preliminary reports for expert review. This technology enables efficient, effective, and cost-conscious workflows even at high case volumes.</div></div><div>The evolution of forensic imaging—from its early experimental stages to its current status as a globally recognised scientific discipline—reflects a remarkable synergy of technological innovation and interdisciplinary collaboration. A significant milestone in the development of cross-sectional imaging technologies such as spiral CT and multislice CT came in the late 1990s with the foundation of the Virtopsy project at University Bern. What began in a mo","PeriodicalId":40763,"journal":{"name":"Forensic Imaging","volume":"45 ","pages":"Article 200749"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147951864","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":"How PMCT Unmasked Silent Coronary Disease in Sudden Cardiac Death: Indonesia's Experience","authors":"Yudy , Chandra Haryadi","doi":"10.1016/j.fri.2026.200744","DOIUrl":"10.1016/j.fri.2026.200744","url":null,"abstract":"<div><h3>Background</h3><div>Conventional autopsy is widely regarded as the gold standard in forensic investigations for determining the cause of death. In recent years, postmortem computed tomography (PMCT) has emerged as a non-invasive imaging modality with considerable potential in forensic diagnostics. Studies indicate that combining PMCT with conventional autopsy improves diagnostic accuracy and facilitates the detection of critical findings compared with autopsy alone. This case report evaluates the comparative diagnostic outcomes of PMCT and conventional autopsy in a forensic case of sudden cardiac death.</div><div>Case Presentation: A 60-year-old male with a history of hypertension was discovered unconscious in a restaurant restroom. Comprehensive postmortem examinations, including postmortem computed tomography (PMCT), conventional autopsy, and histopathological analysis, were performed. PMCT revealed coronary artery disease with calcified plaques in the right coronary artery (RCA), findings that closely corresponded with autopsy and histopathological results. Both autopsy and histological examination confirmed acute myocardial infarction as the cause of death. This case demonstrates a strong correlation between PMCT findings and conventional forensic methods.</div></div><div>Conventional autopsy is widely regarded as the gold standard in forensic investigations for determining the cause of death. In recent years, postmortem computed tomography (PMCT) has emerged as a non-invasive imaging modality with considerable potential in forensic diagnostics. Studies indicate that combining PMCT with conventional autopsy improves diagnostic accuracy and facilitates the detection of critical findings compared with autopsy alone. This case report evaluates the comparative diagnostic outcomes of PMCT and conventional autopsy in a forensic case of sudden cardiac death.</div><div>Case Presentation: A 60-year-old male with a history of hypertension was discovered unconscious in a restaurant restroom. Comprehensive postmortem examinations, including postmortem computed tomography (PMCT), conventional autopsy, and histopathological analysis, were performed. PMCT revealed coronary artery disease with calcified plaques in the right coronary artery (RCA), findings that closely corresponded with autopsy and histopathological results. Both autopsy and histological examination confirmed acute myocardial infarction as the cause of death. This case demonstrates a strong correlation between PMCT findings and conventional forensic methods.</div><div><h3>Discussion</h3><div>The combination of post-mortem computed tomography (PMCT) and conventional autopsy yielded comprehensive diagnostic information. PMCT offered enhanced visualization of coronary artery calcification relative to conventional autopsy. While PMCT enabled reliable non-invasive detection of major pathological features, including vascular abnormalities, definitive diagnosis still required autopsy and hi","PeriodicalId":40763,"journal":{"name":"Forensic Imaging","volume":"45 ","pages":"Article 200744"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147951966","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":"Iron concentration and longitudinal relaxation rate (R1) in MRI of the post-mortem human brain","authors":"Anna Capponi , Nikolaus Krebs , Walter Goessler , Eva Scheurer , Kathrin Yen , Stefan Ropele , Alessandra Bertoldo , Christian Langkammer","doi":"10.1016/j.fri.2026.200753","DOIUrl":"10.1016/j.fri.2026.200753","url":null,"abstract":"<div><h3>Background</h3><div>Iron accumulation in the brain varies substantially across regions and can influence MR relaxation properties. In forensic imaging, post-mortem MRI is used to assess tissue integrity, support neuropathological evaluations, and complement death investigations. However, the sensitivity of the longitudinal relaxation rate R1 (1/T1) to iron content in post-mortem tissue remains unclear. This study examines the relationship between regional iron concentration and R1 in unfixed human brains.</div></div><div>Iron accumulation in the brain varies substantially across regions and can influence MR relaxation properties. In forensic imaging, post-mortem MRI is used to assess tissue integrity, support neuropathological evaluations, and complement death investigations. However, the sensitivity of the longitudinal relaxation rate R1 (1/T1) to iron content in post-mortem tissue remains unclear. This study examines the relationship between regional iron concentration and R1 in unfixed human brains.</div><div><h3>Methods</h3><div>Thirteen post-mortem human brains (mean age = 65.9 ± 10.2 years) were scanned in situ at 3 T using a 3D inversion-recovery turbo spin echo sequence. R1 values were estimated from multi-TI fitting. Following MRI, brains were extracted and tissue samples were collected from basal ganglia, cortical regions, and white matter—areas commonly examined in forensic neuropathology. Iron concentration (mg/kg wet tissue) was quantified using inductively coupled plasma mass spectrometry (ICP-MS). Statistical analyses included region-wise and subject-level linear regressions, as well as mixed-effects models to incorporate inter-individual variability.</div></div><div>Thirteen post-mortem human brains (mean age = 65.9 ± 10.2 years) were scanned in situ at 3 T using a 3D inversion-recovery turbo spin echo sequence. R1 values were estimated from multi-TI fitting. Following MRI, brains were extracted and tissue samples were collected from basal ganglia, cortical regions, and white matter—areas commonly examined in forensic neuropathology. Iron concentration (mg/kg wet tissue) was quantified using inductively coupled plasma mass spectrometry (ICP-MS). Statistical analyses included region-wise and subject-level linear regressions, as well as mixed-effects models to incorporate inter-individual variability.</div><div><h3>Results</h3><div>Iron concentration was highest in the basal ganglia, followed by white matter and cortex. Significant positive associations between iron concentration and R1 were observed in the basal ganglia and cortex, while white matter showed no significant relationship. Mixed-effects models confirmed these associations but indicated that inter-subject variability accounted for most of the explained variance.</div></div><div>Iron concentration was highest in the basal ganglia, followed by white matter and cortex. Significant positive associations between iron concentration and R1 were observed in the basal g","PeriodicalId":40763,"journal":{"name":"Forensic Imaging","volume":"45 ","pages":"Article 200753"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950821","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 use of bone mineral density in forensic medicine: A systematic review","authors":"Dennis Vinther, Kasper Hansen, Troels Græsholt-Knudsen, Lene Warner Thorup Boel, Lars Uhrenholt","doi":"10.1016/j.fri.2026.200777","DOIUrl":"10.1016/j.fri.2026.200777","url":null,"abstract":"<div><h3>Background</h3><div>There is a growing interest in the role of BMD in forensic settings. For example, a reduced bone quality, i.e. low BMD, could influence the interpretation of a particular trauma. This could ultimately impact the determination of the manner of death. The aim of this study is to review the current literature to clarify when and how BMD estimation has been applied to forensic cases.</div></div><div>There is a growing interest in the role of BMD in forensic settings. For example, a reduced bone quality, i.e. low BMD, could influence the interpretation of a particular trauma. This could ultimately impact the determination of the manner of death. The aim of this study is to review the current literature to clarify when and how BMD estimation has been applied to forensic cases.</div><div><h3>Materials and Methods</h3><div>A systematic review of the existing literature (PubMed) was conducted using the Preferred Reporting Items for Systematic Reviews (PRISMA) checklist. The search string included terms related to BMD estimation in a forensic population.</div></div><div>A systematic review of the existing literature (PubMed) was conducted using the Preferred Reporting Items for Systematic Reviews (PRISMA) checklist. The search string included terms related to BMD estimation in a forensic population.</div><div><h3>Results</h3><div>The preliminary results include a total of 26 studies in the period 2005 to 2024. All studies used imaging modalities for BMD-estimation. A total of 13 studies used DEXA, 11 used CT, and 3 used micro-CT. Following were some of the findings:</div><div>BMD-estimations have predominantly been used for age and sex estimations in cadavers and skeletal remains.</div><div>A correlation between BMD and body weight have been shown in skeletal remains. Reduced BMD had been observed in subjects with chronic alcohol abuse.</div><div>A strong correlation between BMD and minimum diameter after gunshots to the cranium.</div><div>A case-study examined that BMD could be helpful to identify malnutrition and to understand fracture patterns in specific cases.</div><div>An osteoarchaeological study found a relationship between BMD, stature and socioeconomic status in a medieval population.</div><div>Micro-CT has been used for age estimations in adult cadavers and in infant skeletal remains. Furthermore, micro-CT has been used to investigate the shape development of pars basilaris in early postnatal life, using skeletal remains.</div></div><div>The preliminary results include a total of 26 studies in the period 2005 to 2024. All studies used imaging modalities for BMD-estimation. A total of 13 studies used DEXA, 11 used CT, and 3 used micro-CT. Following were some of the findings:</div><div>BMD-estimations have predominantly been used for age and sex estimations in cadavers and skeletal remains.</div><div>A correlation between BMD and body weight have been shown in skeletal remains. Reduced BMD had been observed in subjects","PeriodicalId":40763,"journal":{"name":"Forensic Imaging","volume":"45 ","pages":"Article 200777"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950862","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":"Peer Review Saves Lives (After Death): Ensuring Quality in PMCT Cause-of-Death Reporting","authors":"Fatima Ahmad , Nina Breunung-Joshi , Mohammad Ali Shah , Reena Tanna , Natasha Davendralingam , Salman Rahimi , Milda Dedelaite","doi":"10.1016/j.fri.2026.200761","DOIUrl":"10.1016/j.fri.2026.200761","url":null,"abstract":"<div><h3>Problem</h3><div>Post-mortem CT (PMCT) is increasingly adopted as a first-line alternative to invasive autopsy. However, interpretation is challenging: artefacts from decomposition, prior interventions, or storage can mimic pathology, and subtle conditions such as pulmonary embolism may be overlooked. Without quality assurance mechanisms, there is a risk of misattribution of cause of death (COD), undermining confidence in PMCT as a reliable diagnostic tool.</div></div><div>Post-mortem CT (PMCT) is increasingly adopted as a first-line alternative to invasive autopsy. However, interpretation is challenging: artefacts from decomposition, prior interventions, or storage can mimic pathology, and subtle conditions such as pulmonary embolism may be overlooked. Without quality assurance mechanisms, there is a risk of misattribution of cause of death (COD), undermining confidence in PMCT as a reliable diagnostic tool.</div><div><h3>Innovation</h3><div>We embedded a structured peer review process within a coronial PMCT service handling 452 consecutive cases over 15 months. All reports flagged with diagnostic uncertainty, complex findings, or equivocal imaging appearances were subject to blinded secondary review by an experienced forensic radiologist. Discrepancies between original and peer-reviewed reports were documented, and where available, findings were correlated with autopsy results.</div></div><div>We embedded a structured peer review process within a coronial PMCT service handling 452 consecutive cases over 15 months. All reports flagged with diagnostic uncertainty, complex findings, or equivocal imaging appearances were subject to blinded secondary review by an experienced forensic radiologist. Discrepancies between original and peer-reviewed reports were documented, and where available, findings were correlated with autopsy results.</div><div><h3>Impact</h3><div>Peer review led to reclassification of COD in a subset of cases, most notably:</div><div>Bowel perforation vs post-mortem gas: additional review upgraded suspicion of true duodenal ulcer perforation, later confirmed at autopsy.</div><div>Pulmonary embolism: missed emboli in several cases were identified on secondary review.</div><div>Artefacts (e.g. thawing, wadding, putrefaction) were correctly re-classified, preventing false attribution.</div><div>Overall, peer review reduced “no correlation” rates between PMCT and autopsy by ensuring subtle but critical findings were captured and artefacts were not over-called.</div></div><div>Peer review led to reclassification of COD in a subset of cases, most notably:</div><div>Bowel perforation vs post-mortem gas: additional review upgraded suspicion of true duodenal ulcer perforation, later confirmed at autopsy.</div><div>Pulmonary embolism: missed emboli in several cases were identified on secondary review.</div><div>Artefacts (e.g. thawing, wadding, putrefaction) were correctly re-classified, preventing false attribution.</div><div>Over","PeriodicalId":40763,"journal":{"name":"Forensic Imaging","volume":"45 ","pages":"Article 200761"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147951467","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":"Radiologic imaging properties of various gemstones","authors":"Angi Christensen , Ian Saginor , Mary Mosh , Thomas Ruder , Jodi Webb","doi":"10.1016/j.fri.2026.200754","DOIUrl":"10.1016/j.fri.2026.200754","url":null,"abstract":"<div><div>Differences in the radiologic appearance of diamonds compared to other gemstones such as cubic zirconia have been noted, but the radiological imaging properties of many gemstones have never been systematically examined. The radiologic appearance of these and other gemstones could have potential relevance to their detection or concealment in forensic contexts such as theft or smuggling. In this study, digital radiographs (DR) and computed tomography scans (CT) were taken of twenty-five gemstones with standardized acquisition parameters using an industrial micro-CT scanner. Radiodensity of each gemstone was assessed by calculating greyscale values (GV) from DR images using the open-source image processing program ImageJ. In addition, a recently deceased guinea pig was imaged along with a diamond and cubic zirconia affixed to its thorax to simulate a gemstone smuggling scenario. Results show that gemstones with higher densities appear more radiodense (R2 = 0.66). Diamonds were found to be the least radiodense, while many common diamond simulants such as cubic zirconia were found to be the most radiodense. The guinea pig imaging showed that, especially when superimposed with anatomical structures, diamonds would be very difficult to detect using radiology technologies such as those used in transportation screening. CT imaging, however, can improve differentiation between diamonds and surrounding tissues, in part because of the additional manipulation and adjustments that allow selective visualization of certain density values. This suggests that CT may be useful for detecting diamonds in forensic or investigative contexts and may also have applications in postmortem examinations.</div></div><div>Differences in the radiologic appearance of diamonds compared to other gemstones such as cubic zirconia have been noted, but the radiological imaging properties of many gemstones have never been systematically examined. The radiologic appearance of these and other gemstones could have potential relevance to their detection or concealment in forensic contexts such as theft or smuggling. In this study, digital radiographs (DR) and computed tomography scans (CT) were taken of twenty-five gemstones with standardized acquisition parameters using an industrial micro-CT scanner. Radiodensity of each gemstone was assessed by calculating greyscale values (GV) from DR images using the open-source image processing program ImageJ. In addition, a recently deceased guinea pig was imaged along with a diamond and cubic zirconia affixed to its thorax to simulate a gemstone smuggling scenario. Results show that gemstones with higher densities appear more radiodense (R2 = 0.66). Diamonds were found to be the least radiodense, while many common diamond simulants such as cubic zirconia were found to be the most radiodense. The guinea pig imaging showed that, especially when superimposed with anatomical structures, diamonds would be very difficult to detect using radiolo","PeriodicalId":40763,"journal":{"name":"Forensic Imaging","volume":"45 ","pages":"Article 200754"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147951788","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":"Study on the Use of Imaging Techniques at the Capital Death Verification Service in São Paulo City (Brazil)","authors":"Edna Iwamura , Lara De Lima , Cassio Miri Oliveira , Anna Luísa Patti , Jair Teodoro Filho , Andrea Malinverni","doi":"10.1016/j.fri.2026.200738","DOIUrl":"10.1016/j.fri.2026.200738","url":null,"abstract":"<div><h3>Introduction</h3><div>Since the discovery of X-rays and the emergence of equipment capable of acquiring detailed images of the body, such as Computed Tomography (CT) and Magnetic Resonance Imaging (MRI), these techniques have been introduced into the criminal and mortuary fields, initiating the verification of deaths through virtopsy.</div></div><div>Since the discovery of X-rays and the emergence of equipment capable of acquiring detailed images of the body, such as Computed Tomography (CT) and Magnetic Resonance Imaging (MRI), these techniques have been introduced into the criminal and mortuary fields, initiating the verification of deaths through virtopsy.</div><div><h3>Objective</h3><div>To analyze the radiological techniques used to aid in identifying the cause of death at the Serviço de Verificação de Obitos da Capital (SVOC), an international reference in the Brazilian model of natural death investigation, and at the Institute of Radiology of the Hospital das Clínicas of São Paulo, Brazil.</div></div><div>To analyze the radiological techniques used to aid in identifying the cause of death at the Serviço de Verificação de Obitos da Capital (SVOC), an international reference in the Brazilian model of natural death investigation, and at the Institute of Radiology of the Hospital das Clínicas of São Paulo, Brazil.</div><div><h3>Methodology</h3><div>Bibliographic review, and description of the main contributions and limitations found in the implementation of this technique at the SVOC, following a technical visit, highlighting the importance of radiology as a complementary alternative to conventional autopsy and evaluating the use of different imaging techniques in this process.</div></div><div>Bibliographic review, and description of the main contributions and limitations found in the implementation of this technique at the SVOC, following a technical visit, highlighting the importance of radiology as a complementary alternative to conventional autopsy and evaluating the use of different imaging techniques in this process.</div><div><h3>Results and Discussion</h3><div>The Platform for Imaging in the Autopsy Room (PISA) offers equipment such as MRI, CT, and Ultrasonography (USG). The post-mortem analysis protocol generally begins with whole-body CT and angio-CT, reserving MRI for cases with neurological findings. MRI demonstrated high resolution and contrast in soft tissues, making it excellent for natural deaths of cardiac or neurological origin, complementing CT. However, its effectiveness is limited by the cadaver's temperature, as image quality and contrast significantly decrease below 10ºC due to dehydration and tissue rigidity. CT is crucial for detecting foreign objects in non-natural deaths and hemorrhages (such as aortic dissection) in clinical autopsies. Nevertheless, artifacts generated by decomposition gases and the absence of blood circulation represent significant limitations for CT quality in cadavers.</div></div><div>Th","PeriodicalId":40763,"journal":{"name":"Forensic Imaging","volume":"45 ","pages":"Article 200738"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147951800","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":"Complementary roles of postmortem CT and MRI in forensic trauma investigations: a two-case comparison","authors":"Midiri Mauro , Puntarello Maria , Giuseppe Lo Re , Malta Ginevra , Zerbo Stefania , Argo Antonina , Albano Giuseppe Davide","doi":"10.1016/j.fri.2026.200705","DOIUrl":"10.1016/j.fri.2026.200705","url":null,"abstract":"<div><h3>Background</h3><div>Postmortem CT (PMCT) and MRI (PMMR) are increasingly central to post-mortem imaging, each offering distinct strengths. PMCT excels in identifying skeletal trauma and gas distribution, while PMMR provides superior characterization of soft tissues and organ injuries. Evaluating their combined use in real-case scenarios is essential for optimizing imaging workflows and supporting autopsy planning.</div></div><div>Postmortem CT (PMCT) and MRI (PMMR) are increasingly central to post-mortem imaging, each offering distinct strengths. PMCT excels in identifying skeletal trauma and gas distribution, while PMMR provides superior characterization of soft tissues and organ injuries. Evaluating their combined use in real-case scenarios is essential for optimizing imaging workflows and supporting autopsy planning.</div><div><h3>Methods</h3><div>Two deaths investigated with both PMCT and PMMR before autopsy were examined. Case 1 involved a sharp-force homicide with suspected multiorgan injury. Case 2 concerned a woman who fell from 7 metres, with suspected extensive skeletal trauma. For each case, PMCT and PMMR findings were compared with autopsy results and contextualized within current evidence on postmortem imaging performance.</div></div><div>Two deaths investigated with both PMCT and PMMR before autopsy were examined. Case 1 involved a sharp-force homicide with suspected multiorgan injury. Case 2 concerned a woman who fell from 7 metres, with suspected extensive skeletal trauma. For each case, PMCT and PMMR findings were compared with autopsy results and contextualized within current evidence on postmortem imaging performance.</div><div><h3>Results</h3><div>In the homicide case, PMCT identified the number and direction of stab wounds, but it was insufficient in defining organ involvement. PMMR revealed visceral lesions, intraparenchymal hemorrhages, and subtle soft-tissue tracts not appreciable on CT, refining the reconstruction of assault and guided targeted autopsy dissection. In the fall-from-height case, PMCT was essential, demonstrating multiple cranial and skeletal fractures, including complex skull-base disruptions not externally evident. This information shaped the autopsy approach. PMMR contributed minimal additional value due to the predominantly osseous nature of the injuries. Together, the cases illustrate the modality-specific advantages in the literature: PMCT as the first-line tool for high-energy skeletal trauma, and PMMR as a crucial adjunct when assessing soft tissue or viscera.</div></div><div>In the homicide case, PMCT identified the number and direction of stab wounds, but it was insufficient in defining organ involvement. PMMR revealed visceral lesions, intraparenchymal hemorrhages, and subtle soft-tissue tracts not appreciable on CT, refining the reconstruction of assault and guided targeted autopsy dissection. In the fall-from-height case, PMCT was essential, demonstrating multiple cranial and skeletal f","PeriodicalId":40763,"journal":{"name":"Forensic Imaging","volume":"45 ","pages":"Article 200705"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147951802","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":"Japan Postmortem Imaging Interpretation Guidelines 2025 Edition","authors":"Hideki Hyodoh, Yohsuke Makino, Masanori Ishida, Naoya Takahashi, Kotaro Matoba, Yoko Ihama, Eiji Oguma, Yosuke Kudo, Seiji Shiotani, Hisakazu Takatsuka, Yohei Ikebe, Kiyokadzu Ebata, Maki Ohtani, Masatoshi Kojima, Wataru Gonoi, Tomoya Kobayashi, Tsuyoshi Shirota, Yoshiaki Shinkawa, Shogo Shimbashi, Akiko Takeuchi, Maiko Yoshida","doi":"10.1016/j.fri.2026.200768","DOIUrl":"10.1016/j.fri.2026.200768","url":null,"abstract":"<div><div>In Japan, guidelines for postmortem imaging interpretation were first developed in 2015 with the aim of promoting evidence-based practice. These guidelines have since undergone revisions, with the third edition completed in 2025. Initially created in Japanese, an English translation was finalized in 2026 to broaden international accessibility.</div><div>The 2025 edition addresses 55 Clinical Questions (CQs) that frequently arise in the interpretation of postmortem imaging. Each CQ is answered based on scientifically validated evidence, and recommendation grades are presented following extensive discussions within a national committee in Japan. This process highlights the independent and systematic approach adopted domestically, distinguishing these guidelines from other international initiatives. The guidelines provide essential baseline knowledge indispensable for practitioners engaged in postmortem imaging and serve as a reference for maintaining standardized interpretation practices. Importantly, the guidelines also fulfill the knowledge requirements defined for Level 1 readers by the ISFRI Education Working Group, thereby ensuring alignment with international educational standards.</div><div>In this presentation, we will introduce selected sections of the Postmortem Imaging Interpretation Guidelines, focusing on the methodology of their development and the rationale for their recommendations. We will also illustrate how the guidelines can be practically applied in routine forensic practice through case-based examples. Furthermore, we will present their integration into structured training systems designed for postmortem image interpretation, highlighting their role in education and professional development.</div><div>These guidelines represent a comprehensive and objective tool that supports both clinical and forensic applications of postmortem imaging. By combining scientific evidence with practical usability, they contribute to improving diagnostic accuracy and standardization in forensic radiology worldwide.</div></div><div>In Japan, guidelines for postmortem imaging interpretation were first developed in 2015 with the aim of promoting evidence-based practice. These guidelines have since undergone revisions, with the third edition completed in 2025. Initially created in Japanese, an English translation was finalized in 2026 to broaden international accessibility.</div><div>The 2025 edition addresses 55 Clinical Questions (CQs) that frequently arise in the interpretation of postmortem imaging. Each CQ is answered based on scientifically validated evidence, and recommendation grades are presented following extensive discussions within a national committee in Japan. This process highlights the independent and systematic approach adopted domestically, distinguishing these guidelines from other international initiatives. The guidelines provide essential baseline knowledge indispensable for practitioners engaged in postmortem imaging a","PeriodicalId":40763,"journal":{"name":"Forensic Imaging","volume":"45 ","pages":"Article 200768"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147951971","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":"Ghosts in the Machine - Thaw, Pack, Decay: Spotting Artefacts Before They Fool You in PMCT","authors":"Mohammad Ali Shah , Natasha Davendralingam , Fatima Ahmad , Nina Breunung-Joshi , Reena Tanna , Salman Rahimi , Milda Dedelaite","doi":"10.1016/j.fri.2026.200710","DOIUrl":"10.1016/j.fri.2026.200710","url":null,"abstract":"<div><h3>Background</h3><div>Interpretation of post-mortem CT (PMCT) can be complicated by artefacts introduced through freezing, storage, and autopsy procedures. Failure to recognise these patterns risks misclassification of cause of death and unnecessary escalation to invasive autopsy.</div></div><div>Interpretation of post-mortem CT (PMCT) can be complicated by artefacts introduced through freezing, storage, and autopsy procedures. Failure to recognise these patterns risks misclassification of cause of death and unnecessary escalation to invasive autopsy.</div><div><h3>Methods</h3><div>We conducted a case-based review of PMCTs performed within a coronial service (May 2024 – July 2025) in which artefactual appearances were initially mistaken for, or raised concern about, pathology. Cases included thawing artefacts, post-autopsy packing/wadding, and decomposition changes. Radiological appearances were correlated with autopsy findings and peer review outcomes to define characteristic imaging patterns.</div></div><div>We conducted a case-based review of PMCTs performed within a coronial service (May 2024 – July 2025) in which artefactual appearances were initially mistaken for, or raised concern about, pathology. Cases included thawing artefacts, post-autopsy packing/wadding, and decomposition changes. Radiological appearances were correlated with autopsy findings and peer review outcomes to define characteristic imaging patterns.</div><div><h3>Results</h3><div>Three recurring artefact categories were identified:</div><div>Thawing – fluid layering in pleura and heart chambers, mottled parenchyma due to ice-crystal damage, mimicking haemothorax or infection.</div><div>Packing/wadding – soft-tissue density with mixed gas and fluid, filling cavities after autopsy, sometimes confused with masses or foreign bodies.</div><div>Putrefaction – diffuse gas in vessels, organs and body cavities, distinguishable from true perforation or embolism by its distribution and lack of inflammatory change.</div><div>Autopsy correlation confirmed the non-pathological nature of these findings. Peer review highlighted that artefact recognition prevented over-calling in several cases, avoiding misattributed COD certification.</div></div><div>Three recurring artefact categories were identified:</div><div>Thawing – fluid layering in pleura and heart chambers, mottled parenchyma due to ice-crystal damage, mimicking haemothorax or infection.</div><div>Packing/wadding – soft-tissue density with mixed gas and fluid, filling cavities after autopsy, sometimes confused with masses or foreign bodies.</div><div>Putrefaction – diffuse gas in vessels, organs and body cavities, distinguishable from true perforation or embolism by its distribution and lack of inflammatory change.</div><div>Autopsy correlation confirmed the non-pathological nature of these findings. Peer review highlighted that artefact recognition prevented over-calling in several cases, avoiding misattributed COD certif","PeriodicalId":40763,"journal":{"name":"Forensic Imaging","volume":"45 ","pages":"Article 200710"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147951977","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}