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Evaluation of the Routine Use of CT Scanning to Supplant or Supplement Autopsy in a High-Volume Medical Examiner’s Office

NCJ Number
Natalie Adolphi, Ph.D.
Date Published
June 2021
17 pages

This is the Final Technical report of an NIJ-funded study whose primary goal was to evaluate the integration of post-mortem computed tomography (PMCT) scanning into the practice of death investigations based on current practices of the New Mexico Office of the Medical Investigator (OMI), which includes routine scanning of about 90 percent of decedents to aid in case triage, with image interpretation performed primarily by forensic pathologists.


The study was conducted in three phases. The first phase evaluated the PMCT image interpretation performance of forensic pathologists for identifying injuries or disease in four types of fatalities in 200 cases: blunt force injury, firearm injury, pediatric trauma, and drug poisoning. Phase 2 evaluated how PMCT imaging was used by forensic pathologists in daily practice and how PMCT impacted their investigations regarding case management, workflow, and resource use. Phase 3 evaluated the effectiveness of integrating PMCT into routine investigations by retrospectively auditing 10 percent of Phase 2 cases. Over 5 years of incorporating PMCT into daily practice, the New Mexico OMI has slightly decreased the number of full autopsies, even as the total number of cases reported has increased. This was largely due to the impact of PMCT. Minor unrecognized or undocumented PMCT findings occurred in 95 percent of cases overall, with little difference in the four case categories. The overall conclusion is that pathologists reliably interpreted PMCT scans, avoided major errors, and accurately certified death in most cases. The data suggest that radiology consultation (RC) may reduce major errors, although the statistical significance of RC efficacy could not be determined from this study due to the few cases that used RC. 2 tables and a listing of project products