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ISFRI Guidelines Working Group: Best practice standards for non-contrast postmortem computed tomography (PMCT) of overdose ISFRI指南工作组:过量非对比死后计算机断层扫描(PMCT)的最佳实践标准
IF 0.8 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-09-01 Epub Date: 2025-04-25 DOI: 10.1016/j.fri.2025.200635
Jamie Elifritz , Heather Jarrell , Fabrice Dedouit , Laura Filograna , ISFRI guidelines Working Group
Postmortem computed tomography (PMCT) has emerged as a valuable tool in forensic investigations, supporting the investigation of suspected overdoses. While not specific, Cerebral edema, pulmonary edema, and urinary bladder distention (the overdose triad) can suggest overdose in unsuspected cases. Furthermore, a high-density basal layer in the stomach may indicate intentional therapeutic medical overdose. Challenges include short agonal intervals and decomposition changes. Confirmatory blood toxicology is necessary. Dual-energy computed tomography (DECT) can play a role in differentiation of material contributing to dense basal layers and body packing scenarios. PMCT serves as a valuable complement to autopsy findings, aiding in the assessment of internal pathology while also offering a non-invasive alternative in specific forensic contexts where autopsy may not be performed.
尸体计算机断层扫描(PMCT)已成为法医调查的一种有价值的工具,支持对疑似过量用药的调查。脑水肿、肺水肿和膀胱膨胀(“过量三联征”)虽然没有特异性,但可能提示在未被怀疑的病例中过量用药。此外,胃中高密度的基底层可能表明有意的治疗性药物过量。挑战包括短时间间隔和分解变化。确认血液毒理学是必要的。双能计算机断层扫描(DECT)可以在导致致密基底层和身体堆积的材料分化中发挥作用。PMCT是对尸检结果的宝贵补充,有助于评估内部病理,同时也为无法进行尸检的特定法医环境提供非侵入性替代方案。
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引用次数: 0
White paper by the international society of forensic imaging guidelines working group on non-contrast PMCT for decomposed remains 国际法医成像指南协会工作组关于分解遗体非对比PMCT的白皮书
IF 1 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-09-01 Epub Date: 2025-07-14 DOI: 10.1016/j.fri.2025.200643
Jamie Elifritz , Micillo Andrea , Fabrice Dedouit , Laura Filograna
Overdose deaths, particularly from opioids and synthetic analogs, continue to rise globally. While some cases present with overt indicators, others lack external signs, complicating initial investigation. Postmortem computed tomography (PMCT) has emerged as a valuable adjunct in these cases, offering radiologic features that may suggest overdose and support triage, even in unsuspected deaths. Characteristic findings—such as cerebral edema, pulmonary edema, and urinary bladder distention—comprise the so-called “overdose triad,” which demonstrates high specificity for overdose-related fatalities. PMCT also detects ancillary features including findings related to pill fragments, signs of body packing, and hypertensive intracerebral hemorrhage. In overdose investigations, PMCT’s high negative predictive value helps exclude internal trauma and skeletal injuries, guiding case management and informing decisions on the necessity for full autopsy. While PMCT findings are not pathognomonic and may be absent in rapidly fatal intoxications, the technique offers considerable value, particularly when integrated with toxicological analysis and full autopsy. The International Society of Forensic Radiology and Imaging (ISFRI) supports the standardized use of PMCT in suspected overdose deaths as part of a comprehensive forensic approach.
过量死亡,特别是阿片类药物和合成类似物,在全球继续上升。虽然有些病例有明显的体征,但其他病例缺乏外部体征,使初步调查复杂化。在这些病例中,尸检计算机断层扫描(PMCT)已经成为一种有价值的辅助手段,它提供了可能提示用药过量的放射学特征,并支持分诊,即使是在未被怀疑的死亡中。特征性表现,如脑水肿、肺水肿和膀胱膨胀,构成了所谓的“过量三联征”,这表明了过量相关死亡的高特异性。PMCT还可以检测辅助特征,包括与药片碎片、身体堆积和高血压脑出血相关的发现。在过量调查中,PMCT的高阴性预测值有助于排除内部创伤和骨骼损伤,指导病例管理,并告知是否需要进行全面尸检的决定。虽然PMCT的发现并不是典型的,而且在快速致命的中毒中可能没有发现,但该技术具有相当大的价值,特别是当与毒理学分析和全面尸检相结合时。国际法医放射学和成像学会(ISFRI)支持将PMCT作为综合法医方法的一部分用于疑似过量死亡的标准化使用。
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引用次数: 0
ISFRI guidelines working group: best practice standards for non-contrast postmortem computed tomography (PMCT) of adults ISFRI指南工作组:成人非对比死后计算机断层扫描(PMCT)的最佳实践标准
IF 0.8 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-09-01 Epub Date: 2025-05-15 DOI: 10.1016/j.fri.2025.200632
Jamie Elifritz , Chris O’Donnell , Garyfalia Ampanozi , Thomas Ruder , Lenetta Boyce , Natasha Davendralingam , Maarja Mölder , Laura Filograna , ISFRI Guideline Working Group
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引用次数: 0
ISFRI guidelines working group: best practice standards for non-contrast postmortem computed tomography (PMCT) of blunt force trauma ISFRI指南工作组:钝器创伤非对比死后计算机断层扫描(PMCT)的最佳实践标准
IF 0.8 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-09-01 Epub Date: 2025-07-02 DOI: 10.1016/j.fri.2025.200630
Jamie Elifritz , Garyfalia Ampanozi , Ludo Beenen , Laura Filograna
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引用次数: 0
The sternum as a key to identity: enhancing biological profiling in forensic science 胸骨作为鉴定的关键:加强法医科学中的生物侧写
IF 0.8 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-09-01 Epub Date: 2025-06-04 DOI: 10.1016/j.fri.2025.200640
Sushobhita Singh , Pallavi Kumari , Tejasvi Pandey

Purpose

Forensic anthropometry focuses on the precise measurement and analysis of human skeletal elements, which is crucial for constructing biological profiles in forensic investigations. This examination specifically looks at the forensic applications of the sternum, concentrating on its role in estimating sex, stature, and age.

Method

The review emphasizes the importance of the combined length of the manubrium and sternal body for accurate estimations of sex and stature, particularly in challenging cases. It explores age estimation based on morphological changes and ossification patterns, noting promising results from some studies. The examination also discusses the integration of digital tools such as 3D imaging and advanced morphometric software to enhance the precision and reliability of sternum-based analyses.

Results

The review highlights the sternum’s benefits for estimating sex and stature, as well as the potential for age estimation. Despite the recognized advantages, it points out gaps in the current research, particularly the lack of studies on ancestry estimation.

Conclusion

The review offers a thorough overview of the sternum’s forensic value and calls for ongoing research to improve accuracy and broaden its application. It underscores the evolving importance of forensic anthropometry, emphasizing how technological advancements are revolutionizing the analysis of skeletal remains and expanding the capabilities of forensic investigators. The findings highlight the necessity of continued research and innovation in refining sternum-based identification methods for forensic and anthropological applications.
目的法医人体测量学侧重于人体骨骼元素的精确测量和分析,这对于法医调查中构建生物图谱至关重要。这次检查特别关注胸骨的法医应用,集中在它在估计性别、身材和年龄方面的作用。方法本综述强调胸骨柄和胸骨体的长度对于准确估计性别和身高的重要性,特别是在具有挑战性的病例中。它探讨了基于形态变化和骨化模式的年龄估计,注意到一些研究的有希望的结果。研究还讨论了数字工具的集成,如3D成像和先进的形态测量软件,以提高胸骨分析的精度和可靠性。结果该综述强调了胸骨在估计性别和身高方面的益处,以及估计年龄的潜力。尽管具有公认的优势,但它指出了当前研究中的差距,特别是缺乏对祖先估计的研究。结论本文综述了胸骨的法医学价值,并呼吁进一步研究以提高准确性和扩大其应用范围。它强调了法医人体测量学不断发展的重要性,强调了技术进步如何彻底改变了骨骼遗骸的分析,并扩大了法医调查员的能力。研究结果强调了继续研究和创新的必要性,以改进法医和人类学应用的基于胸骨的鉴定方法。
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引用次数: 0
ISFRI guidelines working group: Best practice standards for non-contrast postmortem computed tomography (PMCT) investigations of medical treatment and in-hospital deaths ISFRI指南工作组:医疗和院内死亡的非对比死后计算机断层扫描(PMCT)调查的最佳实践标准
IF 0.8 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-09-01 Epub Date: 2025-05-08 DOI: 10.1016/j.fri.2025.200634
Natasha Davendralingam , Ludo Beenen , Jamie Elifritz , Yohsuke Makino , Laura Filograna , ISFRI Guideline Working Group
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引用次数: 0
White paper by the international society of forensic imaging guidelines working group on non-contrast PMCT for SCUBA-related fatalities 国际社会法医成像指南工作组关于非对比PMCT用于水肺相关死亡的白皮书
IF 0.8 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-09-01 Epub Date: 2025-04-26 DOI: 10.1016/j.fri.2025.200636
Chris O’Donnell , Jamie Elifritz , Laura Filograna
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引用次数: 0
Forensic age estimation of the knee and clavicle using post-mortem CT 用死后CT对膝关节和锁骨的法医年龄估计
IF 0.8 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-09-01 Epub Date: 2025-05-29 DOI: 10.1016/j.fri.2025.200638
Apameh Khatam-Lashgari , Sara Tangmose Larsen , Mette Lønstrup Harving , Niels Lynnerup , Chiara Villa
Age is crucial for constructing a biological profile to match data from missing persons in Disaster Victim Identification (DVI). For adolescents and young adults, methods often rely on bone end closures. Post-mortem computed tomography (PMCT) is a reliable tool for forensic age estimation in DVI cases. This study aimed to develop reference material for estimating the age of deceased adolescents and young adults using PMCT of the knee and clavicle in a Danish population. Results from the knee and clavicle were compared, and decision trees were created for final age estimates based on various bone combinations. The study included 221 individuals (57 females, 164 males) aged 10-25 years who underwent PMCT before medico-legal autopsy. Using the staging method by Schmeling et al. and Kellinghaus et al. ossification in the distal femoral, proximal tibial, proximal fibular, and medial clavicular epiphyses were evaluated. Large age intervals were observed for all bone stages, except for the earliest and latest clavicle stages. The clavicle stage distribution correlated well with chronological age, and reference values were consistent with previous studies. Individuals of younger age exhibited higher knee-bone stages than clavicle stages. Decision trees indicated that age intervals could be narrowed by combining clavicle stages with femur and fibula stages, though caution is required when intervals are too narrow. This study provides reference material for forensic age estimation in adolescents and young adults using PMCT of the knee and clavicle, relevant in DVI cases where limited body parts are available for analysis.
在灾害受害者身份识别(DVI)中,年龄对于构建与失踪人员数据相匹配的生物概况至关重要。对于青少年和年轻人,方法通常依赖于骨端闭合。死后计算机断层扫描(PMCT)是一个可靠的工具,法医年龄估计在DVI的情况下。本研究旨在为丹麦人群中使用膝关节和锁骨PMCT估计死亡青少年和年轻人的年龄提供参考资料。对膝关节和锁骨的结果进行比较,并根据不同的骨骼组合创建决策树以进行最终年龄估计。该研究包括221名10-25岁的个体(57名女性,164名男性),他们在法医尸检前接受了PMCT。采用Schmeling等人和Kellinghaus等人的分期方法,评估股骨远端、胫骨近端、腓骨近端和锁骨内侧骨骺的骨化情况。除了最早和最晚的锁骨期外,所有骨期的年龄间隔都很大。锁骨分期分布与实足年龄相关性较好,参考值与前人研究一致。年轻个体的膝骨阶段高于锁骨阶段。决策树显示年龄间隔可以通过结合锁骨分期与股骨和腓骨分期来缩小,但当间隔太窄时需要谨慎。本研究为使用膝关节和锁骨PMCT估计青少年和年轻人的法医年龄提供了参考资料,这与DVI病例中可用于分析的身体部位有限有关。
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引用次数: 0
Automated volumetric estimation of six basic thoracic and abdominal organs in postmortem computed tomography data using deep learning techniques 使用深度学习技术对死后计算机断层扫描数据中六个基本胸腹器官的自动体积估计
IF 0.8 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-09-01 Epub Date: 2025-06-30 DOI: 10.1016/j.fri.2025.200642
Joël Fehr , Astrid Kurmann , Philippe Handschin , Ampanozi Garyfalia , Sabine Franckenberg , Raffael Golomingi , Till Sieberth , Lars C. Ebert , Akos Dobay

Purpose

Computed tomography (CT) has become a widely adopted and standard procedure as an adjunct to autopsies in numerous countries. However, owing to the high number of cases and the limited availability of skilled practitioners, the need to streamline the diagnostic process has spurred the advancement of automated solutions. These solutions leverage deep learning methodologies to potentially automate diagnoses by analyzing postmortem CT data. Here, we show how deep learning techniques enable segmentation and volume evaluation to be concurrently performed for six basic thoracic and abdominal organs in postmortem CT data: the heart, lungs, liver, spleen, kidneys, and urinary bladder. Based on these automated volumetric estimations we automatically derived the weight of the heart, lungs, liver, spleen, and kidneys.

Methods

We developed a convolutional neural network tailored for conducting volumetric data segmentation in postmortem computed tomography images based on the U-Net architecture.

Results

Our best model achieved an overall Dice score (F1 score) of 0.907±0.029. The heart, lung, and liver yielded higher scores than did the spleen, kidneys, and urinary bladder. We also automated the weight calculation of the heart, lungs, liver, spleen, and kidneys.

Conclusion

Our study demonstrated that a convolution neural network such as U-Net could reliably estimate concurrently the volumes of six basic thoracic and abdominal organs from postmortem CT data. Our study also shows how this information can be subsequently used to automatically estimate their weight. However, post- and perimortem changes pose substantial challenges for automatically processing postmortem CT data.
在许多国家,计算机断层扫描(CT)已成为一种广泛采用的标准程序,作为尸检的辅助手段。然而,由于病例数量多,技术熟练的从业人员有限,简化诊断过程的需要促使了自动化解决方案的发展。这些解决方案利用深度学习方法,通过分析死后CT数据来自动诊断。在这里,我们展示了深度学习技术如何能够同时对死后CT数据中的六个基本胸部和腹部器官(心脏、肺、肝脏、脾脏、肾脏和膀胱)进行分割和体积评估。基于这些自动的体积估计,我们自动得出了心脏、肺、肝、脾和肾的重量。方法基于U-Net架构开发了一种卷积神经网络,用于对尸体计算机断层扫描图像进行体积数据分割。结果最佳模型的Dice总分(F1分)为0.907±0.029。心脏、肺和肝脏的得分高于脾脏、肾脏和膀胱。我们还自动计算了心脏、肺、肝脏、脾脏和肾脏的重量。结论基于U-Net的卷积神经网络可以可靠地从死后CT数据中同时估计六个基本胸腹器官的体积。我们的研究还显示了如何利用这些信息来自动估计他们的体重。然而,死后和死前的变化对自动处理死后CT数据提出了实质性的挑战。
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引用次数: 0
Postmortem computed tomography imaging in giant anteaters (Myrmecophaga tridactyla) 巨型食蚁兽(Myrmecophaga tridactyla)死后计算机断层成像
IF 0.8 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-09-01 Epub Date: 2025-07-19 DOI: 10.1016/j.fri.2025.200645
Maria Jaqueline Mamprim , Sheila Canevese Rahal , Jeana Pereira da Silva , Jair Theodoro Filho , Gabriela Montezel Frigerio , Paulo Hilário Nascimento Saldiva , Isabela Cristina de Souza Marques , Ricardo Shoiti Ichikawa
This study aimed to describe the findings of post-mortem CT in three adult giant anteaters. The first animal was found with paraparesis of the hind limbs in a rural area and rescued by a fire brigade. CT of the thoracic spine showed malalignment with a fracture-dislocation of T15. The fracture of T15 was compressive and there was a moderate narrowing of the spinal canal. The death was likely due to a spinal cord injury. The second animal was found unconscious in a rural area and rescued by the municipal guard. A CT scan revealed a significant increase in volume that extended to the submandibular and ventral upper cervical region with the presence of gas and a low-density core. Additionally, the right tympanic cavity was filled with material of soft tissue density. The animal likely died due to a severe neck infection. The third animal was in a rural area with body wounds. The CT scan showed an increase in muscle volume in the hind limbs with the presence of gaseous content. There was a loss of definition of the abdominal wall and the presence of free intraperitoneal gas. The death was attributed to the heavily infected and deep skin wounds, possibly leading to peritonitis. The post-mortem CT findings were valuable in identifying lesions and determining the cause of death in the three giant anteaters. The sensitivity of the post-mortem exam could be increased by including other imaging techniques such as magnetic resonance imaging.
本研究旨在描述三只成年巨食蚁兽的死后CT结果。第一只动物在农村地区被发现后肢截瘫,并被消防队救出。胸椎CT显示T15骨折脱位错位。T15骨折为压缩性骨折,椎管有中度狭窄。死因很可能是脊髓损伤。第二只动物在农村地区被发现失去知觉,并被市政警卫救出。CT扫描显示体积明显增加,并延伸至下颌下和上颈椎腹侧区域,存在气体和低密度核心。此外,右鼓室充满软组织密度物质。这只动物可能死于严重的颈部感染。第三只动物出现在农村地区,身上有伤。CT扫描显示后肢肌肉体积增加,并伴有气体含量。腹壁模糊,存在游离腹膜内气体。死亡的原因是严重感染和很深的皮肤伤口,可能导致腹膜炎。验尸后的CT检查结果对确定三只巨型食蚁兽的病变和死亡原因很有价值。通过使用磁共振成像等其他成像技术,可以提高尸检的灵敏度。
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引用次数: 0
期刊
Forensic Imaging
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