Post-mortem computed tomography (PMCT) is a valuable tool for medicolegal death investigation. PMCT examination may be used to supplement traditional autopsy or anthropological examinations. Further, PMCT combined with external examination may be used as an alternative to full autopsy for many commonly encountered case types, such as motor vehicle accidents, non-suspicious suicides, and some natural deaths.
At the New Mexico Office of the Medical Investigator (OMI), PMCT has been used routinely for more than seven years, with over 15,000 full body PMCT scans performed. Reducing the number of full autopsies has enabled OMI forensic pathologists to manage increasing caseloads. In this six-part webinar series, New Mexico OMI faculty will introduce participants to their use of PMCT, including basic technical aspects, workflow, triage, and the PMCT appearance of many injuries and pathologies commonly encountered by the forensic pathologist. Topics covered will include post-mortem change, gunshot wounds, blunt force injuries, natural disease, and several other non-natural causes of death.
PMCT Basics: Facility and Technical Aspects
This webinar originally occurred on April 13, 2021
Presenter: Natalie Adolphi, Ph.D.
In the first webinar, participants were introduced to x-ray computed tomography (CT) and some key differences between CT and traditional x-ray. The basic specifications of a CT scanner (such as bore diameter, maximum image size, and table specifications) were introduced, with reference to their impact on whole body post-mortem scanning in particular. Basic considerations for deploying a CT scanner in a medical examiner setting (cost, personnel, space, safety) was also be discussed.
Overview of PMCT for Pathologist Triage
This webinar originally occurred on April 20, 2021
Presenter: Clarissa S. Krinsky, MD, CFP
In the second webinar, participants were introduced to the use of PMCT as a triage tool in a busy forensic pathology practice. Participants first learned about the history of the use of PMCT at the New Mexico Office of the Medical Investigator (OMI) and the existing research and literature on the efficacy of PMCT in the medical examiner setting.
PMCT of Gunshot Wounds
This webinar originally occurred on April 27, 2021
Presenter: Lauren Decker, MD
In the third webinar, participants were introduced to the use of PMCT for examining decedents with gunshot wounds, both homicidal and self-inflicted. At the New Mexico OMI, a PMCT scan is performed in virtually all gunshot wound (GSW) related deaths. In cases of suspected homicide or suspicious suicides, autopsy is also performed. However, in non-suspicious cases involving self-inflicted GSW, PMCT is combined with an external examination, and sometimes a partial autopsy to retrieve a retained projectile, replacing the full autopsy.
PMCT of Blunt Force Trauma
This webinar originally occurred on May 4, 2021
Presenter: Heather Jarrell, MD
In the fourth webinar, participants were introduced to the use of PMCT in the diagnosis of blunt force trauma. PMCT scan may be used to diagnose fatal trauma in certain situations, allowing an external examination with postmortem CT to supplant an autopsy, which may better honor religious and cultural requests of grieving family members. Non-suspicious, traumatic deaths, such as motor vehicle collisions, are such an example. Additionally, PMCT often provides additional documentation of internal injuries where fatal injuries are obvious on external examination.
In the fifth webinar, participants were introduced to the use of PMCT in the investigation of natural deaths. At the New Mexico OMI, a PMCT scan may be used to rule out trauma in apparently natural deaths, or to confirm a natural cause of death. Depending on investigative details (circumstances, age, and medical history), and the PMCT findings, pathologists may choose to perform an external exam or a full autopsy.
PMCT Potpourri of Unnatural Deaths
This webinar originally occurred on May 18, 2021
Presenter: Lauren Dvorscak, MD
In the sixth and final webinar, participants were introduced to the use of PMCT in the investigation of a variety of unnatural deaths not discussed in previous webinars. Topics included overdose deaths, select asphyxial mechanisms of death, and sharp force injury.
Funding for this Forensic Technology Center of Excellence webinar series has been provided by the National Institute of Justice, Office of Justice Programs, U.S. Department of Justice.
The opinions, findings, and conclusions or recommendations expressed in this webinar series are those of the presenter(s) and do not necessarily reflect those of the U.S. Department of Justice.