Ministry of Higher Education
Pembekalan Peralatan Dan Sistem ’Virtual Autopsy Technology’ (VAT) Di Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
Virtual Autopsy Technology
Agenda
Virtual Autopsy TechnologyWhy Virtual Autopsy?
Components of Virtual Autopsy System
System Demo
The urgency of VAT is seriously required in order to fulfill the:
‘Fatwa Majlis Kebangsaan Bagi Hal Ehwal Agama Islam Malaysia kali ke-73 yang bersidang 4-6 April 2006’ which clearly stated:
“Penggunaan Kaedah Autopsi Maya (Virtual Autopsy) dalam bedah siasat mayat wajib di beri keutamaan selaras dengan keperluan, Hajat dan kemampuan berbanding kaedah bedah siasat yang diamalkan sekarang”
Enakmen Negeri Selangor
Project Background
It is a pilot turnkey project in Malaysia:-• Method of work/procedure is not defined• Focus of the project is on the outcome
Adhering to :- • Ethical guidelines• System Integrity do not impair and acceptable
by:– Forensics Practice Guidelines– Laws of Malaysia– Halal / Haram Protocol of handling Muslim and Non-
Muslim dead bodies
Project Highlights
• It is a technology of new protocols and imaging sequences in Computed Tomography
• The VAT was born from the desire to implement new technique in radiology for the benefits of forensic sciences and medicine
• It is the latest Technology in Multi-Slice Computed Tomography (MSCT) Technology increasing both contrast and resolution, possibilities of 2D and 3D reconstruction
Virtual Autopsy Technology (VAT)
• Reduce number of Conventional Post Mortems solving problem of acute shortage of Forensic Pathologists
• Autopsy done without traditional dissection on a dead body.
• Fast turnaround of Forensic Reports
• Speedy Release of Body for Burial
• Excellent Teaching Tool
• Facilitate and Expedite Medico-legal Cases
• Evidences recorded eliminating need for exhumation
Why Virtual Autopsy?
The ProposedVirtual Autopsy System
Components of Virtual Autopsy
Medical ImagingCT
Advanced Digital Imaging
Photography
LaboratoryToxicology
HistopathologyMicrobiologyEntomology
Forensic Information Management
TeraRecon System
Forensic Data Exchange
Identification
FingerprintDNA Fingerprinting
Odontology
Proposed System ComponentsNo Component Description
1 Forensic Information Management and Mortuary System (FIMMS)
To facilitate registration, storage and release of the deceased person; as well as notation for post mortems.
To register specimen and send requests for analysis.
2 Laboratory Information System (LIS)
To automate laboratory operation. Accepts investigation order and return results online.
3 Radiology Information System / Picture Archiving and Communication System (RIS/PACS)
To acquire, archive and report on CT images convert to DICOM format. Interface to FIMMS to receive orders and send results.. Able to accept JPEG file and
4 3D Image Visualization
To perform 3D reconstruct of CT images. Make use of thin client technology to deliver interactive 3D images to standard PCs.
5 Forensic Data Exchange
A platform which accepts imaging and laboratory data to display in consolidated format to the users. HIPPA compliance.
Body/Body Part arrives at Mortuary
Register Body / Body Part
Store Body in Freezer
Autopsy Required?
Identify & Claim Body
Issue Burial Permit
Document Claimant Details
Release Body
N
High Level Workflow
Virtual Autopsy Processes
Y
The accident scene in Cheras after a 10-tonne lorry rammed into seven vehicles, leaving two dead and seven injured. – The Star Online, 1 August, 2008
Virtual Autopsy ArchitectureVirtual Autopsy Architecture
CT Image
TeraRecon
6
Registration (FIMMS)
2
BID
Finger Printing
Image Upload
3
External PM
7
Radiology & Lab Reports
Forensic Pathologist Report (FIMMS)
89
PMR
CT Scan
5DICOMWorklist
CTImage
Lab
Lab Request
Lab Result
RIS/PACS
4
LIS
Ix / Dx
Request
1
Crime Scene/ Hospital
Authorities
InternetReport Viewing
Second Opinion
Forensic Data Exchange
10
Crime / Accident Scene Photos
Body ID - Fingerprinting
Unknown body Fingerprinting
AFIS (Automated Fingerprint Identification System)
Database SearchSearch Result Authorities
Body ID – DNA Fingerprinting
Body ID – Dental Record
Dental Chart Dental Record
Body Registration, Tagging & Exam
Register body(FIMMS)
Body Tagging
Assign Body StorageRecord Findings(FIMMS)
External PM
Print Body Tag(Barcoded)
Diagnostic Imaging
Image ArchiveCT Console
TeraReconReconstructed Images
Forensic Laboratory Services
Toxicology
LCMS
To aid medical or legal investigation of death, poisoning and drug use.
Entomology
Evident Field Kit
Use to detect drugs and poisons, determine the location of an incident, find the presence and time of the infliction of wounds.
Microbiology
Real Time PCR
Application of DNA testing to microorganisms. Use DNA sequencing to distinguish between strains of viruses.
Histopathology
Microscope
The application of histological techniques and examination to forensic pathology practice.
System Integration – LIS
LISFIMMS
Barcoded Label
Label
Specimen Tubes
Sample Collection
Sample
Preparation
Perform
Test
FDX
Ix Request(HL7)
lx Result(HL7)
Ix Request
Ix Result
General Workflow for Laboratory Equipment that can be Interfaced
System Integration – LIS
LISFIMMS
Barcoded Label
Label
Specimen Tubes
Sample Collection
Sample
Preparation
Perform
TestFDX
Ix Request(HL7)
lx Result(HL7)
Enter Result. Scan and upload signed reports and Images
General Workflow for Laboratory Equipment that cannot be Interfaced
System Integration – Terarecon
DICOM
Worklist
RIS
Dx Request(HL7)
Dx Result(XML)
PACS
TeraRecon
ArchiveCT Images
Reconstruct
CT Images
Perform report in RIS
FDX
FIMMS
Register
Body
Internet
Report Viewing
Second Opinion(Secured
VPN)
DICOMWorklist
CT Scanner
Equipment
Data
Information
Post Mortem Report
Medical Imaging Clinical Laboratory Services
Histo-pathology
DNA Finger Printing
ToxicologyImaging VisualTool
Ento-mology
Photo Odon-tology
Micro-biology
LCMS Genetic Analyzer
Microscope AFIS & CODIS
CT TeraRecon Evident Field Kit
Digital Camera
DentalInstrument
Real Time PCR
• Unknown male motorcyclist – BID, accompanied by
Police with PM Order• Involved in a RTA with multiple injuries to head and body• Forensic Pathologist performed External PM & Virtual
Autopsy • Pathologist access FIMMS
• To document PM findings• To request pathology & imaging investigations• To view laboratory results
• Pathologist access TeraRecon system, via FIMMS • To view CT images & CT reports
Demo Test Case
Recommended