Imaging techniques for postmortem forensic radiology

Postmortem forensic radiology aims to acquisition, interpretation, and reporting of radiologic images for the purpose of forensic investigations, in the living as well as the deceased. Conventional radiology still remains the most common modality used in the forensic setting and the gold standard method for many forensic challenges. X-rays are commonly used for visualization and localization of foreign bodies, and for body identification and identities confirmation. Computed tomography (PMCT) is the most frequent imaging tool in forensic pathology besides X-ray. Indications of PMCT are especially focused on cases of unnatural deaths: traumatic events such as bone fractures and nonaccidental injury in children; gunshot injuries; hanging, strangulation, and drowning cases; putrefied, carbonized, and badly damaged bodies. In order to visualize the soft tissue, especially organs, MRI can be used. Although this technique has the potential to overcome the limitations of PCMT, it is only rarely used in forensic imaging as it is a complex technology requiring specific training, expensive, and with some complication in execution due to body size, artifact, and protocols. MRI is of special significance for the diagnosis of natural death, especially related to diseases of the cardiovascular or central nervous system, and for investigations concerning neonatal and perinatal deaths. Comparing the results of postmortem imaging with subsequent autopsies, rates of major discrepancies between cause of death identified by radiology and autopsy of 32% for PMCT, 43% for PMMR, and 30% for PMCT + PMMRI have been reported. Vice versa, different studies have demonstrated that PMCT or PMMRI in conjunction with conventional postmortem examinations can augment the value of postmortem examinations, providing more information than either examination alone.