Diffusion MRI in Forensic Medicine
Kathrin Yen1

1Institute for Forensic and Traffic Medicine, Heidelberg

Synopsis

Educational lecture on Diffusion MR Imaging in forensic medicine and research.

Highlights

- Postmortem diffusion MRI is an emerging field of research that yields excellent imaging data and offers unique possibilities of directly comparing imaging and (micro-)structural tissue findings

- Forensic-radiologic diffusion MRI studies forwad neurotraumatology dignostics from an indirect, hemorrhage based assessment towards a direct tissue and fiber based approach

- Diffusion imaging studies demonstrated some potential to get a better understanding of the process of dying based on cause-of-death-related ADC changes

Target audience

Clinical radiologists and scientists interested in new applications of diffusion imaging and novel research fields; forensic imaging experts, neuroscientists and neuroradiologists.

Outcome / Objectives

In this presentation, the forensic application of diffusion imaging in postmortem subjects will be demonstrated with focus on the potential of such an approach and the benefits of clinical-forensic research cooperations in this specific field. It will be shown how forensic imaging can add highly specific knowledge to clinical research. Besides the current state-of-the-art in postmortem diffusion imaging and its limitations and challenges, results are shown from studies of the in-situ postmortem brain following different causes of death and with or without previous traumatic brain injury.

Purpose

To give a broad overview of the state-of-the-art in post-mortem forensic diffusion imaging, its applications, current research issues and results.

Methods

As with other MRI applications in forensic imaging, previous studies [1-7] have demonstrated that diffusion imaging at 1.5 or 3T can well be applied in post-mortem situations and yields good results even days after death. However, the imaging parameters must be adjusted to the post-mortem situation according to the cooler body temperature. The absence of movement artifacts due to blood flow and breathing is advantageous for the image quality. Another specific benefit of forensic diffusion imaging is the unique possibility to compare the MRI results with the true findings from macroscopic examination and tissue samples. In the case of e.g. traumatic fiber rupture in the brain tissue, autopsy and histopathologic examination can be used to reveal the exact localization, extent and type of tissue damage.

Results

Forensic diffusion MRI pilot studies in recent years mainly focused on the post-mortem in situ brain and on characteristic post-mortem alterations and traumatic or non-traumatic changes, respectively [1,2,4-7]. Apart from the basic applicability of diffusion imaging in bodies that has been proven so far, the findings that were detected reflected mechanical trauma sequelae, a generally reduced ADC in the post-mortem brain and ADC changes that correlated with the time since death. The ADC was also lower following mechanical and hypoxic brain injury having caused death when compared to heart failure cases.

Discussion / Conclusion

Post-mortem diffusion imaging in forensic cases is quite new. It has however demonstrated its potential to gain new insights into the morphology and function of tissues and organs and to serve as a reasonable supplement to clinical research. Hearers of this presentation should understand the potential and limitations of post-mortem diffusion MRI, its main applications and the usefulness of interdisciplinary clinical-forensic research.

Acknowledgements

Special thanks goes to the Forensic Imaging Research Group from the Forensic Institute at Heidelberg and the German Cancer Research Institute for continuously high engagement and support.

References

[1] Flach PM et al., Am J Forensic Med Pathol 2015 [2] Ruder TD et al., Br J Radiol 2014 [3] Winklhofer S et al., Eur Radiol 2014 [4] Schmidt TM et al., Forensic Sci Int 2012 [5] Scheurer E et al., AJNR 2011 [6] Yen K et al., AJNR 2006


Proc. Intl. Soc. Mag. Reson. Med. 24 (2016)