An In-depth Look at

CT/MRI in Forensic
Science
Shannon Goel
April 17, 2014

The area of 3D forensics is a rapidly growing sub field of forensic science. The
advancement in technologies, practices, and increased public awareness has led to a
rapid change in the field of forensic science over the last few decades. Technologies
once reserved for use in the health care industry are now being used by forensic
scientists and police. The use of computed tomography (CT) and magnetic resonance
imaging (MRI) in the medical field is widely known but their implementation in the field of
forensic science has increased in recent years. Instead of being used to diagnose
illnesses in individuals, they are being used to identify potential objects of interest.
These can include but are not limited to: the identification of bullets, determining fracture
patterns, victim identification, and brain contusions (1). Their use in conducting
virtopsies, or virtual autopsies, has shown to be a possible alternative to conducting a
traditional autopsy. Developed by Dr. Richard Dirnhofer of Switzerland, a virtopsy
consists of two parts (2). The first is body volume documentation using CT, MRI and
microradiology while the 3D body surface documentation uses photogrammetry and 3D
optical scanning (2).
A CT scan involves the use of an x-ray to generate tomographic images (3). A
tomographic image is produced when a penetrating wave generates a sectional image
of an object (3). For CT scans, an x-ray takes multiple images at different angles in
order to generate tomographic images of a specific object without penetrating the
surface (3). An x-ray is a type of electromagnetic radiation whose wavelength varies
between 0.01 to 10 nanometers. A CT scanner is a rotating circular frame with an x-ray
tube on one side and a detector on the other (3). A beam of x-rays is produced as the
frame spins generating a single cross sectional image per rotation (3). CT scans are

generally used to produce images of the soft tissue and bone (3). The image below
shows a 3D image of a skull generated using CT scans.

This right anterior view of a three-dimensional CT reconstruction of the bony skull with bullet wounds.
National Library of Medicine. Virtopsy: the visual autopsy. (2006).
http://www.nlm.nih.gov/visibleproofs/galleries/technologies/virtopsy.html Accessed January 21, 2014

An MRI uses a magnetic field and radio waves to generate images (4). A
magnetic field is generated around the object being analyzed (4). A radio frequency is
then emitted from the object as the hydrogen atoms within it become excited by the
energy supplied by the magnetic field (4). The time it takes for the hydrogen molecules
to assume their natural position determines the type of tissue as the molecules in
different tissues realign at different times (4). The image below shows a cross sectional
image of a brain taken by an MRI.

Would track of a bullet through the brain

National Library of Medicine. Virtopsy: the visual autopsy. (2006).
http://www.nlm.nih.gov/visibleproofs/galleries/technologies/virtopsy.html Accessed January 21, 2014

The use of x-ray technology in the legal system was first demonstrated in a
Canadian case that occurred in the late 19 th century. The incident which occurred in
Montreal involved the shooting of Tolson Cunning by George Holder (5). Trying to locate
the bullet failed initially until a 45 minute x-ray exposure revealed the bullet between the
two lower leg bones (5). The x-ray image was submitted to the court providing the
crucial evidence needed to convict Holder. Holder was subsequently sentenced to 14
years in prison for attempted Murder. With the development of forensic photogrammetry
in the 1990s, the idea of developing an objective and non-invasive method to document
the body was proposed (2). The idea was proposed as a result of a high profile case in
Switzerland involving the comparison of an impression taken from the skull to the
murder weapon (2). The need for a technique to compare the impression to the weapon

was the catalyst that led to the idea of using photogrammetry to document the body (2).
Anecdotal evidence suggests that the lack of developments since the 1990s may be
caused by hesitation in the forensic community as using such technologies would result
in a drastic change in practices (5). Resistance to using cross sectional imaging for
forensic purposes could be a direct result of these fears (5).
The ability to turn the 2D images into 3D models is important. With respect to CT,
the axial images generated from a scan can be integrated to create a 3D image (6).
Shaded surface display (SSD) and maximum intensity projection (MIP) are the more
commonly utilized 3D rendering techniques (6). SSD was first used on medical data (6).
It involves using an algorithm to locate a surface within a data set (6). Surface contours
are displayed as overlapping polygons (6). A virtual light source is then made for each
polygon resulting in surface shading (6). An advantage of this technique is that it allows
surface models to be repositioned and manipulated which is beneficial in surgical
planning (6). The rendering technique uses a small percentage of the CT data set which
could result in inaccurate models (6). Commercial CT image processing packages for
surface rendering are widely available (6). Maximum intensity projection displays 3D
data into 2D planes (6). The maximum voxels are displayed for each visualization plane
(6). A voxel is a volume element that can be organized to form a 3D matrix (6). MIP has
proven to be a useful tool in generating angiographic images from CT and MRI data (6).
The angiographic images display the vessels in the body (6). MIP is available in
commercial 3D software packages (6). The image below is a 3D model generating
using MIP technology.

MIP used for pulmonary artery mapping.

Calhoun P, Kuszyk B, Heath D, Carley J, Fishman E. Three-dimensional volume
rendering of spiral CT data: Theory and method. Radiographics. 1999 MAYJUN;19(3):745-64.

Unlike MIP and SSD, 3D volume rendering takes into account the whole data set
generated from a CT or MRI (6). Volume rendering takes into account each voxel and
generates a composite (6). The information from the entire data set is used to create a
model that adheres to the data (6). Powerful computers are needed for this process in
order for a model to be generated in a reasonable amount of time (6).
A major breakthrough was the multislice CT. Multislice CT is a 3D imaging
technique whose popularity has grown exponentially (7). Unlike normal CTs that use a
single detector arc or ring, multislice uses two or more parallel detectors (7). Multislice
allows for faster scan times, longer scan ranges, and thinner cross sections (7). Some
disadvantages include the increase in data load as a result of more images being taken

(7). Producing thicker cross sections can be used to decrease the data load although
this negates the major benefit associated with multislice CT (7).
Autopsy practices have remained relatively unchanged over the course of the
past century (8). Pathologists rely on analyzing the macroscopic organ morphology as
well as microscopic examination of a deceased (8). MRI and CTs have been used as
diagnostic tools but their implementation in autopsies have been limited. A study by
Westphal and Apitzsch compared traditional autopsies to virtopsy in order to determine
the feasibility of their use in clinical autopsies. Results showed that the virtual autopsy
was a great tool for the documentation of pathologic findings (8). It was shown to
compliment traditional techniques and enhance the diagnostic process and wholeness
of autopsy reports (8).
Using CT and MRI technology to conduct a virtopsy in conjunction with traditional
techniques or as a replacement is a future possibility. A major advantage to using such
methods is that they are non-invasive and non-destructive. Any evidence within an
object could be analyzed in its current position without being disturbed. The world we
live in is changing with countries becoming multicultural consisting of individuals of
various backgrounds and religions. Some religions prohibit post-mortem alterations to
the body which conflicts with the methods used in traditional autopsies. Having an
alternative method that limits the modifications done to the deceased would be
desirable. Only in certain cases where tissue samples are needed would they be taken
(2). Another benefit is the ability to send the images taken to other experts who are able
to provide their opinion. The peer review aspect is important in the field of forensic
science as it limits the potential for errors and reinforces objective results. Conducting a

virtual autopsy from any location is possible with the use of volume rendering tools on a
data set (2). The virtopsy project conducted by Dirnhofer and colleagues was done to
validate the use of radiologic and surface scanning methods in autopsies by comparing
them to traditional methods (2).
Knowing whether an injury occurred post or ante mortem is critical as it
establishes a timeline of events and can be helpful in determining cause of death (2). In
the case of an injury caused by blunt trauma, the presence of soft tissue emphysema is
indicative of post trauma breathing (2). The examination of emphysema during an
autopsy is difficult as the air disappears once the overlying skin is cut (2). An abdominal
CT scan of an individual hit by a car displayed immense soft tissue emphysema where
air pockets within the tissues indicated that the individual was breathing for a period of
time after the incident (2). The pockets of air were shown as black patches on the scan
as they did not contain water needed for hydrogen excitation. This shows how imaging
technologies can be used to interpret injuries that normal medical practices cannot.
CT and MRI can be used in forensic reconstruction. This includes impact
direction, entrance and exit wounds, and driver/pilot determination. A CT scan can help
determine impact directionality and force of impact (2). Looking at the degree of
contusions on fatty subcutaneous tissue can be used to determine the force of impact
while analyzing the bone fractures themselves determines directionality (2). The
morphology of the wound, characteristic skull fractures, and injuries on the opposite
side of impact can be used to conclude whether head injuries were caused by a fall or a
blow to the head (2). The presence of a ring fracture is indicative of a blow to the head
while the presence of a comminuted fracture, involving a number of bone fragments, is

caused by a fall (2).These injuries can be visualized using a CT scan. When looking at
gunshot wounds in bone, a cone shaped deformity indicates the direction the bullet
passed through (2). A comparison of autopsy photographs to images generated using a
CT determined that both methods revealed similar findings when determining entrance
and exit wounds (2). Knowing who was controlling a vehicle at the time of an accident is
critical and can be determined by analyzing the injuries obtained by individuals in an
accident (2). Seat belt and dashboard injuries can establish which individuals were
sitting in the front while specific palm injuries indicate whether an individual was piloting
a plane (2). An MRI of the hand and lower arm of a deceased individual piloting a plane
revealed a fractured ulna and hyper intense regions on the image (2). The autopsy
photographs revealed subcutaneous bleeding in these regions explaining the presence
of the hyper intense regions caused by the blood (2). These injuries were caused by the
control lever indicating that the individual was piloting the plane at impact (2). Knowing
who was in control of a vehicle during a crash is needed in order to determine liability.
The application of CT and MRI for other forensic purposes can also be done.
Victims of assault can have an MRI taken to medically determine the severity of the
assault (2). This is especially useful in cases of strangulation where the severity of such
act is important to laying specific criminal charges (2). Before this practice the
determination of life threatening injuries was subjective and was based on the victims
loss of consciousness or pressure sensitivity in the neck area (2). Using an MRI to
analyze internal bleeding around the neck area can be an objective method for
determining the severity of the strangulation (2). Detection of illicit drugs carried by body
packing can also be done using CT. Body packing, the internal concealment of drugs, is

used by criminals for the transportation of drugs. A case study looked at the possible
presence of body packing in a 41 year old individual. An initial abdominal X-ray was
conducted yielding no results but at the request of the Australian Federal Police a CT of
the abdomen and pelvis region was performed (9). The standard abdominal window was
normal but the wider window revealed heroin packages in the colon (9). If an individual
is suspected of being a body packer then reviewing the scans on different windows may
increase the detection of body packing (9).
There are a few disadvantages to using CT/MRI techniques. The first is that the
resolution on CT and MR images may not be able to answer questions related to wound
analysis (2). In such cases the use of micro-CT and micro-MR imaging may be
warranted as high resolution images are generated (2). MRI is also quite costly and is
not as available as CT. Employing both methods would prove costly as individuals
would need to be trained on how to properly use the equipment. Privacy concerns over
how the data will be used and stored may also arise. The lack of recognition of using CT
and MRI to conduct autopsies or for use in other forensic areas has not become a
widely accepted method. More publications and studies need to be conducted to allow
for the best practices governing the use of such technologies to be employed.
The replacement of traditional autopsies using CT and MRI would require further
testing in order for its use to be accepted by the forensic community. The short imaging
times and non-invasive procedures is needed to decrease the time of autopsies and
reduce post-mortem body modifications. The ability to determine entrance and exit
wounds, uncover traumatic injury, and determine the driver of a vehicle will aid the
investigation process.

References
1. National Library of Medicine. Virtopsy: the visual autopsy. (2006).
http://www.nlm.nih.gov/visibleproofs/galleries/technologies/virtopsy.html Accessed
January 21, 2014
2. Dirnhofer R et al. VIRTOPSY: minimally invasive, imaging-guided virtual autopsy.
Radiographics 2006;26(5):1305-33
3 Siemens. Computed Tomography. (2012). http://www.medicalradiation.com/types-ofmedical-imaging/imaging-using-x-rays/computed-tomography-ct/ Accessed March 22,
2014
4 Gould, RT-(R)(MR)(ARRT), Todd A., Edmonds M. How MRI Works .(2010).
HowStuffWorks.com. http://science.howstuffworks.com/mri.htm Accessed March 22,
2014.
5 Beck JJW. What is the future of imaging in forensic practice? Radiography
2011;17(3):212-17
6 Calhoun P, Kuszyk B, Heath D, Carley J, Fishman E. Three-dimensional volume
rendering of spiral CT data: Theory and method. Radiographics. 1999 MAYJUN;19(3):745-64.
7 Prokop M, Galanski M, van der Molen A, Schaefer-Prokop C. Spiral and Multislice
Computed Tomography of the Body. (2002). Thieme: New York
8 Westphal SE, Apitzsch J, Penzkofer T, Mahnken AH, Knuechel R. Virtual CT autopsy
in clinical pathology: Feasibility in clinical autopsies. Virchows Arch. 2012
AUG;461(2):211-9.
9 Sengupta A, Page P. Window manipulation in diagnosis of body packing using
computed tomography. Emergency radiology 2008;15(3):203-5