Applicability of postmortem CT organ-selective volume rendering in evaluating liver and heart injuries

Postmortem computed tomography (PMCT) is widely used in forensic cause-of-death investigations, and 3D volume rendering is commonly employed for visualizing PMCT data. However, no studies have investigated the effectiveness of organ-selective 3D volume rendering for detection of organ injuries such as liver and heart. This study aimed to assess whether selective volume rendering could enhance the detectability of organ damage that is generally difficult to observe in 2DCT images. Using 22 selected cases of liver or heart injury, the detectability of the injury in 2DCT images and selective volume-rendered images was compared with actual autopsy findings. Among 15 cases of liver injury confirmed at autopsy, 2DCT imaging detected two, whereas selective volume-rendered imaging detected one. Furthermore, among 17 cases of cardiac injury, 2DCT imaging detected two, whereas selective volume-rendered imaging detected four. Thus, a small proportion of liver and heart injury cases were detectable using 2DCT imaging or selective volume rendering. In all cases where selective volume rendering identified an injury, the injury was not identified by radiologist interpretation of the 2DCT images, although a review of the 2DCT images did allow identification of the injury when corroborated by the findings of selective volume rendering. One additional case demonstrated the usefulness of selective volume rendering for estimation of puncture wound direction. Although selective volume rendering has seldom been effective in detecting heart or liver damage, organ-selective volume rendering may provide clues for detection of injuries that are often overlooked in 2DCT images alone.