This study, in which researchers worked with the New Mexico Office of the Medical Investigator, assessed whether postmortem computed tomography (PMCT) might supplement or supplant forensic autopsy.
The overall conclusion of the study is that PMCT, when coupled with a thorough external examination, could supplant autopsy, particularly in cases where the family of a decedent has religious or cultural objections to an autopsy. Researchers found strong agreement between autopsy and PMCT in determining cause of death. In 85 percent of blunt-force injury deaths, 99.5 percent of firearm fatalities, and 81.4 percent of pediatric trauma deaths, the cause of death determined by the PMCT was correct, matching the autopsy. Agreement between PMCT and autopsy was significantly less in drug-poisoning deaths, ranging from 34.2 percent to 77.9 percent, with less agreement in cases involving decedents over 40 years old. PMCT accurately detected more injuries than autopsy in the blunt-force and firearm cases, but autopsy performed better in cases of pediatric trauma and drug poisoning. The researchers advise that an ideal circumstance in determining cause of death is for all medical examiners to have access to a CT scanner and an experienced radiologist to interpret the results from the scans. The research team evaluated 174 blunt-force injury deaths, 205 firearm deaths, 65 pediatric trauma deaths, and 460 drug-poisoning deaths that occurred between June 2011 and December 2013. In each case, a full autopsy and complete PMCT were performed.