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 Table of Contents  
REVIEW ARTICLE
Year : 2021  |  Volume : 7  |  Issue : 1  |  Page : 24-27

Application of virtopsy in the police activities in China


1 The Institute of Criminal Science and Technology, Shandong Public Security Department, Jinan, China
2 Liaocheng Public Security Bureau, Liaocheng, China
3 Shandong Rehabilitation Research Center, Jinan, China
4 Huimin County Public Security Bureau, Huimin, China
5 Weifang Public Security Bureau, Weifang, China
6 Physical Evidence Identification Research Center of Dezhou Public Security Bureau, Dezhou, China
7 Xiajin County Public Security Bureau, Xiajin, China
8 Department of Pathology, Affiliated Hospital of Qingdao University, Qingdao, China

Date of Submission08-Dec-2020
Date of Acceptance09-Dec-2020
Date of Web Publication24-Mar-2021

Correspondence Address:
Ligang Tang
The Institute of Criminal Science and Technology, Shandong Public Security Department, Jinan 250001
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jfsm.jfsm_68_20

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  Abstract 


This review summarizes the mode of application of virtual anatomy technology in the construction of a police system. Local public security organizations have explored the application modes of virtual anatomy construction, such as the multiparty co-construction mode, cooperation mode, and individual construction mode, and reviewed (1) the understanding of public security and application process of virtual anatomy; (2) the problems faced in the construction and application processes, such as those associated with support of human resources, equipment supplies and financial expenditure, the limitations of the technology itself, legal issues with application, shrinkage of the identification business, and appraiser-related problems; and (3) the prospect of application of virtopsy in public security systems.

Keywords: Autopsy, cause of death, forensic pathology, virtopsy


How to cite this article:
Tang L, Liu Z, Xue Y, Zhang L, Zhao D, Diao L, Zhang Y, Teng F, Zhao P. Application of virtopsy in the police activities in China. J Forensic Sci Med 2021;7:24-7

How to cite this URL:
Tang L, Liu Z, Xue Y, Zhang L, Zhao D, Diao L, Zhang Y, Teng F, Zhao P. Application of virtopsy in the police activities in China. J Forensic Sci Med [serial online] 2021 [cited 2021 Jul 28];7:24-7. Available from: https://www.jfsmonline.com/text.asp?2021/7/1/24/311863




  Introduction Top


Virtual autopsy (otherwise known as “virtopsy”) is a noninvasive or minimally invasive approach to autopsy that uses modern medical imaging and computer technologies, together with anatomical principles and technical adjuncts, to obtain both internal and external positive information and to ascertain the cause of death without causing damage – or at least mitigating damage – to the body.[1] This approach can be traced back to the Visible Human Project initiated by the United States in the 1980s, which aimed to build a digital library of real human computed tomography (CT), magnetic resonance imaging (MRI), and anatomical cross-sectional data.[2] With advances in the imaging resolution and in contrast of CT and MRI, as well as in digital two-dimensional (2D) and three-dimensional (3D) imaging, Prof. Dirnhofer of the University of Bern (Bern, Switzerland) pioneered the application of virtopsy techniques in forensic medicine.[3] Internationally, this technology has yielded some research results in victim identification in cases of major disasters, sudden cardiac death, bullet wounds, and forensic anthropology. In China, the Academy of Forensic Science has achieved a level of research and application in the field of virtopsy, including traffic accidents and postmortem angiography, that is at par with international standards.[4] To fully implement the strategy of police revitalization through science and technology and vigorously strengthen key scientific research findings and technological promotion of criminal technology, the Ministry of Public Security of the People's Republic of China formulated the “Double-Ten Program for Key Science and Technology Development Projects and Key Promotion Projects in Criminal Technology.” This program has listed the development of virtopsy technology and its verification with anatomical pathology, as well as the development of imaging-based, noninvasive rapid testing technology, as important developmental initiatives for assessing difficult cases in forensic medicine in 2019. The program has also encouraged the implementation of virtopsy according to local conditions. Current applications of this technology and its integration in the construction of the police system are summarized in the following sections.


  Application Modes of Virtopsy Technology in Police System Top


To promote the strengthening of ties between the police and science and technology, to enhance investigations using science and technology, and to explore novel pathways to technological synthesis, some local bodies have integrated their current protocols with local medical resources to actively explore the following new modes of virtopsy construction.

Police–hospital cooperation mode

In our province, the Forensic Medicine Office of the Huimin County Public Security Bureau, the Accident Department of the Traffic Police Brigade, and two local hospitals have reached a cooperative agreement. A public security–hospital cooperation mode has been adopted to conduct cadaver surface plus virtopsy examinations on traffic accident fatalities, provided that the wishes of the family members are respected. The hospitals are responsible for performing CT examinations of the head, neck, chest, abdomen, and extremities of the deceased and producing a report. The forensic medicine department is responsible for the cadaver surface examination, which is combined with CT examination for issuing the report describing the cause of death. Details of the examination report can provide the evidence required for financial compensation in civil cases and criminal litigation. As of December 31, 2019, autopsies for 118 individuals who experienced road traffic accidents were conducted in Huimin County, among whom 62 with unknown causes of death were examined using virtopsy. No error was found in the appraisal certificate, and the protocol was successful.

Police–university–hospital–enterprise co-construction mode

With the strong support of the Physical Evidence Appraisal Center of the Jilin Public Security Bureau, the Changchun Public Security Bureau joined forces with Jilin University, Jilin University Hospital, the College of Basic Medical Sciences, and high-tech medical enterprises to adopt a “police–university–hospital–enterprise” intelligent synthesis mode. This collaboration has enabled the establishment of the first joint virtopsy experimental center equipped with CT and MRI among all public security organizations in the country.[3]

Individual construction mode

The Forensic Appraisal Center of the Beijing Municipal Public Bureau has built upon its existing capabilities for clinical CT imaging examination for forensic medicine and purchased additional CT equipment for postmortem examination. Thus, it has adopted an individual mode of construction.[4]

Other modes

The Liaocheng Public Security Bureau will attempt a public security–hospital co-construction mode, whereby the municipal public security bureau will provide the venue and the hospitals will provide the CT equipment and operators. This mode is currently under construction.


  Application of Virtopsy in Police System Top


The development of virtopsy technology in China can be roughly divided into three stages.

First stage: Initial, 2005–2007

This stage primarily involved technology introduction and preliminary exploration, mainly centering on the use of CT, MRI, and other imaging modalities to perform 3D image reconstruction for exploration and experimentation. A solid foundation was laid for the subsequent development of virtopsy technology in China.

Second stage: Rapid development, 2008–2012

This stage mainly involved improvement of virtopsy technology and the application of virtopsy technology in teaching, archeology, skeletal age estimation, and other new areas. The application scope of this technology underwent a significant expansion in this study.

Third stage: Fluctuating development, 2013 to present

This may be attributed to the fact that, during the course of in-depth research investigating virtopsy technology, researchers began to recognize its limitations and adopted a more rational attitude.[5] With the growing literature on virtopsy technology reported by Chinese medical universities and research institutes, forensic medicine experts in public security have gradually gained an understanding of virtopsy technology. This has enabled them to discuss the involvement of virtopsy technology with regard to the accuracy of autopsy conclusions and associated ethical dilemmas[6] and its application in forensic pathology[7] and other issues, while also attempting to implement it in practice.

Police organizations have attempted to implement virtopsy in accordance with legal principles. First, for the bodies of individuals experiencing traffic fatalities, regulations[8] stipulate that postmortem examination can be performed using virtopsy technologies including X-ray, CT, MRI, microscopic radiological scanning, and 3D scanning. Second, for cadavers with unknown causes of death, virtopsy can only be used as an auxiliary method under special circumstances. This includes to determine the status of internal and external injuries and to identify and locate possible foreign bodies in the cadaver.[9] Third, units with adequate capacity for virtopsy should routinely perform it in addition to conventional autopsy to accumulate data for both methods, thereby laying a foundation for subsequent analysis and research.


  Advantages and Limitations of Virtopsy Top


Advantages of virtopsy

Traditional autopsy, which is the gold standard forensic technique used to obtain evidence supporting the cause of death, has gradually revealed certain drawbacks during the process of its application. First, traditional autopsy is an invasive technique that essentially destroys the integrity of the cadaver and has poor repeatability. The amount and quality of information that can be obtained from a second autopsy are greatly reduced, while multiple autopsies yield only scant information.[10] In addition, this invasive approach may be emotionally unacceptable to the family members of some victims or may conflict with the beliefs of certain religions (e.g., traditional Islam and Judaism). Virtopsy, as a noninvasive or minimally invasive method of cadaver examination, involves the use of imaging technologies to digitally examine and record fractures, internal foreign bodies, and other injuries in the cadaver. Thus, it can effectively resolve the legal, religious, and cultural prohibitions of infringements to the body for postmortem examination. It also permits multiple examinations, has strong repeatability, and is helpful for re-examination and expert consultation in difficult and/or complex cases.

Second, virtopsy uses digital radiological techniques to scan cadavers and obtain 3D images, which can provide objective data that are independent of the observation at any time. Furthermore, 2D and 3D postprocessing techniques can be applied to integrate external and internal information, which is valuable in the reconstruction of injuries, including those sustained in traffic accidents and falls from a height. It can even be combined with fine element analysis for computer simulation in dynamic simulation research, which will enable the reconstruction of injury occurrence and development in the 3D space of time–space–force. When presented as evidence in court, it is clear, intuitive, vivid, and easy to understand.[11]

Third, virtopsy has technical advantages in the discovery of hidden injuries in complex anatomical structures (e.g., skull base, spine, and pelvis), in the special postmortem examinations (e.g., air embolism, hemorrhage, or bullet wounds), and in determining the cause of injury. Buck et al.[12] used MRI to perform virtopsy on several cadavers of traffic fatalities and successfully identified bone marrow hemorrhage caused by trabecular microfractures under the cortical bone. Schnider et al.[13] compared the accuracy of multi-slice computed tomography (MSCT) and autopsy to identify internal foreign bodies, wounds, bone, and organ damage and subsequently inferred the cause of death. The results demonstrated that MSCT demonstrated a very high detection rate for deep, potentially dangerous, and even fatal wounds and was essentially able to replace traditional wound inspection methods. MSCT and MRI can reveal injury-induced changes, such as hemothorax, pneumothorax, and pleural effusion, among others. It can also be used to accurately diagnose cardiac tamponade and air embolism. Thus, it can prevent accidental gas escape caused by operating error(s) in the manual examination for air embolism.[14] In addition, virtopsy can be used to determine the position of gunshot residues, such as shrapnel and bullet fragments in the body, which is helpful in estimating the shooting angle. Fractures can be used to determine the impact point from falls from a height, and 3D-CT reconstruction can help recreate the scene of traffic accidents.

Finally, virtopsy is a rapid examination method that can guarantee appraisal quality, while also effectively reducing the autopsy workload of forensic pathologists. Postmortem examination of individuals involved in road traffic accidents is an important part of primary forensic medicine in public security. If all cadavers required fixed evidence from autopsies, the workload would clearly exceed the capacity of primary forensic pathologists. However, significant risk is associated with issuing the appraisal certificate based on cadaver surface examination alone. For such cases, the Forensic Medicine Department of the Huimin County Public Security Bureau will perform cadaver surface plus virtopsy examinations, and the forensic pathologist is able to issue an autopsy certificate on the same day. Three days after the police handle the case and inform the parties involved in the accident, the cadaver can be dealt with if there are no objections from either party. If, however, there are objections, the autopsy can be repeated. This process has significantly improved the efficiency of case management.

Limitations of virtopsy

There are differences between the characteristics of postmortem CT changes compared with premortem CT changes, which can lead to false positives (e.g., mistaking normal exudation after death for bleeding, mistaking putrefaction gas for air embolism, or gas accumulation in the gastrointestinal wall) and false negatives (e.g., undetected small contusions, intravascular thrombosis, acute infarction, or foreign bodies).[15] The digital and imaging information obtained using virtopsy can be altered, moved, and deleted, which is also why it has been called into question.[16] Furthermore, large sample case studies investigating virtopsy examinations are lacking, especially comparative studies with forensic pathology. Thus, virtopsy cannot yet replace forensic pathology as the gold standard for diagnosis.


  Problems with Implementing Virtopsy Top


Various local regions have encountered significant problems in implementing virtopsy including human, financial, and material security, limited scope of application, shrinkage of appraisal services, and appraisers' personal reasons.

Support of human resources, equipment supplies, and financial expenditure

The implementation of virtopsy relies on advanced technological equipment and specialized technical personnel who have undergone systematic training. It involves equipment procurement, staff recruitment, and securing a supply of consumables, all of which require substantial human, financial, and material resources. Furthermore, in this program, the initial stage of construction involved the accumulation of data and experience, which means that technological breakthroughs are unlikely in the short term. Therefore, it is necessary for the construction unit to have a long-term plan to ensure the continuous investment of funds.

Limited scope of application

At present, the qualification accreditation of inspection and testing institutions indicates that public security organizations are generally not equipped with the necessary hardware and personnel to perform virtopsy under existing conditions. Moreover, this technique cannot be outsourced to subcontractors. Therefore, the vast majority of units have listed virtopsy as restricted or restricted behavioral analysis projects.

Shrinkage of appraisal service volume and appraisers' personal reasons

Since the Fourth Plenary Session of the 18th CPC Central Committee, the concept of governing the country by law has been established in the population's minds, and the legal environment has undergone continuous optimization. This has led to the accelerated investigation of homicide cases, the rate of which has continued to decrease. As the reform of public security forensic appraisal continues to deepen, some units have subcontracted the autopsy of abnormal deaths to judicial appraisal institutions accredited for forensic pathology appraisals, especially autopsy of individuals dying in road traffic accidents. This has further reduced the autopsy workload of forensic pathologists in public security organizations. Furthermore, virtopsy imposes higher requirements on the appraiser's ability to interpret radiological images, and the emergence of the expert witness system has increased the pressure on appraisers to appear in court, both of which have dampened appraisers' enthusiasm for virtopsy.


  Application Prospects for Virtopsy in the Police System Top


The application of innovative virtopsy technology is being explored for postmortem examination. Although virtopsy cannot currently fully replace traditional autopsy, it is an appealing technique due to its noninvasiveness, objectivity, and repeatability. It can be used as a pre-examination technique that can complement systematic/conventional autopsy; reconstruct cases more authentically; and achieve efficiency, informatization, and digitization in forensic postmortem examination. On October 30, 2019, the “Three-Year Plan of the Shandong Public Security Bureau for the Development of Criminal Technology (2020–2022),” formulated by the Shandong Public Security Bureau, clearly proposed exploring the application of forensic imaging technology focusing on the construction of virtopsy laboratories and fully utilizing the supporting role of criminal technology in public security. At present, virtopsy has much room for innovation and improvement in terms of large sample, comparative research, noninvasive rapid testing, in-depth research, and other aspects. Public security organizations should fully utilize their functional advantages, conduct extensive exchanges and collaborate with universities and judicial appraisal institutions, and jointly promote the development of virtopsy technology in China.

Acknowledgment

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

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Bin C. Forensic Pathology. 5th ed. Beijing: People's Medical Publishing House; 2016. p. 467.  Back to cited text no. 1
    
2.
Chunguang J, Huilong D, Weixue L. Development and application of the visible human project. Foreign Med 1997;20:13-8.  Back to cited text no. 2
    
3.
Takatsu A, Suzuki N, Hattori A, Shigeta A. The concept of the digital morgue as a 3D database. Legal Medicine 1999;1:29-33.  Back to cited text no. 3
    
4.
Zhengdong L, Lei W, Ping H. Comments and reflections on the 8th International Conference on Forensic Radiology and Imaging. J Forensic Sci Med 2019;35:748-53.  Back to cited text no. 4
    
5.
Bo Y, Farong Y. Bibliometric analysis of the research progress of virtopsy technology. China Public Secur (Academic Edition) 2018;51:108-13.  Back to cited text no. 5
    
6.
Xiaohui L, Junquan L, Huipeng W, Yongli L, Zhiqiang M. The role of virtopsy in solving the accuracy of forensic autopsy conclusions and ethical dilemmas. Guide China Med 2010;8:114-5.  Back to cited text no. 6
    
7.
Qiufeng T. Application of Virtual Anatomy in Forensic Pathology: Professional Theory and Practice of Forensic Clinical Science – Proceedings of the 18th National Symposium on Forensic Clinical Science. Heilongjiang Science and Technology Press: China Forensic Association; 2015. p. 557-8.  Back to cited text no. 7
    
8.
National Road Traffic Management and Standardization Technology Committee. GA/T 268-2019 Examination of Corpse in Road Traffic Accident. Beijing: China Standards Press; 2019  Back to cited text no. 8
    
9.
Forensic Examination Sub-Committee of National Criminal Technology Standardization Technical Committee. GA/T 147-2019. Forensic Medicine—General Technical Specifications for Examination of Deaths. Beijing: China Standards Press; 2019.  Back to cited text no. 9
    
10.
Yen K, Lövblad KO, Scheurer E, Ozdoba C, Thali MJ, Aghayev E, et al. Post-mortem forensic neuroimaging: Correlation of MSCT and MRI findings with autopsy results. Forensic Sci Int 2007;173:21-35.  Back to cited text no. 10
    
11.
Thali MJ, Dirnhofer R, Vock P. Methods of Virtual Autopsy: 3D Optical and Radiological Scanning and Reconstruction in Forensic Medicine. Trans Zhang Huiqin Beijing: People's Public Security University of China Press; 2012.  Back to cited text no. 11
    
12.
Buck U, Christe A, Naether S, Ross S, Thali MJ. Virtopsy – Noninvasive detection of occult bone lesions in postmortem MRI: Additional information for traffic accident reconstruction. Int J Legal Med 2009;123:221-6.  Back to cited text no. 12
    
13.
Schnider J, Thali MJ, Ross S, Oesterhelweg L, Spendlove D, Bolliger SA, et al. Injuries due to sharp trauma detected by post-mortem multislice computed tomography (MSCT): A feasibility study. Leg Med (Tokyo) 2009;11:4-9.  Back to cited text no. 13
    
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Jingru G, Zhongfeng W, Xianqi L. Application of virtual anatomy on forensic medicine. Chin J Forensic Med 2016;31(S2):192-3.  Back to cited text no. 14
    
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Dong HW, Sun Y, Qian H, Jian JQ, Shao Y, Li ZD, et al. Research progress on postmortem changes of computed tomography imaging characteristics on corpses. Fa Yi Xue Za Zhi 2019;35:716-20.  Back to cited text no. 15
    
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Chen YJ. Research development and application of virtopsy. Fa Yi Xue Za Zhi 2014;30:360-6.  Back to cited text no. 16
    




 

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