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 Table of Contents  
REVIEW ARTICLE
Year : 2020  |  Volume : 6  |  Issue : 4  |  Page : 144-147

Expediting the development of virtopsy identification technology in forensic medicine in China


Collaborative Innovation Center of Judicial Civilization; institute of Evidence Law, Key Laboratory for Evidence Science (China University of Political Science and Law), Ministry of Education; Center for Health and Pharmaceutical Law and Ethics of China University of Political Science and Law, Beijing, China

Date of Submission05-Oct-2020
Date of Acceptance03-Dec-2020
Date of Web Publication05-Jan-2021

Correspondence Address:
Liu Xin
Collaborative Innovation Center of Judicial Civilization, Beijing 100088
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jfsm.jfsm_74_20

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  Abstract 


Virtopsy technology is noninvasive, noncontact, and can find potential lesions. For these reasons, it has broad application prospects in forensic pathology and forensic clinical science. The present article reviews the brief history of virtopsy development, introduces the application of virtopsy in various fields of forensic medicine, summarizes the current situation regarding virtopsy in China, and puts forward suggestions for strengthening planning, setting standards, strengthening assistance, and promoting scientific research.

Keywords: Judicial expertise, postmortem computed tomography, postmortem computed tomography angiography, postmortem magnetic resonance imaging, virtopsy


How to cite this article:
Xin L, Xiechang Z. Expediting the development of virtopsy identification technology in forensic medicine in China. J Forensic Sci Med 2020;6:144-7

How to cite this URL:
Xin L, Xiechang Z. Expediting the development of virtopsy identification technology in forensic medicine in China. J Forensic Sci Med [serial online] 2020 [cited 2021 Jan 16];6:144-7. Available from: https://www.jfsmonline.com/text.asp?2020/6/4/144/306184




  Brief History of Virtopsy Technology Top


Virtopsy technology originated in Europe and was first applied in forensic science. In 1977, in a case of death by gunshot to the head, computed tomography (CT) technology was applied to determine the trajectory of the bullet.[1] In the late 1990s, a high-profile murder case in Switzerland required accurate forensic expertise; the imprint on the victim's skull needed to be matched to the most likely murder tool, so forensic experts focused on applying objective forensic analysis methods. To minimize damage to the victim's skull, imaging methods were used to analyze the corpse of the deceased. The forensic expert opinions subsequently given were helpful in the judge's decision, laying the foundation for virtopsy.[2] In Switzerland, research into forensic imaging started in the mid-1990s. The Institute of Forensic Medicine at the University of Bern and the Center for Security Studies in Zurich co-operated in research involving three-dimensional (3D) reconstruction and scanning to record characteristics of body surface injuries. At the beginning of the 21st century, the two institutions co-operated again to study multi-slice CT and magnetic resonance angiography of corpses. At this time, they first introduced the concept of virtopsy.

The word “virtopsy” is a combination of “virtual” and “autopsy.”[2],[3] Since 2000, the Department of Radiology of Gouda Groene Hart Hospital in the Netherlands has co-operated with the Netherlands Forensic Institute in the Hague, the Netherlands, to conduct prospective CT examination before forensic autopsy, collecting more than 2100 forensic radiology cases and carrying out systematic research.[4] At present, an increasing number of institutions and experts conduct virtopsy research, and some trade associations in European countries have even formulated virtopsy standards. On the basis of the original Journal of Forensic Radiology and Imaging, the International Society for Forensic Radiology and Imaging launched the journal Forensic Imaging in 2020 (https://www.sciencedirect.com/journal/forensic-imaging/issues). It is the first and only professional academic journal devoted to forensic imaging and virtopsy. It is edited by Professor Michael Thali of the University of Zurich in Switzerland. The Institute of Forensic Medicine of the University of Zurich is a world leader in virtopsy research, teaching, and case study. The Department of Forensic Imaging and Medicine of the University of Zurich has obtained ISO9001:2008 quality management certification, which covers clinical, autopsy, and radiological examinations, including reports and written expert opinions, which can be found at www.virtopsy.com.

Using any imaging workstation with voxel scanning, professionally trained identification can carry out a virtopsy, which is more objective, cleaner, and more convenient than traditional autopsy methods, does not damage corpses, and can identify many lesions that are difficult to identify using traditional methods. Combined with practical and reliable field investigation results, as well as sufficient and accurate autopsy conclusions, virtopsy technology can help forensic experts to solve forensic problems, such as causes and manners of death.[5] In the literature, an increasing number of research and case reports have used virtopsy for scene reconstruction and whole-body scanning of corpses. Therefore, virtopsy is gradually becoming widely used in forensic practice.


  Application of Virtopsy Technology in Forensic Medicine Top


At present, Switzerland, Japan, and Britain lead the world with respect to postmortem crime scene investigation (PMCSI) research. Postmortem CT (PMCT), postmortem CT angiography (PMCTA), and postmortem magnetic resonance imaging (PMMRI) have been deeply studied. Research in PMCSI has influenced forensic medicine, jurisprudence, imaging, and medicine internationally.[6] Recently, some perspective forensic imaging technologies have emerged, such as postmortem magnetic resonance angiography, postmortem CT image-guided biopsy, PMMRI-guided biopsy, ventilated postmortem CT, and ventilated PMMRI. Forensic virtopsy technology has developed rapidly and has been extended into forensic clinical science, forensic anthropology, and other fields. In fact, virtopsy has been applied to some extent in forensic psychiatry and forensic genetics.

In 2020, with the outbreak of the novel coronavirus disease, which is transmitted through aerial droplets, many scholars have used virtopsy to conduct teaching and examine cases in many new professional fields. The technique has been fully developed in medicine and forensic medicine, and it has been widely used in medicine, forensic medical teaching, diagnosis, and research. Since it is noninvasive and can easily identify potential pathological changes, it has been widely used in forensic identification. With the rapid development of computer technology, big data, artificial intelligence, virtual reality, and various other technologies, virtopsy has been more widely developed and applied. By combining, integrating, and reconstructing these technologies, forensic information can be obtained from examined corpses, stored as data, and processed to generate colorful images of body surface injuries and internal lesions. Therefore, virtopsy technology has broader application prospects in the field of law.

The research and application of virtopsy in forensic science is expanding into many fields. According to research by Xiao et al., (1) the research of PMCT mainly focuses on analysis of nonspecific and specific PMCT images of corpses, radiation individual identification, or mass disaster death of individual identification (emergence of victim identification, disaster victim identification DVI), PMCT scanning methods, and 3D visualization technology, etc.; (2) research of PMCTA mainly focuses on the following aspects: research in systemic angiography and heart coronary artery targeted imaging technology; comparison of PMCTA and traditional autopsy in information mining ability and accuracy of death diagnosis; research in intravascular stability of different types of vascular contrast agents; and effects of contrast agents on forensic examinations such as histology, toxicology, DNA, and microbiology; and (3) PMMR research mainly focuses on the establishment of corpse scanning method and procedure; nonspecific PMMRI analysis of corpses; and infant PMMRI; sudden cardiac death PMMRI analysis, etc.[6]


  Virtopsy Technology in Forensic Medicine in China Top


The concept of virtopsy, as well as its related theories and techniques in forensic science, was not introduced late to China. However, the development of teaching, scientific research, and case investigation practice lags behind. In 2005, Xiao et al. introduced prospects for applying virtopsy technology in the field of forensic medicine.[7] In 2010, Yang systematically introduced the application of virtopsy technology in forensic examination.[8] The Academy of Forensic Science of the Ministry of Justice of China was the first identification institution to implement virtopsy technology. Since 2005, about 500 cases have been examined so far.[9] More teaching, research, and case investigation institutions have purchased devices and carried out virtopsy in the past 5 years. According to incomplete statistics, the Academy of Forensic Science of the Ministry of Justice, the Institute of Evidence Law and Forensic Science of China University of Political Science and Law, the Forensic Identification Center of Beijing Public Security Bureau, the Forensic Identification Center of Shijiazhuang Public Security Bureau, the Forensic Identification Center of Changchun Public Security Bureau, and the Forensic Identification Center of Huimin County Public Security Bureau, among other institutions, have purchased and installed virtopsy equipment. They have already carried out work in teaching, scientific research, and case investigation, and achieved certain results [Table 1]. Furthermore, some security institutions, such as Daqing Public Security Bureau and Liaocheng Public Security Bureau, co-operate with medical institutions to apply virtopsy technology in forensic case investigation. However, because the equipment is expensive and difficult to operate, requiring intensive training of identification personnel, and because no macro management or industry technical standards have been established, some problems remain in virtopsy identification practice.
Table 1: Virtopsy equipment and case investigation in relevant institutions in China

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  Prospects and Recommendations for Developing Forensic Virtopsy Technology in China Top


China's forensic virtopsy technology started relatively late. Nevertheless, through more than 10 years of knowledge introduction, as well as theory and technology accumulation, the forensic science community has a relatively full understanding of the technology. Therefore, the development in the past 5 years has been rapid, and some achievements have been made. However, compared with European countries, we still have a big gap in teaching, scientific research, and case investigation. We should try our best to narrow the gap and improve the level and quality of teaching, scientific research, and application of virtopsy technology in China as soon as possible. To this end, we put forward the following suggestions.

  1. Relevant regulatory authorities should formulate macro development strategies as early as possible to administer the application of virtopsy technology. The equipment needed for virtopsy technology is relatively expensive. China has many forensic medicine identification institutions and the management is scattered. If no macro development thinking is applied to virtopsy technology in China, and no planning is implemented for the construction of virtopsy laboratories, the construction of virtopsy laboratories will be repeated and scattered, causing waste of human, material, and financial resources. In addition, the marketization of judicial expertise in China will lead to disorderly and unfair competition, leading to errors in identification and ultimately wrongful conviction
  2. Corresponding technical specifications and standards should be formulated. Currently, no matter what identification techniques are used, they must be operated by humans, and human judgment and interpretation must be applied to the identification results. Different organizations and people can commit individual or even systematic errors in the operation, interpretation, and explanation of identification results. They may even differ in the identification itself, leading to different or even opposite identification results. Virtopsy identification standards will effectively standardize identification. At present, only the technical specification “Forensic Virtopsy Operation Procedure” (SF/ZJD0101003-2015) has been stipulated by the Ministry of Justice. Therefore, the National Committee for Standardization of Criminal Technology and the Chinese Institute of Forensic Medicine must be consulted to formulate technical standards, teaching standards, research standards, scientific research standards, and management standards for virtopsy as soon as possible
  3. Regional cooperative organizations should be established. To save financial, human, and material resources to carry out identification using virtopsy technology, regional co-operation and co-ordination should be strengthened in places where virtopsy equipment has been purchased and virtopsy laboratories have been constructed. Regional assistance organizations for virtopsy technology should be established to learn from each other's strong points and complement each other in terms of equipment and technology, taking full advantage of the strengths of existing equipment and technology, making full use of everything, and thereby, allowing virtopsy technology to serve forensic identification work
  4. It is necessary to carry out teaching and case investigation summary, promptly promote training for identification personnel and management personnel, promote scientific research achievements in a timely manner, and carry out training for policy formulators and prosecutors on the display and application of virtopsy identification opinions. On the basis of carrying out the work of case investigation, as well as solving difficult and complicated cases, and being guided by the problems reflected in the practice of case investigation, we have carried out basic research in virtopsy and applied research in case investigation, applied the scientific research results to case investigation to solve the practical difficulties and problems in forensic case investigation and teaching of forensic medicine.


Acknowledgement

This article was originally released in the Chinese language in the Chinese Journal of Forensic Medicine.

Financial support and sponsorship

This study was financially supported by National Social Science Fund Key Research Project “Research on Ethical Thinking and Legal Regulation of Medical Behavior in China from the Perspective of Doctor-Patient Relationship” (15AZD065) and Key Consulting Research Project of the Chinese Academy of Engineering (2019-XZ-31).

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Wullenweber R, Schneider V, Grumme T. A computer tomographical examination of cranial bullet wounds [in German]. Z Rechtsmed 1977;80:227-46.  Back to cited text no. 1
    
2.
Dirnhofer R, Jackowski C, Vock P, Potter K, Thali MJ. VIRTOPSY: Minimally invasive, imaging-guided virtual autopsy. Radiographics 2006;26:1305-33.  Back to cited text no. 2
    
3.
Badam RK, Sownetha T, Babu DB, Shefali W, Reddy L, Garlapati K, et al. Virtopsy: Touch-free autopsy. J Forensic Dent Sci 2017;9:42.  Back to cited text no. 3
[PUBMED]  [Full text]  
4.
de Bakker HM, Soerdjbalie-Maikoe V, Kubat B, Maes A, de Bakker BS. Forensic imaging in legal medicine in The Netherlands: Retrospective analysis of over 1,700 cases in 15 years' experience. J Forensic Radiol Imaging 2016;6:1-7.  Back to cited text no. 4
    
5.
Thali MJ, Yen K, Schweitzer W, Vock P, Chirs B, Ozdoba C, et al. Virtopsy, a new imaging horizon in forensic pathology: Virtual autopsy by postmortem multislice computed tomography (MSCT) and magnetic resonance imaging (MRI) – A feasibility study. J Forensic Sci 2003;48:386-403.  Back to cited text no. 5
    
6.
Zhiyuan X, Wenju J, Fangyu W, Bing H, Beibei L, Lan D, et al. Bibliometric analysis of post-mortem cross-sectional imaging. Evid Sci 2020;28:238-57.  Back to cited text no. 6
    
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Xiao J, Zhang H, Liu L. Application of virtual reality technique in forensic pathology. J Forensic Med 2005;21:146-8.  Back to cited text no. 7
    
8.
Yang T. Virtopsy. Evid Sci 2010;18:234-48.  Back to cited text no. 8
    
9.
Wan L, Song YX, Li ZD, Wan L, Song YX, Li ZD, et al. The approach of virtual autopsy (VIRTOPSY) by postmortem multi-slice computed tomography (PMCT) in China for forensic pathology. Forensic Imaging 2020;20:200361.  Back to cited text no. 9
    



 
 
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