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Since the beginning of this century, the use of postmortem computed tomography (PMCT) in forensic autopsies has increased. In this study we examined how similar dental charts created using PMCT as a solitary examination mode were to dental charts created using the conventional method of a clinical inspection including intraoral radiographs. A total of 100 previously performed dental identification cases were retrospectively included in the study. For each case, a dental chart was created solely based upon PMCT. The PMCT based dental chart was subsequently compared with the chart created from the previous conventional identification examination. Based upon the accuracy, sensitivity and specificity values PMCT performed very well compared to the conventional method in the identification concerning presence or absence of teeth, the presence of crowns, bridges and endodontic treatments as well as the presence and types of fillings. PMCT performed poorly concerning the extension of fillings and identification of small, tooth-colored fillings. The use of PMCT is a valuable supplement to the conventional methods available for forensic odontologists and may be of great value for initial screening in mass fatalities. [ABSTRACT FROM AUTHOR]

Purpose: This paper presents a proposed guideline for the use of post-mortem computed tomography (PMCT) during forensic dental identification. Currently, whole-body PMCT is widely used prior to autopsies for the diagnosis of fractures, organ changes, hemorrhages, and for the localization of foreign bodies, but it may also facilitate the odontological identification process in single cases and in cases involving multiple fatalities. Several studies have described the use of PMCT in forensic odontological work, but we have not found any comprehensive set of guidelines on how to perform a forensic odontological examination using PMCT. The aim was to develop guidelines for creating post-mortem dental charts during forensic odontological identification examinations using the standard functions of PMCT. Methods: A proposed guideline was developed from 15 selected cases examined at the Section of Forensic Pathology, Department of Forensic Medicine at the University of Copenhagen in Denmark from October 2011 to May 2012. Using the functionalities and three-dimensional (3D) reconstructions of OsiriX DICOM-viewer software (Pixmeo Sarl, Bernex, Geneva, Switzerland) we adjusted the contrast and brightness settings and developed a proposed guideline for creating PMCT-based dental charts. A four-step guideline was produced. Conclusion: In our casework, we are currently using the guidelines proposed herein. The use of PMCT has allowed us to target our clinical examinations, greatly improving their efficiency. Furthermore, PMCT allows the storage of data for later documentation and research. Further research is needed to validate the proposed guideline. [ABSTRACT FROM AUTHOR]

Epicardial adipose tissue (EAT) may play a role in the development of coronary artery disease. The purpose of this study was to evaluate a method based on postmortem computed tomography (PMCT) for the estimation of EAT volume. We PMCT-scanned the eviscerated hearts of 144 deceased individuals, who underwent a medicolegal autopsy. Using Mimics® we performed segmentation of the images and obtained the volumes of EAT and myocardium. Total heart volume was calculated by adding the volumes of EAT and myocardium. Total heart weight, including EAT, myocardium and attached vessels, was measured during autopsy. Inter-observer analysis was performed on 30 randomly chosen subjects. We included 132 individuals in the results (age range: 22-94 years; 56% men). Twelve individuals were excluded due to inadequate PMCT scanning. Median EAT volume was 73.0 mL (Interquartile range; IQR: 45.6-113.7 mL) in men and 64.8 mL (IQR: 44.0-98.0 mL) in women, which accounted for 20.4 ± 10.2% and 21.9 ± 9.5% of total heart volume, respectively. This corresponded with former autopsy studies. Total heart volume measured by PMCT was highly correlated with heart weight (R = 90%). Mean inter-observer difference of EAT volume was −1.7 mL (95% limits of agreement: −37.0-33.6 mL), with an Intra Class Correlation of 0.91. It was possible to estimate EAT volume using PMCT on eviscerated human hearts. Our method was fast and accurate with good inter-observer agreement. This is a useful method to determine EAT at autopsy, and we will apply this method in future research. [ABSTRACT FROM AUTHOR]

Calculation of the estimated body surface area ( BSA) by body height and weight has been a challenge in the past centuries due to lack of a well-documented gold standard. More recently, available techniques such as 3D laser surface scanning and CT scanning may be expected to quantify the BSA in an easier and more accurate way. This study provides the first comparison between BSA obtained from post-mortem whole-body CT scans and BSA calculated by nine predictive formulae. The sample consisted of 54 male cadavers ranging from 20 to 87 years old. 3D reconstructions were generated from CT scans using Mimics software, and BSA values were automatically extracted from the program. They were compared with nine predictive equations from the literature. Remarkably, close correlations ( r > 0·90) were found between BSA values from CT scans and those from the predictive formulae. A mean BSA of the 54 cadavers of 1·84-1·87 m2 was calculated by all formulae except one, SD values varying between 0·171 and 0·223 m2. T-tests revealed significant differences between mean BSA values calculated with CT and three of the formulae. Regression analyses showed intercepts >(0;0) and slopes <1·0 using all predictive equations, with the CT scan determination as gold standard. It is concluded that DuBois and DuBois' equation can be safely used in normal-weight male subjects with high accuracy, but it seems likely that BSA is underestimated in underweight subjects and overestimated in overweight individuals. Creation of new formulae specific for overweight subjects and children may be needed. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate the utility of postmortem computed tomography (PMCT) images in estimating organ sizes and to examine the use of the cardiothoracic ratio (CTR). Methods: We included 45 individuals (19 females), who underwent a medico-legal autopsy. Using the computer software program Mimics, we determined in situ heart and liver volumes derived from linear measurements (width, height and depth) on a whole body PMCT-scan, and compared the volumes with ex vivo volumes derived by CT-scan of the eviscerated heart and liver. The ex vivo volumes were also compared with the organ weights. Further, we compared the CTR with the ex vivo heart volume and a heart weight-ratio (HWR). Intra- and inter-observer analyses were performed. Results: We found no correlation between the in situ and ex vivo volumes of the heart and liver. However, a highly significant correlation was found between the ex vivo volumes and weights of the heart and liver. No correlations between CTR and the ex vivo heart volume nor with HWR was found. Concerning cardiomegaly, we found no agreement between the CTR and HWR. The intra- and inter-observer analyses showed no significant differences. Conclusions: Noninvasive in situ PMCT methods for organ measuring, as performed in this study, are not useful tools in forensic pathology. The best method to estimate organ volume is a CT-scan of the eviscerated organ. PMCT-determined CTR seems to be useless for ascertaining cardiomegaly, as it neither correlated with the ex vivo heart volume nor with the HWR. [ABSTRACT FROM AUTHOR]

The most common method to predict nasal projection for forensic facial approximation is Gerasimov's two-tangent method. Ullrich H, Stephan CN ( J Forensic Sci, 2011; 56: 470) argued that the method has not being properly implemented and a revised interpretation was proposed. The aim of this study was to compare the accuracy of both versions using a sample of 66 postmortem cranial CT data. The true nasal tip was defined using pronasale and nasal spine line, as it was not originally specified by Gerasimov. The original guidelines were found to be highly inaccurate with the position of the nasal tip being overestimated by c. 2 cm. Despite the revised interpretation consistently resulting in smaller distance from true nasal tip, the method was not statistically accurate ( p > 0.05) in positioning the tip of the nose (absolute distance >5 mm). These results support that Gerasimov's method was not properly performed, and Ullrich H, Stephan CN ( J Forensic Sci, 2011; 56: 470) interpretation should be used instead. [ABSTRACT FROM AUTHOR]

Age estimation methods are often based on the age-related morphological changes of the auricular surface and the pubic bone. In this study, a mathematical approach to quantify these changes has been tested analyzing the curvature variation on 3D models from CT and laser scans. The sample consisted of the 24 Suchey-Brooks ( SB) pubic bone casts, 19 auricular surfaces from the Buckberry and Chamberlain ( BC) 'recording kit' and 98 pelvic bones from the Terry Collection (Smithsonian Institution). Strong and moderate correlations between phases and curvature were found in SB casts (ρ 0.60-0.93) and BC 'recording kit' (ρ 0.47-0.75), moderate and weak correlations in the Terry Collection bones (pubic bones: ρ 0.29-0.51, auricular surfaces: ρ 0.33-0.50) but associated with large individual variability and overlap of curvature values between adjacent decades. The new procedure, requiring no expert judgment from the operator, achieved similar correlations that can be found in the classic methods. [ABSTRACT FROM AUTHOR]

We examined the utility of CT scans in the evaluation of degree of ectocranial suture closure. Five cranial points (left and right midcoronal positions, left and right midlambdoidal positions, and the lambda) were evaluated in 231 CT scans using a three-point scoring system (open, partial closed, and closed). The slice increment and thickness varied between three groups of the scans. The results showed a good correlation between degree of suture closure and increasing age in each group. Young individuals (<40 years) and old individuals (>60 years) could be clearly distinguished from the middle-aged individuals. ANOVA test revealed no difference between two groups of scans and between left and right sides ( p > 0.05). Interobserver agreement was good, especially considering the score by sides. The results of this study create the base for developing a robust and simple method to estimate the age at death using CT scans. [ABSTRACT FROM AUTHOR]

Examination of three frozen bodies, a 13-y-old girl and a girl and boy aged 4 to 5 y, separately entombed near the Andean summit of Volcán Llullaillaco, Argentina, sheds new light on human sacrifice as a central part of the Imperial Inca capacocha rite, described by chroniclers writing after the Spanish conquest. The high-resolution diachronic data presented here, obtained directly from scalp hair, implies escalating coca and alcohol ingestion in the lead-up to death. These data, combined with archaeological and radiological evidence, deepen our understanding of the circumstances and context of final placement on the mountain top. We argue that the individuals were treated differently according to their age, status, and ritual role. Finally, we relate our findings to questions of consent, coercion, and/or compliance, and the controversial issues of ideological justification and strategies of social control and political legitimation pursued by the expansionist Inca state before European contact. [ABSTRACT FROM AUTHOR]

Abstract: Weight but occasionally also the volume of cremated human remains may often be the primary basis for interpreting the many stages involved in past cremation ceremonies. However, methods used for describing volume for cremated remains are extremely varying and biased by many factors. Here we evaluate different methods for calculating and describing volume and propose a method for estimating the original prehistoric post-cremation weight. Our data suggests that low cremation weights reported for archaeologically recovered cremated remains are markedly underestimated, and that whole cremated bodies probably are represented more often than discussed in osteoarchaeology. Hence, this contests many suppositions on ritual selection of cremated human remains in prehistoric and early historical archaeology. A simple descriptive Fragmentation Index for cremated remains is further suggested. [Copyright &y& Elsevier]

This article presents the results of a validation study of a previously published method of sex determination from the temporal bone. The purpose of this study was to evaluate the lateral angle method for the internal acoustic canal for accurately determining the sex of human skeletal remains using measurements taken from computed tomography ( CT) scans. Previous reports have observed that the lateral angle size in females is significantly larger than in males. The method was applied to an independent series of 77 postmortem CT scans (42 males, 35 females) to validate its accuracy and reliability. The mean lateral angle of the internal acoustic canal was found to be larger in females (46.5°) than in males (43.4°). However, the difference was not statistically significant and the sex differences reported in previous studies were not substantiated. In light of the observed results, the lateral angle method appears to be of minimal practical use in forensic anthropology and archeology. [ABSTRACT FROM AUTHOR]

This article presents the results of a validation study of a previously published method of sex determination from the temporal bone. The purpose of this study was to evaluate the lateral angle method for the internal acoustic canal for accurately determining the sex of human skeletal remains using measurements taken from computed tomography ( CT) scans. Previous reports have observed that the lateral angle size in females is significantly larger than in males. The method was applied to an independent series of 77 postmortem CT scans (42 males, 35 females) to validate its accuracy and reliability. The mean lateral angle of the internal acoustic canal was found to be larger in females (46.5°) than in males (43.4°). However, the difference was not statistically significant and the sex differences reported in previous studies were not substantiated. In light of the observed results, the lateral angle method appears to be of minimal practical use in forensic anthropology and archeology. [ABSTRACT FROM AUTHOR]

Abstract: Computed tomography (CT) has been used routinely at the Department of Forensic Medicine, University of Copenhagen since 2002. A retrospective study was performed in order to correlate CT-scan based diagnoses of cranial and cerebral lesions with macroscopic autopsy diagnoses in 56 cases. The CT-scans were performed by a forensic pathologist. They were obtained by using two different CT-scan protocols. The results showed correct skull fracture diagnoses in 34/56 cases. Fractures were diagnosed partially (9) or missed totally (13) on CT-images in 22 cases. The agreement for fracture diagnoses of the anterior, medial and posterior cranial fossae was 20%, 52% and 60%, respectively. Fractures involving bilateral bones were diagnosed correctly more frequently. The diagnostic agreement regarding brain injuries varied from 0% to 79%. Both the autopsy-reports and CT-scan descriptions need to be standardized in order to secure more exact comparisons in the future. [Copyright &y& Elsevier]

We analyzed the trabecular bone changes in the pubic bone (PB) and in the auricular surface (AS) of the ilium using 319 CT scans of cadavers to estimate the age. Although the sharpness of the trabecular structure decreases in CT images when soft tissues are present, we identified four phases for the changes in PB and five in AS; a juvenile trait in PB and a senile trait in AS helped narrow the age range. High correlation with age was identified for both sexes in PB (F 0.89; M 0.75) and in AS (F 0.85; M 0.71) used independently or combined (F 0.91; M 0.78). The old adults (>60 years) could be evaluated with better accuracy and discriminated in several phases. We found low inter-observer error and low inaccuracy (about 6 years, mean for all age ranges). The method is robust with respect to slice thickness, display window and kernel within the tested ranges. [ABSTRACT FROM AUTHOR]