Review Article DOI: 10.18231/2455-1732.2017.0017 Virtopsy: Emerging frontier in forensics Mamta Malik1, Rakesh K. Mishra2,*, Kanwalpreet Kaur3, Sanjeev Laller4, Vijay Kumar5 1,4Reader, 2Post Graduate, 3Lecturer, 5Dental Surgeon, 1,4Dept. of Oral Medicine and Radiology, 2Dept. of Forensic Medicine & Toxicology, 3Dept. of Conservative and Endodontics, 1,4PDM Dental College & Research Institute, Bahadurgarh, Haryana, 2Santosh Medical College, Ghaziabad, Uttar Pradesh, 3BJS Dental College, Ludhiana, Punjab, 5Oscar Multispecialty Hospital and Trauma Center Rohtak, Haryana, India Corresponding Author: Email: [email protected] Abstract It is long back that the autopsy procedures were invented and till now the same age old technique for autopsy are being used, though in the other fields of Forensic Medicine, there is rapid growth and advancement in the procedures performed and technology employed. Virtopsy is one step towards this end. Virtopsy came from virtual autopsy, which is a scalpel free procedure of autopsy carried out using modern medical, imaging and measuring technology. The technique could offer an alternative to the standard invasive procedure that upsets many families and is prohibited by some religion. With the help of this paper an effort is made to discuss a few points in the field of Forensics. Keywords: Virtopsy, Virtual autopsy, Forensics, Autopsy. Introduction been done in the procedures performed and technology Forensic science is the branch of medicine which employed in autopsy procedure. Virtopsy is one step aims for the documentation of medical and other towards this end which came from virtual autopsy, forensic findings in living and deceased persons, for the which is a scalpel free procedure of autopsy wherein police and the judiciary system. As we know that death modern medical, imaging and measuring technology is an inevitable part of everyone’s life, but sometimes are used such that there is no need of any dissection of for furtherance of law scientific examination of bodies the body for opening the body cavities or dissection of after death becomes mandatory to find out the reasons the different organs of the body.(2-4) for death. The contribution of Forensic science Virtopsy versus autopsy: Term autopsy was derived involving ten disciplines (which include Criminalistics, from Greek words as autos (self) and opsomei (I will engineering science, general, jurisprudence, see) – “To see with one's own eyes”. Whereas virtopsy odontology, pathology/biology, psychiatry and or "virtual autopsy" was derived from the words behavioral science, questioned documents, toxicology “virtual” (Latin: virtus: effective) which means useful, and physical anthropology) in achieving this is efficient and good‟ and elimination of autos ie, self thus appreciable.(1,2) leading to the scientific word virtopsy.(1,4) The term autopsy often referred to as “medico- Conventional Autopsy procedure involves invasive legal autopsy” or “medicolegal necropsy” is thought to body opening through incisions and dissection – the be the most important forensic tool to know the cause traditional means of postmortem investigation in of death, and therefore it is even called “the expertise of Humans and with the same time one have to consider expertises”. The conventional autopsy procedure where the sentiment of the relatives of the deceased, who are whole surface of the body as well as all the body always upset and usually against conventional cavities are explored to record the findings or is body autopsies. On the other hand virtopsy is a minimally dissection or mutilating techniques which is objected by invasive or noninvasive emerging technology in the the emotional aspects of the victim’s relatives as they field of Forensic medicine which incorporates imaging know these mutilation forms of autopsies. But most technology wherein radiologists and forensic clinicians importantly the need to know the cause of death and reflect documentation of the body in the observation of identification of an unknown deceased individual and the anatomical structures through computed also may help the law enforcement overrules this tomography (CT), magnetic resonance (MRI) and emotional involvement and justify the autopsy micro radiology devices. Thus there is no need of any procedure. Therefore, the families and relatives of the dissection of the body for opening the body cavities or victim often remain in a conflicting situation with the dissection of the different organs of the body and also forensic examiners and are usually not in favor of keep sentiments, cultural and religious beliefs of autopsy. Even some religious and cultural beliefs also patient’s family members.(1,4-6) stand against the autopsy procedure. An example is Background of virtopsy: It was in the nineties when observed in religious strands, such as Judaism, where it Richard Dirnhofer, former Director of Forensic is not permitted to undergo the process of autopsy. To Medicine, at the Institute of Forensic Medicine of the overcome, this rapid growth and advancement have University of Bern, Switzerland, started working on the Santosh University Journal of Health Sciences 2017;3(2):54-56 54 Rakesh K. Mishra et al. Virtopsy: Emerging frontier in forensics characteristics of the human body (observation of the vehicles with high stability and accuracy, (vi) anatomical structures) in a concrete, objective and non- Angiography – post-mortem heart-lung machine: it is invasive protocol created a new discipline in autopsy, done to se intravascular and intra-articular display for named as “Virtopsy”, which was a virtual project of small as well as longer circulatory system, to analyze autopsy and anatomy of body was observed and individual body organs, vascular injury leakages and to examined through computed tomography (CT), estimate quantity of stenosis, (vii) Programmable magnetic resonance (MRI) and micro radiology biopsy – contamination-free sampling: by this the body devices. The same research was then continued by his fluids can be examined for toxicological purpose successor, Michel Thali (the forensic pathologist and without contamination and requires less manpower, project manager for virtopsy) and his colleagues at the (viii) Ultrasound Technology: done to produce pictures University of Berne's Institute of Forensic Medicine, of anatomical structures like cardiac evaluation, Switzerland who said "If you are doing an autopsy, you tumours, abscesses, vascular structures, solid organ are always destroying the 3-D geometry of the body". assessment, and pregnancy etc, (ix) Animations in Using this cross-section imaging technique, it is Forensic Pathology: this helps the forensic pathologists possible to document the same findings in a to process complex evidence in animated series to noninvasive way. Idea of “all in one research area” was communicate for juries in a clear-cut and easy mode so proposed encouraging virtopsy as a promising field that jury can easily understand the justifications and with clear and controlled procedure. Virtopsy procedure observations, and (x) Photography: Digital imaging start from surface documentations carry on with CT technique is used for photography because provides it scanning and fallowed with image-controlled sampling provides exact image record of the crime scene along for histological, bacteriological and toxicological with it show present physical evidence.(2-4,7-11) examination.(2-4,7) Applications of virtopsy: Virtopsy technique is used in Imaging techniques of virtopsy: A two dimensional multiple number of forensic situations/science, such as view of the particular object is given by a photograph. thanatological investigations; carbonized and putrefied Same way, if photograph of a wound is taken, it will body identifications; mass disaster cases; age give the position, as well as length and breadth of the estimation; anthropological examinations and skin wound but cannot display the depth of the wound. So lesion analyses.(3) for determination of the depth, a three dimensional a. Cause of death in drowned cases is diagnosed by view of the wound is essential to understand the actual CT images by giving information about the dimensions. In autopsy dissection is done to get this volume, density, size of the lungs and the amount three dimensional view but same can be done without of liquid observed.(3,12) the use of scalpel in virtopsy by using combination of b. Human identification is possible in mass disaster imaging modalities.(4) cases as CT images ease in data collection on the So virtopsy involves combination of the different disaster field.(3,13) technologies of medical imaging as well as other c. In forensic odontology branch, respiratory technologies used in other field of science. An insight obstruction by foreign body is best differentiated into the future of forensic is visualized by the emerging by virtopsy using CT and MRI images as compared involvement of advanced imaging technology that can to conventional autopsy where it is difficult to enhance or even in the future may be an alternative to know the exact depth of obstructed foreign conventional forensic examination. It relies on certain body.(3,14) fundamental techniques of imaging which include (i) d. Personal identification is possible by Computed Tomography (CT) – for three-dimensional superimposition and comparing AM imaging and analysis of autopsy findings including orthopantomograms and PM reconstructed gross tissue injury and pathologic gas collections, CT panoramic