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Health

Forensic imaging technology helps virtual autopsies outnumber invasive post-mortem procedures

Forensic imaging, augmented reality headsets and artificial intelligence could reduce the need for invasive autopsies, saving families from further trauma, according to the Victorian Institute of Forensic Medicine (VIFM).

In many cases, "virtual autopsies" can be performed by forensic pathologists to determine a cause of death, says the VIFM deputy director Richard Bassed.

The images are generated using CT scans, which can survey a dead body and collect sensitive, specific and accurate information about it.

"Physical autopsies take time, they're distressing for families and there's lots of religious and cultural reasons why people might not want an autopsy in any particular case," Dr Bassed said.

"And they're expensive, so anything we can do to reduce the number of autopsies without compromising the validity and accuracy of the work is a good thing."

Monash University PhD student Vahid Pooryousef has made a prototype using an augmented reality (AR) headset that allows a user to see the room around them.

The technology means a pathologist wearing the headset could dissect a virtual 3D projection of a body, while simultaneously looking at the physical body in the mortuary along with relevant police or medical reports.

Dr Bassed said the headset and imaging technologies were already here, and the project was a way for pathologists to easily interact with the images to determine the cause of death.

Imaging already reducing autopsies

Technology has already drastically reduced the need for autopsies in Victoria.

Before a CT scanner was introduced at the VIFM in 2005 nearly all cases required an autopsy, Dr Bassed said.

Today autopsies are required in less than half of their cases.

Dr Bassed believes harnessing a combination of AR and artificial intelligence (AI) technology could reduce that rate even further.

"I doubt we will ever get down to zero, but that's the holy grail — that everything in forensic medicine is just done by imaging," he said.

Teaching for real-world use

Dr Bassed became inspired to investigate AR virtual autopsies four years ago when his colleagues took him to Monash University's vision lab.

They were using virtual reality headsets to teach anatomy to medical students.

"You'd get a 3D version of a heart sitting there in mid-air and you could dissect it with your fingers," he said.

"I thought this would be fantastic if we could do this to real dead people in the mortuary."

Now the first prototypes have been completed, Dr Bassed is hoping to introduce the technology at VIFM in the next two to three years.

"It gives you more flexibility with what you're looking at … than seeing it on a two-dimensional screen," he said.

You get a much better view of reality.

"For example, if somebody comes in with a knife in their chest, on a 2D screen you have to go through each individual slice to see where the knife is going.

"But in a 3D reconstruction, you can see exactly where that knife has gone."

Diagnosis determined by AI

Dr Bassed is also working on a project that could see AI interpreting post-mortem scans and automatically diagnosing problems.

Using more than 100,000 full-body CT scans from past VIFM cases, he is hoping to train a machine to learn to identify conditions such as broken bones, cancer, or heart disease.

"The challenge is to try and get that data into such a state that it can be analysed [and] looked at, and the machine learning algorithm can make some conclusions from that data," Dr Bassed said.

"You need a set of data that's been pre-labelled [and] pre-diagnosed manually so the machine can start seeing the patterns that we can't see."

The research was currently in its early stages and progressing slowly due to lack of funding, Dr Bassed said.

"I need squads of people to accurately label the scans," he said.

"If I get all the money I need to do it, we'd have a full system up and running in three or four years."

Reducing trauma in the justice system

Marc Trabsky is an associate law professor at La Trobe University undertaking a three-year research program to examine how forensic imaging technology is impacting coronial investigations and Australia's justice system.

He believes the use of forensic imaging to determine a person's cause of death — instead of invasive autopsies and photographs — is having a "profound effect for the better".

"It is reducing the caseload for coroners and other personnel," Dr Trabsky said.

"They are able to complete investigations in a more timely manner, which is good for everyone."

Australia was the first jurisdiction to introduce forensic imaging on a widespread scale, Dr Trabsky said, with more than 15,000 post-mortem scans carried out every year.

Dr Trabsky suspects his research into the use of post-mortem scans and digital reconstructions will find a reduction in trauma.

"It's decreasing vicarious trauma in the court itself, as well as trauma for the families," he said.

Post-mortem CT scanning had also led to a reduction in the amount of time a body must stay in the morgue, Dr Trabsky said.

"When the loved one is returned to the family there is perhaps no sign of an autopsy – that has beneficial effects for the bereaved family," he said.

"It also has a positive effect on coroners, lawyers, police, jurors, judges and others, due to less visually traumatic evidence being passed around."

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