Postmortem Imaging (Virtopsy) vs Conventional Autopsy – A Comparative Review

Abstract

In this review, we have compared the diagnostic performance as well advantages and limitations of Post-mortem imaging (virtopsy) versus traditional Autopsy techniques according to the literature available between 2022 and 2024 January. This systematic review was performed through a search on PubMed, Scopus, Web of Science and Google scholar by combination of the following words: "virtopsy", "postmortem imaging", "conventional autopsy", ""forensic pathology" and "diagnostic accuracy". Comparative studies of both techniques were searched, focusing on peer-reviewed publications from 2015-2022.  The main findings:  PMCT and PMMR present high diagnostic accuracy for traumatic lesions (sensitivity 85–95%), skeletal abnormalities (98% accuracy), as well as cardiovascular diseases. Traditional autopsy continues to outperform NC in its results on microscopic pathology, toxicologic assessment, and diagnosis of infectious diseases. Hybrid 3D virtual autopsy proves to be superior in diagnostic yield, benefiting from the preliminary nature of virtopsy plus additional dimensions added by other methods. "cost saving will be dependent upon infrastructure and volume of cases". Although the traditional autopsy is still considered to be the gold standard for full postmortem investigation, virtopsy has several advantages: it is minimally invasive, provides permanent digital documentation and improved family acquiescence as well as better visibility of some pathological changes. Combining the two modalities represents the ideal approach to forensic routine work nowadays, virtopsy being an alternative but not a substitution of the conventional one.  

CBMJ 2026 July: Vol. 15 No. 02 P:430-440