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Kinecting with the dead

by Brendon Nafziger, DOTmed News Associate Editor | July 07, 2011
From the June 2011 issue of HealthCare Business News magazine

Courtesy Virtopsy

“Switzerland is not the U.S.,” Ebert wryly noted.

Helpful, but expensive
The main advantage of the virtopsy approach is its comprehensiveness, Ebert said. A pathologist dissecting a cadaver takes notes about what he sees, but he doesn’t write down everything. If you take a CT or MRI scan, you have the complete body regardless of what you’re looking for, Ebert said. If new questions arise, you can always go back to re-examine the slides.

Yet Ebert cautioned that a virtual autopsy is not a substitute for a normal autopsy, as medical examiners cannot identify all pathologies and diseases just using MRI and CT scans.

“A CT scan can be a good adjunct to an autopsy,” Dr. Stephen Cina, deputy chief medical examiner of Broward County, Fla., professor of pathology at the University of Miami and president of the Florida Association of Medical Examiners, told DOTmed News. “But an autopsy is still the gold standard.”

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Currently, Cina said the recommended use for CT scans is to help guide the autopsy, by identifying injuries or pathological conditions in areas not routinely dissected by examiners. For instance, examiners often respect family wishes to hold open-casket funerals. This means they rarely cut deep inside the facial bones, so a CT scan could be useful to get preliminary information about the face.

It’s also helpful in high-profile cases where a lot evidence is needed, or if the family has strong religious objections to autopsies, such as among Orthodox Jews.

But with the exception of the military, where nearly all soldiers killed in combat are scanned when their bodies return home, virtual autopsy technology is not routinely used by medical examiners in the United States [See Sidebar]. Fewer than 10 of the big U.S. examiner offices either have the technology or are planning to buy it in the near future, Cina said.

The main problem with adopting the technology is the one afflicting nearly every aspect of health care: cost.

In his recent survey of 100 medical examiners, nearly one-fifth of all practicing, board-certified examiners in the country, Cina said he found the majority would use virtual autopsy technology if it were accessible and affordable.

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