1 Evaluate radiologist's current role in forensic medicine.2 Discuss the growing role of forensic imaging. 3 Discuss market demand and need for structured training in forensic radiology.
METHOD AND MATERIALSThe role of radiology in forensic science has continued to expand over the years. The value of forensic imaging is most apparent in traumatic deaths due to strangulation, drowning, or projectile objects. In traditional autopsies, dissecting difficult areas often distorts normal anatomy and leads to the loss of valuable information. Forensic imaging requires no tissue manipulation and allows for continuous reassessment of findings, which is useful in criminal cases. Even in cases where an autopsy may be necessary, imaging may help a pathologist plan a more accurate autopsy. The term "forensic radiology" is not recognized by the American Board of Radiology and without any available formal training programs, radiologists who incorporate forensics in their practice usually happen to stumble upon the field. Radiologists that dedicate most of their time to clinical practice may not be aware of imaging manifestations of a cadaver and are at risk of misinterpreting postmortem images.
RESULTSForensic pathologists now increasingly include radiographic findings in their reports and more institutions are investing in postmortem imaging. Studies have shown that 18% of traumatic injuries are diagnosed solely by postmortem imaging. In some cases, imaging may quickly identify the cause of death without the need for an autopsy. Autopsies are not covered by Medicare, Medicaid, and most insurance plans, and autopsies can cost up to $5,000. Cost is one factor that has led to less autopsies being performed. Autopsies are performed in only 5% of hospital deaths and 40% of hospitals do not perform any autopsies. Postmortem imaging is about half as expensive as an autopsy and can provide results in a shorter period of time.
CONCLUSIONAccording to the most recent survey from ASRT, radiologists interpret 26.6% of postmortem imaging. With the demand for forensic imaging continuing to grow, formal and structured training will help more radiologists become experts in postmortem imaging manifestations.
CLINICAL RELEVANCE/APPLICATIONIn light of the increasing demand and utilization of imaging by forensic pathologists, it behooves radiology as a discipline to introduce postmortem imaging into the curriculum of residency training programs and into academic practices.