Advanced medical imaging for forensic triage: a study of the added value of combining PMCT and PMMR of the head

Ingrid Haest*, Paul Hofman, J.P.J. Herbergs, Hans Nelen, Marko Jelicic

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: Approximately 170,000 individuals die annually in the Netherlands. Dutch law mandates examinations to distinguish between natural death and unnatural death. Traditionally, this involves external examinations and an inspection of medical records; however, medical imaging has emerged as a tool for investigating deaths. Objective: The objective of the study was to investigate whether the addition of post-mortem magnetic resonance (PMMR) to post-mortem computed tomography (PMCT) could assist in the categorisation of deaths as natural or unnatural and augment confidence in those classifications. Methods: In this retrospective study, the PMCT and PMMR head images of 50 individuals were evaluated by a forensic radiologist. The impact of PMMR on lesion detection, the cause of death (COD), the differentiation between natural death and unnatural death, and confidence levels were assessed. All available case information was used as the reference standard. Results: The addition of the PMMR led to a statistically significant increase in lesion detection (48%), changes in the classification of COD in four cases, and an increased level of confidence in the classification. Differentiation between natural death and unnatural death reversed in 10 cases, altering the overall manner of death (MOD) classification in 20% of cases. Conclusion: When PMCT indicates a natural or unnatural death, PMMR is unnecessary. PMMR of the head is recommended in situations in which the MOD is uncertain based on PMCT findings. The ultimate determination of a natural death and unnatural death should always take into account the results of external examinations, police investigations, and other available information.

Original languageEnglish
Article number200598
Number of pages12
JournalForensic imaging
Volume37
DOIs
Publication statusPublished - Jun 2024

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