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Bladeless Autopsy

#1
I was lucky enough to attend a clinical guest presentation recently on "Bladeless Autopsy Technology and its Clinical Applications". I had never heard of them prior to the lecture. The presenter works mainly as a consultant forensic pathologist for various law enforcement agencies and government bodies. I unfortunately had to leave part way through proceedings and I have not been able to find much about it elsewhere.

Basically the technique as he described it uses a high resolution helical CT scanner. The subject's entire body can be visualised much more clearly due to the higher doses of radiation that can be used, compared to the lower doses used on living subjects. Software, specifically written for this use, then takes the images and melds them into a 3D graphic representation. The presenter said IIRC about 160,000 images on average and about 5 gig of data for one full body high resolution bladeless autopsy. The high quality and detail of the scanning process allows for the subject to remain in bodybag if needed with no loss of imaging clarity. The time factor was also markedly different. One example he used was a cranial scan that took 30 mins and correctly sited and gave cause of death. If it had been done traditionally it would have been at least 24 hrs with a very invasive cranial autopsy giving the same answer. The presenter said it has mainly been trialled by forensic pathologists in Europe as an experiment to see a comparison between traditional autopsy and non-invasive autopsy.

One of the more interesting claims made was that after scanning the subject, if need be, the body could be buried or cremated and any criminal investigations of entry/exit wounds, tissue and organ damage etc could be conducted years or decades down the track without any degradation of the evidence and without having to exhume remains. This was most interesting particularly where there may be little solid evidence of who committed the crime at the time the body is found/scanned but there is ample evidence of how the subject was killed. The presenter then went on to show several case studies where suspects were either charged and convicted or cleared of criminal charges because the bladeless autopsy was actually more clear and gave a better indication of what occurred to the subject than the traditional autopsy that had been performed originally. I had to leave the lecture at this point so missed the rest of what was a very fascinating topic.

Pondering on it further I can see some good applications in military and civilian circumstances. It is far easier and would probably work out cheaper in the long run to have any deceased personnel scanned, bloods and tissue samples taken and then stored that so that the family can bury their loved one but if anything occurs down the track the stored information can be retrieved readily (Pte Jake Kovco would have been a good subject for this). I could see it being used to gain a court ordered autopsy much more easily, particularly on subjects where their religion/culture forbids autopsy, than a traditional autopsy request especially as a judge or magistrate would probably be more amenable to a scan of a body to exclude suspicions than traditional autopsy methods. I do not, however, see it as a means of replacing the traditional autopsy (or investigative techniques) but instead being used to enhance so it can be used almost as a preliminary autopsy and then the traditional autopsy can be performed if required.
 
#4
Bernoulli, Sprjim and Banjo_Basha, just not on chaps, please respect the dead, their friends and relatives may just be reading this.
 
#5
You can still pull the spine out Predator style and swing the vertebrae around your head hooting in triumph berni but just because you cannot relate to live women, as opposed to bloating submariners, doesn't mean normal people can't have pictures of it before you desecrate the bodies.
 
#7
FFS western breathe. I posted an article I thought might be interesting from a clinical standpoint not from a who can be the most funereal. It's ARRSE it's not RP.

I would really appreciate it though, western, if you contributed your opinion or some information on the subject.
 
#8
An interesting concept.
Who was the lecturer btw?

This was talked of as the way forward when I was working in that morbid pathology.
(I was a HSAPT 20 years ago!) but my 2 consultant pathologists thought it fanciful.
At that time CAT scanning was for the living and they saw no need to replace the
traditional methods of investigation.

Not going into techniques but 24 hours for a brain examination?
Sorry only if staff are unavailable.

In all the jobs I assisted with- routine and Home Office it was the MkI eyeball that was most trusted.
Investigations of death require touch, sight, smell and no machine can replace the pathology team.
 
#9
For what it is worth this does look like an exciting development. I am not in a medical profession but have attended a large number of PMs (hence my hypersensitivity I suppose). In the deployed military environment this could be a real breakthrough as imagine using a technique such as this and being able to share the image with medical and forensic experts across the world in minutes following completion. The benefits could be immense especially where the cause of death is unclear. Also the point you make about local cultural and religious sensitivities is another huge potential benefit.

Sadly the law is very slow in adopting new technology and quite rightly the development of 'expert witnesses' takes years. So it could be that this takes a long time to be accepted as evidence in UK courts. I do not know if you are aware of the attempt to get facial recognition technology to be accepted as biometric evidence? I believe the standard required could not be met. Saying that though DNA evidence and all of the recent improvements in DNA analysis seem to have been taken up at breakneck speed, so who knows which way it would go.

Lets hope this sort of technique catches on as the method of post mortem examination has not really changed in a considerable number of years.
 
#10
Well, maybe I am a bit of an old stuck in the mud, but I couldn't be doing with a procedure that didn't allow you to scoop the brain out of the skull pan and weigh it, with unspeakable ichors and fluids oozing over the pan of the scales all the time.
 
#11
bernoulli said:
Well, maybe I am a bit of an old stuck in the mud, but I couldn't be doing with a procedure that doesn't allow you to scoop the brain out of the skull pan and weigh it, with unspeakable ichors and fluids oozing over the pan of the scales all the time.
Nice :puker: You're bringing back 'orrible memories.

Bernoulli? As in the fluid engineering principle?
 
#12
Unless the mortuary and PM room at Dhekelia has changed, this would be an ideal place to start 'Field Trials'. Anyone else recall all the windows open the aircon on full and the ceiling fan whirring like a good 'un when the Cypriot pathologist was required to PM some unfortunate who died in the ESBA? :pukel:
 
#13
Letterwritingman said:
Anyone else recall all the windows open the aircon on full and the ceiling fan whirring like a good 'un when the Cypriot pathologist was required to PM some unfortunate who died in the ESBA? :pukel:
That place was great even after a couple of floaters were pulled from Larnaca Bay in the middle of summer, im sure CYPOL actually moved the bodies onto the ESBA beach by Alex Bks so we had to deal with them 8O
 
#14
Now that is a fasinating concept, I have seen body bags flashed through a scanner before to make sure the bags had the correct bits (dont ask). But never to do an actual PM.
Why not, modern scanners will give you a voxol resolution better than the mark one eyeball can resolve and have the ability to repeat, reconstruct and change the imaging algorithm ad infinitum.
Why stop there? MR is better than CT for some things, perhaps a composite MR / CT 'Body' could be maintained which could be re-examined as required.

Interesting....... Miz sign me up! I'll come and do the techy, spotter imaging bits (and the time consuming 3D recon bits)
 
#15
The applications for such a procedure sounds ground breaking and very revoluntionary. I can see this system becoming a resounding success both in military fields and in the civvy sector not to mention the police forensics area. Imagine the applications it could be used for, not only for establishing causes of death in recently deceased people but also in areas such a archeology and the likes. Wonder what would happen if Tutukamun was put through it I wonder what insights we would glem from him!

I can also see the application of this technology in areas such as war crimes investigation, nothing is more sickening or heartbreaking than having to scoop up the bodies of women and children buried in mass graves and then having to establish who they were and what ultimately killed : them invariably some sick twisted MF with a gun who thought it good fun to kill defenceless people just because they were a different religion or a different nationality!

Anyway I hope that this concept does become a reality I have had friends that have undergone PM's and having witnessed a few myself the feeling that there bodies have been descreasted even after all they have been through is not a nice thought. I would welcome a bladeless autopsy especially if it is was being performed on my nearest and dearest.

As for a military application such a unit could easily be attached to a field hospital admittedly you might want it out of site of the troops working there but it would greatly speed up foresic investigations and also serve all parties by not performing a more tradtional freddie kruger meets the predator style PM that we all know.

I know that with all techniques the old guard will try and resist change as its new and therefore untried but I still feel we could be on to a winner with this new devolpment. Despite my rather one sided view of this system I do feel that nothing can ever replace the mark one eyeball not to mention actually getting your hands in there and using all of your senses to try and establish further information not to mention that good old gut senses that no computer in the world can ever hope to achieve.

In my view then if a cause of death can be easily identified we should not desecreate the bodies of our friends and comrades, however in circumstances where the cause of death is unknown or foul play other than enemy fire or engagement is supected than despite my mis givings and personal feelings a tradtional PM should be the gold standard in every instance.

As i know little about this procedure I am hazarding a guess that the amount of radio isoptopes involved could mask or even destroy certain substances and compounds within the body/organ tissues therefore great care would be needed to decide if mark one eyeball and good old hands and nose approach should be adopted or if we could rely on the more humane bladeless approach.

On a final thought it would be intresting to note if this process could be used on embalmed bodies to establish COD, considering the conspiracy theories relating to a certain famous female figure and her, dare i say it controversial death could it at last silence all those conspiracy nuts and final lay to rest one of the 21st centuries biggest who dunits.

Not expecting a bladeless autopsy on this post! Can hear the bone saw as we speak!

Sneaky_Barstard.
 
#16
When the cause of death is traumatic then yes it could be helpful,
but how will this technique establish COD by poisoning?
For that you still need tissue samples etc.

Most autopsies are routine and take 20 mins on average
More detailed ones not more than 45

Home Office- as long as it takes.

Now Horseferry Road may deal with 30 to 100 examinations per week IIRC using dedicated pathologists

Hospitals with Coroners facilities 30 to 50 examinations per week with the workload as part of the NHS pathologists day

Remember that in most cases the pathologist gives the COD at the time of the examination.

How long will the bladeless autopsy take?

Just work out the timings and although the idea is good the time factor will prevent its development and I really can't see a pathologist sitting at a monitor as an airport baggage checker does.
 
#17
True Archer, I don't see many pathologists sitting down at a scanner, but you have to admit in cases of mulitple victims such as war crimes investigations then the possibility of having a mobile path lab able to go to the site and make immeadiate investigations does sound very promising not to mention means that the degradation of evidence is minimal. For tissue sampling you could still apply the old fashioned slice and dice approach but use it in conjunction with the scan itself this way tissue sample could be taken as well as various other path tests as required.

I see both sides of the argument admitly my reasons for wanting the more humane approach is becasue of the invasive approach that sadly has to be adopted to find these results. Have had two friends undergo PM's both killed in the army and having witnessed PM's first hand it doesn't make for alice in wonderland thoughts. In both cases the cause of death was very traumatic both physically in their cases and emotionally in those that survived them. I very rarely pull the moral highground but in these instances putting them through a PM was and still is a bone of contention especially where COD was in these instance by "engagement" and secondly through explosion. Both resulting in as you can imagine a casket that was not able to be opened at the funerals.

Regardless of my personal feelings my professional stance on the matter is that as such I still feel that ethically and professionally this system given more time could be a valuable tool to forsenic medicine and science as whole and should not be discounted at the first hurdle. If you remember fingerprints were intially laughed at as a measure of convicting a criminal in a crime where their was no material evidence or witness and no look at the advances being made especially the advant of DNA profiling and conviction by this method! OJ Simpson being an exception to this rule of course!

I hope that in time this system will become more and more intregreated into the medical world but as before the need for the mark one eyeball, gut instinct and the hands and nose approach will always be required! No computer can ever take over the role of the man on the ground but it can certainly help!

Yours
Sneaky.
 
#18
SB,
Between 79 and 89 I rose to the position of Higher Senior APT.
Your observations on the rigidity that requires full examinations
when the death has been from massive trauma are sound and I stand with you.

Over the years I assisted and later prepared for the pathologist.
Yes I had to deal with people I knew- one was a close contact (he would
visit my office for coffee) and one - whom I pulled rank to be excused- was my father.
Yes deep down I feel the horror at what we had to do even though I know why.

I concure that this type of examination is long overdue for the specialist "jobs" and welcome any advances.
Forensic examinations are so very detailed that all avenues should be trialed and when dealing with mass graves/ natural disasters/ civil disasters this technique could be invaluabe
I was involved with 2 water disasters when teams had to be assembled and a scanner would have been of great benefit because the recorded details could have been reported on in a less "frantic" atmosphere.

As an aside:
Remembering that Prof Mant dealt with the camp deaths in 45/46 I wonder if he would support this possible new method.

Yours Aye,
Archer
 
#19
I am not a pathologist so comments on PM timings are not mine but the lecturers. I have observed some and they did not seem to take very long, certainly not 24 hrs. Perhaps he was including staffing issues? I did not get a chance to ask, unfortunately, as I had to go early. Comparison of time for scan to physical PM at the moment seems pretty similar from what has been said on here and from what he said was usual scan times. Then again most new technology takes longer until it is further refined so no doubt there will be improvements and it is not impossible to imagine a future scan only taking a few minutes to give same results as it does now. That to me seems a major plus for overworked personnel, if achievable. His name was Stephen or Stefan cannot remember last name. I got the impression from him that he was interested in the extended application of the stored digital images for criminal investigations - cold cases was the word he used. I can see the benefit that a complete scan of a subject can be used for reconstructions of events in a digital or even physical environment. Similar to how they scan those mummified remains and reconstruct them. If a traditional PM has been conducted and reported on, samples taken and stored along with the scan then I would feel happier knowing that bases had been more thoroughly covered and if anything was needed to be reinvestigated down the track then the fact the body had been buried/cremated would not be so great an issue.

I am glad I was not the only one who thought of an MRI/CT combination. The usual risks associated with MRI scanning are pretty much negated with a deceased subject. Mobile MRIs make it easy to set up the entire scanning process where needed. A combined scan I feel could only add more details and increase the usefulness of this technique. I can also see the whole virtual PM technique being extremely useful for teaching purposes. There is usually a shortage of cadavers to allow sufficient hands on practice for all students of the biosciences so many end up missing out on that crucial experience. Many people are reluctant to donate their body for research or study. This technique could be a relatively easy way of building a "body" knowledge database that could be burned/copied onto dvd for study as an adjunct to "live" cadaverals. It could be like people saying yes to organ donor status. A scan is non invasive and the results may actually help someone else in the future particularly if the individual died of something rare/complex, despite receiving treatment.

I absolutely agree nothing can replace the skill, experience and intuitive knowledge of a highly trained pathologist whom has ready access to appropriate technologies. I would only ever want to see this used as an adjunct to a full PM or in circumstances where a proper PM was unable to be performed. I can see situations where this scan may be "better" if the pathologist was not highly skilled, the local morgue set up was so lacking and there was no way to get the subject to a more suitable location. The use of a mobile CT scanner would be, I feel, invaluable when in situations where there are a huge number of subjects to examine, limited staff and there is the danger of further degradation/damage of the body, even with proper storage, if PM is delayed further. Specialised jobs often require specialised techniques. The scan can be done and then the information is there available "forever" as a back up to the PM results. Oversimplified statements I know and I am sure pathologists on here could comment more authoritatively on whether this is a workable concept.
 

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