Recent findings at the Radiological Society of North America (RSNA) show that "Virtual Autopsies" may replace traditional autopsies in certain accidental death cases in the U.S. This technology is not new, but it hasn't been used for autopsies in the United States yet. CT scans give a nice detailed 3-D image that some doctor's believe will replace the need for the traditional autopsy that involves invasive cutting. CT image shows multiple skull and facial bone fractures resulting from fatal blunt trauma to the head in a pedestrian struck by a car. Arrows point to some of the fractures. Computed Tomography (CT) may soon provide radiologists a new tool for conducting an autopsy that is non-invasive, cheaper than a conventional autopsy, and also much quicker. This could save a lot of money in the U.S. on autopsies, considering every state is required to perform an autopsy on victims who die of sudden or unexplained deaths. In Maryland alone, 8,000 deaths were reported to the medical examiner in 2006 and half of them required a full autopsy. CT image depicting internal damage to the brain with diffuse cerebral injury. Blood is present in the right sylvian fissure (arrow). Air (*) has entered the skull due to the skull fractures. The cost of a conventional autopsy varies, but I was able to dig up some ballpark figures, from the Northwest Autopsy Services, that showed the cost somewhere in the $1,700-$3,500 range (depending upon the type of autopsy). Using these figures, the cost of autopsies in Maryland in 2006 were approximately $10 million. Many autopsies are performed free of charge by medical students and other doctors, so this number may not be completely accurate, but it gives a general idea of the cost. CT Scanner The cost of a full-body CT scan varies by location, but Mindfully.org says that it usually costs between $800-$1,500. These figures are not specifically for autopsy purposes, but they give a general idea of the cost-comparison between conventional and virtual autopsies.
The cost of a modern midrange CT machine has dropped in the past 10 years, and according to USA Today , they now cost about $500,000 (as of 2004). Although the cost of these machines is still high, experts believe that they will pay for themselves over time by conducting virtual autopsies rather than conventional ones. CT image shows a severe displaced fracture through the third upper thoracic spine (arrow) in a decedent who suffered multiple injuries in a motor vehicle accident. Aside from the cost benefit of virtual autopsies, there are other benefits as well. Virtual autopsies are non-invasive which means they will not disturb or destroy potential forensic evidence on the body. Another big advantage is that some religions prohibit conventional autopsies because of their beliefs, and virtual autopsies are more acceptable by these same religions because of the non-invasive aspect of the procedure. Lastly, the virtual autopsy with a CT machine only takes about 30 minutes to complete, where as the conventional autopsy takes several hours.
A team of radiologists from the University of Maryland, headed by Barry Daly M.D., has been conducting all of this research and recently has reported their findings to the RSNA at a conference in Chicago. Their study consisted of 20 autopsies conducted using whole-body multi-detector CT. 14 of these cases were victims of blunt trauma, and the other 6 were stab victims. In all but 1 of the 20 cases, the CT machine was able to accurately identify the cause of death. "Although these preliminary results are promising, more research is needed to show that CT could be widely used within the U.S. medical examiners system," Dr. Daly said.
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