Virtopsy

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Virtopsy is a virtual alternative to a traditional autopsy, conducted with scanning and imaging technology. The name is a portmanteau of "virtual" and "autopsy" and is a trademark registered to Richard Dirnhofer, the former head of the Institute of Forensic Medicine of the University of Bern, Switzerland. [1] [2]

Contents

Dirnhofer has proposed virtopsy as a partial or complete replacement for traditional autopsy, [3] and he has asserted that virtopsy fully satisfies the requirement that medical forensic findings provide “a complete and true picture of the object examined”.[ This quote needs a citation ] Furthermore, virtopsy is said to achieve the objective “that the pathologist’s report should ‘photograph’ with words so that the reader is able to follow his thoughts visually”.[ This quote needs a citation ]

Concept

Virtopsy employs imaging methods that are also used in clinical medicine such as computed tomography (CT) scans and magnetic resonance imaging (MRI). [4] Also, 3D body surface scanning is used to integrate body surface documentation with 3D scene or tool scans. The choice of methods is further supplemented with 3D imaging-guided biopsy systems [5] and post-mortem angiography. [6]

CT is well suited to show foreign objects, bone and air or gas distribution throughout the body, whereas MRI sequences are strong in detailing organ and soft tissue findings. A comprehensive analysis of both surface and deep tissue findings may require fusion of CT, MRI and 3D surface data. [7]

Resulting data can be archived and reproduced without loss, [8] analysed elsewhere, or distributed to specialists for technically demanding analysis.

Because traditional autopsies can produce both different and additional findings compared to virtopsies, virtopsy is not a generally accepted method to entirely replace autopsies. [9] In fact, the first scientific study detailing the results of comparing postmortem CT scanning with conventional autopsies concluded that single methods were not as useful as the combination of scanning and autopsy were. [10]

Terms

The term “Virtobot” is a trademark also registered to Prof. R. Dirnhofer. It describes a multi-functional robotic system. [5]

The "Virtangio" machine is a device that is trademarked to Prof. R. Dirnhofer [11] and manufactured by Fumedica . [12]

Operative aspects

With Prof. Michael Thali as operative head of the group, the virtopsy research team has operated out of the Institute of Forensic Medicine at the University of Zurich, Switzerland since early 2011. [13]

Examination of death

The idea to conduct virtual autopsy is not new. In 2003, the British Museum contacted the Institute of Forensic Medicine for their help performing a virtopsy on a 3000-year-old mummy named Nesperennub, as an autopsy could not be done without compromising the body. [14] While manner of death, [4] cause of death, [4] time of death, [15] [16] identification of deceased and a range of practical and reconstructive applications are obviously related to medicolegal investigation of death, virtopsy methods were ground breaking in that they have established a new high-tech toolbox into both research and practice morphological investigation aspects of modern forensic pathology.

Since virtopsy is non-invasive, it can be less traumatic for surviving family members and may not violate religious taboos against violating bodily integrity. [17]

Examination of the living

Non-invasive imaging is also conducted in living or surviving subjects, but as that has been the main clinical application of CT and MR imaging to begin with, their use in medicolegal investigation of the living is not as ground breaking as using them for investigation of death. Nevertheless, a number of applications that may be regarded as specific for medicolegal imaging applications in the living have found attraction for virtopsy-derived methods:

Technology

The technology currently used for conducting a “virtual autopsy” comprises

Virtopsy objectives

The virtopsy idea was generated to yield results along a comprehensive number of performance indicators:

Advantages

This method offers the following advantages:

Disadvantages

Best practice

The National Research Council in the USA, as part of its proposals for reforms in the forensic sciences, has proposed virtopsy as “Best Practice” for the gathering of forensic evidence. [21]

In addition, the International Society of Forensic Radiology and Imaging was founded in 2012 with the aim of enabling a continuous exchange of research results among its members and developing quality standards for the techniques employed.[ citation needed ]

A Technical Working Group Forensic Imaging Methods was founded in 2005 by Michael Thali and Richard Dirnhofer. It aims to promote an increasingly internationally standardised approach.[ citation needed ]

Furthermore, a Technical Working Group Postmortem Angiography Methods was founded in 2012 to promote best practice. Under the direction of the University Hospital of Lausanne and comprising nine European institutes of forensic medicine, it is developing reliable, standardized methods and guidelines for conducting and assessing postmortem angiographic examinations.[ citation needed ]

Virtopsy project leading house

Institutes contributing to the Virtopsy project

Institutes, districts or countries conducting post-mortem scanning

Films

Books and journals

Related Research Articles

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<span class="mw-page-title-main">CT scan</span> Medical imaging procedure using X-rays to produce cross-sectional images

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<span class="mw-page-title-main">Radiology</span> Branch of medicine specialising in medical imaging

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References

  1. ↑ "VIRTOPSY - wirtschaft.ch - trademarks - Universität Bern Institut für Rechtsmedizin (IRM) Prof. Dr. R. Dirnhofer, Direktor Bern - Trademark no. P-491277 - Application no. 04728/2001". wirtschaft.ch. Retrieved 2013-08-28.
  2. ↑ "Home". virtopsy.com. Retrieved 4 September 2024.
  3. ↑ Dirnhofer, Richard (2010). Virtopsy - Obduktion neu in Bildern: gerichtsmedizinische Vorstellung und prozessrechtliche Diskussion einer neuen wissenschaftlichen Autopsiemethode[Virtopsy - Autopsy in Pictures: Forensic presentation and procedural discussion of a new scientific autopsy method] (in German). Manz. ISBN   978-3-214-10191-6.[ page needed ]
  4. 1 2 3 4 Thali, Mj; Yen, K; Schweitzer, W; Vock, P; Boesch, C; Ozdoba, C; Schroth, G; Ith, M; Sonnenschein, M; Doernhoefer, T; Scheurer, E; Plattner, T; Dirnhofer, R (March 2003). "Virtopsy, a New Imaging Horizon in Forensic Pathology: Virtual Autopsy by Postmortem Multislice Computed Tomography (MSCT) and Magnetic Resonance Imaging (MRI)—a Feasibility Study". Journal of Forensic Sciences. 48 (2): 386–403. doi:10.1520/JFS2002166. PMID   12665000.
  5. 1 2 3 4 Ebert, Lars Christian; Ptacek, Wolfgang; Naether, Silvio; Fürst, Martin; Ross, Steffen; Buck, Ursula; Weber, Stefan; Thali, Michael (March 2010). "Virtobot—a multi-functional robotic system for 3D surface scanning and automatic post mortem biopsy". The International Journal of Medical Robotics and Computer Assisted Surgery. 6 (1): 18–27. doi:10.1002/rcs.285. PMID   19806611.
  6. 1 2 Grabherr, Silke; Djonov, Valentin; Friess, Armin; Thali, Michael J.; Ranner, Gerhard; Vock, Peter; Dirnhofer, Richard (November 2006). "Postmortem Angiography After Vascular Perfusion with Diesel Oil and a Lipophilic Contrast Agent". American Journal of Roentgenology. 187 (5): W515–W523. doi:10.2214/AJR.05.1394. PMID   17056884.
  7. ↑ Thali, Mj; Braun, M; Buck, U; Aghayev, E; Jackowski, C; Vock, P; Sonnenschein, M; Dirnhofer, R (March 2005). "VIRTOPSY—Scientific Documentation, Reconstruction and Animation in Forensic: Individual and Real 3D Data Based Geo-Metric Approach Including Optical Body/Object Surface and Radiological CT/MRI Scanning". Journal of Forensic and Sciences. 50 (2): 428–442. doi:10.1520/JFS2004290. PMID   15813556.
  8. ↑ Aghayev, Emin; Staub, Lukas; Dirnhofer, Richard; Ambrose, Tony; Jackowski, Christian; Yen, Kathrin; Bolliger, Stephan; Christe, Andreas; Roeder, Christoph; Aebi, Max; Thali, Michael J. (April 2008). "Virtopsy – The concept of a centralized database in forensic medicine for analysis and comparison of radiological and autopsy data". Journal of Forensic and Legal Medicine. 15 (3): 135–140. doi:10.1016/j.jflm.2007.07.005. PMID   18313007.
  9. 1 2 O'Donnell, C.; Woodford, N. (November 2008). "Post-mortem radiology—a new sub-speciality?". Clinical Radiology. 63 (11): 1189–1194. doi:10.1016/j.crad.2008.05.008. PMID   18929036.
  10. ↑ Donchin, Yoel; Rivkind, Avraham I.; Bar-Ziv, Jacob; Hiss, Jehuda; Almog, Joseph; Drescher, Michael (October 1994). "Utility of postmortem computed tomography in trauma victims". The Journal of Trauma: Injury, Infection, and Critical Care. 37 (4): 552–556. doi:10.1097/00005373-199410000-00006. PMID   7932884.
  11. ↑ "Virtangio - wirtschaft.ch - trademarks - Forim-X AG c/o Prof. Dr. Richard Dirnhofer Bern - Trademark no. 602006 - Application no. 51685/2010". wirtschaft.ch. Retrieved 2013-08-28.
  12. ↑ "Folders - postmortem-angio". Postmortem-angio.ch. Retrieved 2013-08-28.
  13. ↑ "Gestochen scharfe Diagnosen: Der neue Direktor des Instituts für Rechtsmedizin setzt auf digitale Technik als Ergänzung zum Skalpell - Übersicht Nachrichten". Neue Zürcher Zeitung. NZZ. 28 August 2013. Retrieved 2013-08-28.
  14. ↑ "Bringing ideas to life: Making virtual autopsy a reality - The Edge Malaysia". Infovalley.net.my. 2010-06-07. Retrieved 2013-08-28.
  15. ↑ Ith, Michael; Bigler, Peter; Scheurer, Eva; Kreis, Roland; Hofmann, Lucie; Dirnhofer, Richard; Boesch, Chris (November 2002). "Observation and identification of metabolites emerging during postmortem decomposition of brain tissue by means of in situ 1 H-magnetic resonance spectroscopy". Magnetic Resonance in Medicine. 48 (5): 915–920. doi: 10.1002/mrm.10294 .
  16. ↑ Scheurer, Eva; Ith, Michael; Dietrich, Daniel; Kreis, Roland; Hüsler, Jürg; Dirnhofer, Richard; Boesch, Chris (May 2005). "Statistical evaluation of time-dependent metabolite concentrations: estimation of post-mortem intervals based onin situ1H-MRS of the brain". NMR in Biomedicine. 18 (3): 163–172. doi:10.1002/nbm.934. PMID   15578674.
  17. ↑ "Digital autopsy: Replacing scalpels with scanners". Gizmag.com. 27 August 2013. Retrieved 2013-08-28.
  18. ↑ W. Brueschweiler and M. Braun and R. Dirnhofer and M.J. Thali (2003). "Analysis of patterned injuries and injury-causing instruments with forensic 3D/CAD supported photogrammetry (FPHG): an instruction manual for the documentation process". Forensic Science International. 132 (2): 130–138. doi:10.1016/s0379-0738(03)00006-9. PMID   12711193.
  19. ↑ Yen, Kathrin Thali, Michael J and Aghayev, Emin and Jackowski, Christian and Schweitzer, Wolf and Boesch, Chris and Vock, Peter and Dirnhofer, Richard and Sonnenschein, Martin (2012). "Strangulation signs: Initial correlation of MRI, MSCT, and forensic neck findings". Journal of Magnetic Resonance Imaging. 22 (4): 501–10. doi: 10.1002/jmri.20396 . PMID   16142698.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  20. ↑ Flach PM, Ross SG, Ampanozi G, Ebert L, Germerott T, Hatch GM, Thali MJ, Patak MA (2005). ""Drug mules" as a radiological challenge: sensitivity and specificity in identifying internal cocaine in body packers, body pushers and body stuffers by computed tomography, plain radiography and Lodox". Eur J Radiol. 81 (4): 501–510. doi:10.1016/j.ejrad.2011.11.025. PMID   22178312.
  21. ↑ Committee on Identifying the Needs of the Forensic Sciences Community, National Research Council (2009). Strengthening Forensic Science in the United States: A Path Forward. National Academies Press. ISBN   978-0-309-13135-3.[ page needed ]
  22. ↑ Raj K, Dr Karthi Vignesh; Yadav, Dr Abhishek; Manivel, S.; Khan, Dr Anam; Gupta, Dr Sudhir K (June 2022). "Corpus Alienum captured in Post Mortem Computed Tomography, death due to an accidental ingestion of 'Momos (Dumpling)'". Forensic Imaging. 29: 200503. doi:10.1016/j.fri.2022.200503.
  23. ↑ Deepali Jena (Oct 17, 2022). "Virtual Autopsy | Giving dignity to the Dead". India Today. Retrieved 2023-04-02.
  24. ↑ Oyake, Yuji; Aoki, Takeshi; Shiotani, Seiji; Kohno, Mototsugu; Ohashi, Noriyoshi; Akutsu, Hiroyoshi; Yamazaki, Kentaro (22 September 2006). "Postmortem computed tomography for detecting causes of sudden death in infants and children: retrospective review of cases". Radiation Medicine. 24 (7): 493–502. doi:10.1007/s11604-006-0061-y. PMID   17058143.
  25. ↑ "Institute of Forensic Medicine". Sdu.dk. 2012-09-24. Retrieved 2013-08-28.
  26. ↑ "Visible Proofs: Forensic Views of the Body: Galleries: Media: Medical examiners at work". Nlm.nih.gov. 2010-12-14. Retrieved 2013-08-28.
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