The virtopsy is an emerging subject of interest in medical diagnostics (see: Introducing the Virtopsy, a Variant of the Catopsy Theme, The Classic Forensic Autopsy on the Verge of Being Obsolete, Reinventing the Autopsy: CT Imaging as a Routine Part of the Procedure, Additional Discussion About Reinventing the Autopsy). I have referred to the procedure in some of my notes as the catopsy because of the combination of the classic autopsy and the CT scan. The New York Times has now given increased exposure to this new approach to the medico-legal autopsy with a front page story (see: Autopsies of War Dead Reveal Ways to Save Others). Below is an excerpt from it with boldface emphasis mine.
As noted in the story above, there was initial reluctance on the part of the military officials to adopt the virtopsy but it has now proved its value beyond doubt. Also, and as noted above, a wealth of imaging information is now being made available by the military that could potentially facilitate the rapid adoption of the virtopsy. It urgently needs to be adopted for civilian forensic cases as well as for standard hospital autopsies of patients who have died of medical diseases. However, I suspect that the virtopsy will only be slowly embraced by civilian forensic pathologists or hospital-based pathology departments. Here are the reasons behind my prediction:
- Civilian forensic pathologists are overworked and underfunded. Given the current financial downturn, the various city and state governments that support the services of the medical examiners are struggling to meet basic needs. They will probably have little interest in new initiatives no matter what their value. Many forensic pathologists may also balk at having to acquire the new skills involved in the interpretation of CT images.
- There is no question is my mind that virtopsies would yield far better results than current methods -- the success of the Army with the technology bears out this conclusion. However, there is no urgent driver in the civilian world analogous to that in the military of savings soldiers' lives on the basis of the new virtopsy findings about the nature of injuries.
- For hospitals and pathology departments, there is no reimbursement for autopsies and frequently inadequate compensation for forensic cases. On this basis alone, it may be difficult to convince chairpersons of pathology departments to sink capital into enhancements of the pathology suite and new training initiatives.
- The only bright spot in this story is the increased interest in the merger of pathology and radiology, discussed in many previous notes. If this trend takes hold, the notion of training pathology residents rotating through the autopsy service in the interpretation of CT images could be very appealing. For academic departments, there is also the intriguing possibility of extracting more usable information from autopsy cases.