Evaluation of the Routine Use of CT Scanning to Supplant or Supplement Autopsy in a High-Volume Medical Examiner's Office

As submitted by the applicant: X-ray computed tomography (CT) enables three-dimensional, non-invasive imaging, and is routinely used for medical diagnosis in the living. There are many potential advantages of utilizing post-mortem CT (PMCT) for investigating deaths; however, its impact on forensic medical practice in the U.S. has so far been minimal. Clearer definition of the utility of PMCT is needed to justify changes in funding priorities. Recently, the New Mexico Office of the Medical Investigator (NM OMI) conducted a large study (904 cases) evaluating the utility of PMCT imaging, interpreted by a radiologist, for supplementing or replacing the traditional autopsy exam. The study findings have already impacted the daily practice of the NM OMI, resulting in a decrease in autopsy rates for specific case types, such as motor vehicle fatalities. In practice, forensic pathologists often interpret the PMCT images, prior to autopsy, to enable better case management – to decide whether additional laboratory tests are needed, whether to perform an autopsy or an external exam, or whether a family’s request for no autopsy can be honored. Note: This project contains a research and/or development component, as defined in applicable law. ca/ncf