Operational usefulness of postmortem computed tomography for presumed person identification through Antemortem image comparison: A retrospective case series.

This study aimed to evaluate the practical utility of postmortem computed tomography (PMCT) for radiologic comparison-based identification in routine forensic cases where a person was already identified and antemortem (AM) imaging was available. Between January 2021 and January 2024, police requested PMCT-based AM image comparison in 50 forensic cases. In all these cases, neither dental nor fingerprint identification was possible. DNA testing was not planned in most cases because close relatives were not available. AM images were collected from various hospitals and clinics, including radiography, CT, and MRI, acquired under inconsistent conditions. PMCT was performed either before autopsy or inspection with a 64-row multidetector CT scanner. Two board-certified radiologists reviewed the images. Presumed persons ranged in age from 36 to 94 years, with an average of 70.7 years (SD 12.9); 14 were female and 36 male. The body condition at examination was classified as decomposed in 30 out of 50 cases (60%), skeletonized in 9 (18%), burned in 8 (16%), and mummified in 3 (6%). AM material included brain CT in 32 cases (64%), body CT in 11 (22%), brain MRI in 3 (6%), and others in 4 (8%). Concordance between AM and PM images regarding the presumed person was observed in 49 cases. One case was inconclusive, as only a printed right-knee radiograph was available. In routine forensic cases involving a known individual and available AM imaging, PMCT-based radiologic comparison is practically useful, especially when traditional methods are unavailable.