Virtual Autopsies Offer Clues Without the Knife

Virtual autopsies are being developed by scientists in Sweden that would allow doctors and forensic experts to examine murder victims remotely and keep a permanent record of bruises and wounds long after mortal flesh has decayed.

The technology could reveal hidden clues to a murder and uncover new information about fatal diseases.

A virtual autopsy "can see things that are difficult to discover in a conventional autopsy," said Thomas Rydell from the Interactive Institute, who, along with Anders Person and Anders Ynnerman, is developing the software and hardware behind virtual autopsies.

The potential applications, says Rydell, are "endless."

A real autopsy is a grim process. The body is laid face-up on a steel table. A forensic expert, usually a pathologist, makes a Y-shaped incision, down the chest and under each side of the rib cage. The skull is sawed off, exposing the brain. Each organ is removed and weighed, any surface injuries are recorded, and any foreign objects, such as bullets, are removed and saved as evidence.

Once the examiner has gathered all the information the organs are put back into the body, which is then sewn shut. A full autopsy takes about an hour.

Fifty years ago, almost 90 percent of patients who died in the hospital had an autopsy, and everyone who died outside a hospital had an autopsy, said Hans Ringertz, visiting professor at the Lucile Packard Children's Hospital at Stanford University. Those rates have dropped dramatically over the last few decades, down to less than 5 percent of patients.

An autopsy is always performed if murder is suspected.

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Occasionally religious beliefs forbid an autopsy or contact with the deceased. Most of the time, however, family members can't stand the thought of their loved one being dissected.

Even if an autopsy is performed for, say, a murder trial, the evidence in a body eventually decays. About 20 percent of murder cases eventually end up in a higher court, which then asks for new information about a body that has long since decayed. 

Virtual autopsies could solve these problems. The dead body would never need to be touched or dissected. Bullet holes, stab wounds, bruising, broken bones, and any other conditions that might have contributed to the person's death would be permanently recorded using a dual energy CT scanner or an MRI machine, said Rydell. 

Because the person is already dead, the radiologist can use the maximum amount of radiation to reveal, in high resolution, every detail of skin, flesh, bone, and any foreign objects. In less than 15 minutes the real body becomes a virtual body, made up from six gigabits worth of information. 

Rydell and his colleagues from Sweden have created a new way to display that information, on a flat table instead of vertical screen. The raw data from the MRI and CT is downloaded directly into the high resolution, flat screen LCD. The most advanced video graphics cards turns that data into a virtual body, laid out inside the table instead of on it. The full set-up is known as the Virtual Autopsy Table.

With a few finger flicks, a radiologist and a pathologist, working together, can instantly strip away skin and flesh to reveal broken bones or enlarge the arteries to measure plaque buildup. 

For pathologists, a virtual autopsy will speed up actual autopsies. A bullet hole is an obvious entry point, but once the lead enters the body a bullet can ricochet off bones to rest in unexpected places. A virtual autopsy would make finding the bullets much easier and faster by identifying their exact spot. Instead of cutting in lots of places to find the bullet, pathologists could make a single incision.

For doctors, virtual autopsies could provide useful baseline data about a huge variety of diseases, enabling them to tease out relationships between heart disease and plaque, between hemorrhages and stroke, and many other conditions, much like the sequencing the genomes of individual people will provide scientists new information about the heritability of disease.

"There is a fantastic possibility for research with virtual autopsies," said Ringertz, who has already started several projects using the techniques, including one on heart disease.

Virtual autopsies aren't limited to doctors, however. For teachers, virtual autopsies, displayed on the Virtual Autopsy Table, could educate students about human anatomy without the need for cadavers. For attorneys, the Virtual Autopsy Table could help jurors see the extent of damage caused by murderer without bloody and gruesome photographs. For judges, virtual autopsies could eliminate, or lessen, the need for emotionally painful exhumations during appeals trials.

A price for the Virtual Autopsy Table has yet to be set, said Rydell, but the technique is already being used around the world using conventional computers with mice and keyboards.