Virtopsy -- noninvasive detection of occult bone lesions in postmortem MRI: additional information for traffic accident reconstruction

In traffic accidents with pedestrians, cyclists or motorcyclists, patterned impact injuries as well as marks on clothes can be matched to the injury-causing vehicle structure in order to reconstruct the accident and identify the vehicle which has hit the person. Therefore, the differentiation of the primary impact injuries from other injuries is of great importance. Impact injuries can be identified on the external injuries of the skin, the injured subcutaneous and fat tissue, as well as the fractured bones. Another sign of impact is a bone bruise. The bone bruise, or occult bone lesion, means a bleeding in the subcortical bone marrow, which is presumed to be the result of micro-fractures of the medullar trabeculae. The aim of this study was to prove that bleeding in the subcortical bone marrow of the deceased can be detected using the postmortem noninvasive magnetic resonance imaging. This is demonstrated in five accident cases, four involving pedestrians and one a cyclist, where bone bruises were detected in different bones as a sign of impact occurring in the same location as the external and soft tissue impact injuries.

(18)F-Immuno-PET: Determination of Anti-CD66 Biodistribution in a Patient with High-Risk Leukemia

The monoclonal antibody anti-CD66 labeled with (99m)Tc is widely used as Scintimun((R)) granulocyte for bone marrow immunoscintigraphy. Further, recently performed clinical radioimmunotherapy studies with [(90)Y]Y-anti-CD66 proved to be suitable for the treatment of hematologic malignancies. Before radioimmunotherapy with [(90)Y]Y-anti-CD66, dosimetric estimations are required to minimize radiotoxicity and determine individual applicable activities. Planar imaging, using gamma-emitting radionuclides, is conventionally carried out to estimate the absorbed organ doses. In contrast, immuno-PET (positron emission tomography) enables the quantification of anti-CD66 accumulation and provides better spatial and temporal resolution. Therefore, in this study, a semiautomated radiosynthesis of [(18)F] F-anti-CD66 was developed, using the (18)F-acylation agent, N-succinimidyl-4-[(18)F]fluorobenzoate ([(18)F]SFB). As a proof of concept, an intraindividual comparison between PET and conventional scintigraphy, using (18)F- and (99m)Tc-labeled anti-CD66 in 1 patient with high-risk leukemia, is presented. Both labeled antibodies displayed a similar distribution pattern with high preferential uptake in bone marrow. Urinary excretion of [(18)F] F-anti-CD66 was increased and bone marrow uptake reduced, in comparison to [(99m)Tc]Tc-anti-CD66. Nevertheless, PET-based dosimetry with [(18)F] F-anti-CD66 could provide additional information to support conventional scintigraphy. Moreover, [(18)F]F-anti-CD66 is ideally suited for bone marrow imaging using PET.

Long-term follow-up of metabolic activity in human alveolar echinococcosis using FDG-PET

AIM: [(18)F]fluoro-deoxyglucose positron-emission-tomography (FDG-PET) detects metabolic activity in alveolar echinococcosis (AE). The slow changes in metabolic and morphological characteristics require long-term follow-up of patients. This is the first study to evaluate metabolic activity over may years, hereby assessing the utility of FDG-PET for the evaluation of disease progression and response to treatment. PATIENTS, METHODS: 15 patients received a follow-up FDG-PET combined with computed tomography (integrated PET/CT) with a median of 6.5 years after the first PET in 1999. Number and location of enhanced metabolic activity in the area of AE lesions was determined. Quantification of intensity of metabolic activity was assessed by calculation of mean standardized uptake values. RESULTS: AE lesions in 11/15 patients had been metabolically inactive initially, but only two showed permanent inactivity over the course of 81 months. Interestingly, in two patients metabolic activity was newly detected after 80 and 82 months. Benzimidazole treatment was intermittently discontinued in seven cases. Persisting activity at FDG-PET demanded continued benzimidazole treatment in four patients. Neither treatment duration, lesional size, calcifications nor regressive changes correlated with metabolic activity. CONCLUSION: Treatment responses are heterogeneous and vary from progressive disease despite treatment to long-term inactive disease with discontinued treatment. Lack of metabolic activity indicates suppressed parasite activity and is not equivalent to parasite death. However, metabolic activity may remain suppressed for years, allowing for temporary treatment discontinuation. Relapses are reliably detected with PET and restarting benzimidazole treatment prevents parasite expansion.

Novel weapons: Invasive plant suppresses fungal mutualists in America but not in its native Europe

Why some invasive plant species transmogrify from weak competitors at home to strong competitors abroad remains one of the most elusive questions in ecology. Some evidence suggests that disproportionately high densities of some invaders are due to the release of biochemicals that are novel, and therefore harmful, to naive organisms in their new range. So far, such evidence has been restricted to the direct phytotoxic effects of plants on other plants. Here we found that one of North America's most aggressive invaders of undisturbed forest understories, Alliaria petiolata (garlic mustard) and a plant that inhibits mycorrhizal fungal mutualists of North American native plants, has far stronger inhibitory effects on mycorrhizas in invaded North American soils than on mycorrhizas in European soils where A. petiolata is native. This antifungal effect appears to be due to specific flavonoid fractions in A. petiolata extracts. Furthermore, we found that suppression of North American mycorrhizal fungi by A. petiolata corresponds with severe inhibition of North American plant species that rely on these fungi, whereas congeneric European plants are weakly affected. These results indicate that phytochemicals, benign to resistant mycorrhizal symbionts in the home range, may be lethal to naive native mutualists in the introduced range and indirectly suppress the plants that rely on them.

Accident or homicide - virtual crime scene reconstruction using 3D methods

The analysis and reconstruction of forensically relevant events, such as traffic accidents, criminal assaults and homicides are based on external and internal morphological findings of the injured or deceased person. For this approach high-tech methods are gaining increasing importance in forensic investigations. The non-contact optical 3D digitising system GOM ATOS is applied as a suitable tool for whole body surface and wound documentation and analysis in order to identify injury-causing instruments and to reconstruct the course of event. In addition to the surface documentation, cross-sectional imaging methods deliver medical internal findings of the body. These 3D data are fused into a whole body model of the deceased. Additional to the findings of the bodies, the injury inflicting instruments and incident scene is documented in 3D. The 3D data of the incident scene, generated by 3D laser scanning and photogrammetry, is also included into the reconstruction. Two cases illustrate the methods. In the fist case a man was shot in his bedroom and the main question was, if the offender shot the man intentionally or accidentally, as he declared. In the second case a woman was hit by a car, driving backwards into a garage. It was unclear if the driver drove backwards once or twice, which would indicate that he willingly injured and killed the woman. With this work, we demonstrate how 3D documentation, data merging and animation enable to answer reconstructive questions regarding the dynamic development of patterned injuries, and how this leads to a real data based reconstruction of the course of event.

Influence of manure scrapers on dairy cows in cubicle housing systems

Manure scrapers are widely used in dairy cow loose-housing systems. In order to evaluate the effects of the scrapers on the cows, we assessed their impact on the animals' cardiac activity, feeding behaviour, and the behavioural reactions of cows confronted with different types of scrapers. In part I of the study, we measured cardiac activity (mean R–R interval and RMSSD, a parameter of heart-rate variability) whilst observing the behaviour of 29 focal cows on three farms during situations with and without active manure scrapers. Lower RMSSD values were observed during scraping events while cows were either lying, standing or walking in the alleyway, standing completely in the lying cubicle, or standing half in the lying cubicle (P=0.03), but only tended to differ while directly confronted with the scraper (P=0.06). This indicates that dairy cows experienced at least some mild stress during manure-scraping events. In part II, the feeding behaviour of 12 cows on each of two farms was recorded by means of a jaw-movement sensor and compared between situations with the manure-scraping event following forage provision either within or outside the main daily feeding period (i.e. within 1 or after 2 h from forage provisioning, respectively). The duration of night-time feeding (P=0.049) and the number of feeding bouts (P=0.036) were higher when a manure-scraping event took place within the main daily feeding period, indicating that the cows' feeding behaviour had been disturbed. In part III, we observed the cows' behaviour on 15 farms during eight manure scraping events per farm, where each of five farms had one of three different scraper types. We assessed the cows' immediate reactions when confronted with the scraper. In addition, we recorded the number of animals present in the alleyways before and after the manure-scraping events. The more cows that were present in the alleyways before the scraping event, the lower the proportion of cows showing direct behavioural reactions both with (P=0.017) and without (P=0.028) scraper contact, and the higher the number of cows that left the alleyways (P<0.001). Scraper type did not influence the proportion of cows showing behavioural reactions. In conclusion, our results show that dairy cows perceive the manure-scraping event negatively in some situations, that feeding behaviour may be disturbed when scrapers are active during the main feeding period, and that cows avoid the scraper during crowded situations.

Metabotropic glutamate receptor 5 binding in patients with obsessive-compulsive disorder

Obsessive-compulsive disorder (OCD) is a disabling, mostly chronic, psychiatric condition with significant social and economic impairments and is a major public health issue. However, numerous patients are resistant to currently available pharmacological and psychological interventions. Given that recent animal studies and magnetic resonance spectroscopy research points to glutamate dysfunction in OCD, we investigated the metabotropic glutamate receptor 5 (mGluR5) in patients with OCD and healthy controls. We determined mGluR5 distribution volume ratio (DVR) in the brain of ten patients with OCD and ten healthy controls by using [11C]ABP688 positron-emission tomography. As a clinical measure of OCD severity, the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was employed. We found no significant global difference in mGluR5 DVR between patients with OCD and healthy controls. We did, however, observe significant positive correlations between the Y-BOCS obsession sub-score and mGluR5 DVR in the cortico-striatal-thalamo-cortical brain circuit, including regions of the amygdala, anterior cingulate cortex, and medial orbitofrontal cortex (Spearman's ρ's⩾ = 0.68, p < 0.05). These results suggest that obsessions in particular might have an underlying glutamatergic pathology related to mGluR5. The research indicates that the development of metabotropic glutamate agents would be useful as a new treatment for OCD.

VIRTOPSY--scientific documentation, reconstruction and animation in forensic: individual and real 3D data based geo-metric approach including optical body/object surface and radiological CT/MRI scanning.

Until today, most of the documentation of forensic relevant medical findings is limited to traditional 2D photography, 2D conventional radiographs, sketches and verbal description. There are still some limitations of the classic documentation in forensic science especially if a 3D documentation is necessary. The goal of this paper is to demonstrate new 3D real data based geo-metric technology approaches. This paper present approaches to a 3D geo-metric documentation of injuries on the body surface and internal injuries in the living and deceased cases. Using modern imaging methods such as photogrammetry, optical surface and radiological CT/MRI scanning in combination it could be demonstrated that a real, full 3D data based individual documentation of the body surface and internal structures is possible in a non-invasive and non-destructive manner. Using the data merging/fusing and animation possibilities, it is possible to answer reconstructive questions of the dynamic development of patterned injuries (morphologic imprints) and to evaluate the possibility, that they are matchable or linkable to suspected injury-causing instruments. For the first time, to our knowledge, the method of optical and radiological 3D scanning was used to document the forensic relevant injuries of human body in combination with vehicle damages. By this complementary documentation approach, individual forensic real data based analysis and animation were possible linking body injuries to vehicle deformations or damages. These data allow conclusions to be drawn for automobile accident research, optimization of vehicle safety (pedestrian and passenger) and for further development of crash dummies. Real 3D data based documentation opens a new horizon for scientific reconstruction and animation by bringing added value and a real quality improvement in forensic science.

3D documentation and visualization of external injury findings by integration of simple photography in CT/MRI data sets (IprojeCT).

This study evaluated the feasibility of documenting patterned injury using three dimensions and true colour photography without complex 3D surface documentation methods. This method is based on a generated 3D surface model using radiologic slice images (CT) while the colour information is derived from photographs taken with commercially available cameras. The external patterned injuries were documented in 16 cases using digital photography as well as highly precise photogrammetry-supported 3D structured light scanning. The internal findings of these deceased were recorded using CT and MRI. For registration of the internal with the external data, two different types of radiographic markers were used and compared. The 3D surface model generated from CT slice images was linked with the photographs, and thereby digital true-colour 3D models of the patterned injuries could be created (Image projection onto CT/IprojeCT). In addition, these external models were merged with the models of the somatic interior. We demonstrated that 3D documentation and visualization of external injury findings by integration of digital photography in CT/MRI data sets is suitable for the 3D documentation of individual patterned injuries to a body. Nevertheless, this documentation method is not a substitution for photogrammetry and surface scanning, especially when the entire bodily surface is to be recorded in three dimensions including all external findings, and when precise data is required for comparing highly detailed injury features with the injury-inflicting tool.

Non-Contact Documentation of Physical Characteristics of Ecstasy Tablets, Hemp Coins, and Imprint Punches by using 3D Optical Surface Scanning

The description of seized illicit ecstasy tablets and other pressed drug products is an important step in casework. The physical and visual analysis and the description of the characteristics can be employed for intelligence purposes. Besides photography and manual measurements of dimensions, some optical instruments are employed for detailed measurements of physical characteristics. In this work, the method of 3D surface digitizing is introduced as a suitable tool for highly accurate documentation of small objects, especially for pressed drug products. The resulting detailed information about the geometry, and the results of an automatic comparison of apparently uniform tablets and coins with punches, can support drug intelligence.

Virtopsy in der Unfallrekonstruktion

Mit der Virtopsy hat das Institut für Rechtmedizin der Universität Bern unter Prof. Dr. med. R. Dirnhofer und Prof. Dr. med. M. Thali die Rechtsmedizin über die ganze Welt revolutioniert. Obwohl einzelne Techniken, aus dem klinischen Medizinalltag stammend, bereits zu früherer Zeit im einen oder andere Autopsie-Saal bereits zur Anwendung kamen, waren es die Berner Rechtsmediziner, Radiologen und Ingenieure, welche diese kombinierten. Unter dem Begriff Virtopsy vereint sich die Nutzung von medizinischen bildgebenden Verfahren mit dem Erfassen der Körperoberfläche mittels 3D-Oberflächenscanning. Dadurch hat Virtopsy, nebst den rekonstruktiven Möglichkeiten, ein immenses Potential für die Dokumentation sowohl vom Verstorbenen als auch von Verletzungen von Lebenden. Gerade mittels der räumlichen Darstellung von inneren Verletzungen und Frakturen können diese für den medizinischen Laien optimal dargestellt und verständlich gemacht werden. Bei der Klärung von Verkehrsunfällen, insbesondere bei Kollisionen von Motorfahrzeugen mit Fussgängern oder Zweiradfahrern - gegenüber welchen der Mensch besonders exponiert und verletzlich ist - aber auch zur Klärung von Verletzungen an Fahrzeuginsassen, zeigen sich die rekonstruktiven Möglichkeiten von Virtopsy. Dabei gilt zu beachten, dass die 3D-Dokumentation mittels den erwähnten Verfahren eine Akquisition von digitalen Daten, nicht automatisch eine vollständige Auswertung zur Folge haben muss. Trotzdem zeigt sich, dass viele offene Fragen erst im Nachhinein auftreten, wenn die Befunde und Spuren nicht mehr zugänglich sind. Die mittels Virtopsy erhobenen digitalen Daten lassen sich jedoch zu jedem Zeitpunkt neu befunden oder weiter bearbeiten und können auch in Zukunft zur Klärung eines Unfallereignisses beitragen.

Wer lenkte den PW?

Die Rekonstruktion von Verkehrsunfällen ist ein interdisziplinäres Arbeitsgebiet. Verschiedene Institutionen wie z.B. die Polizei, die Rechtsmedizin oder die Unfallanalyse befassen sich mit der Beantwortung von juristischen Fragestellungen bei Verkehrsunfällen. Die modernen 3D-Dokumentations- und Analysemethoden und der Einsatz der bildgebenden Verfahren in der Rechtsmedizin ermöglichen eine disziplinübergreifende Auswertung der vorhandenen Spuren und Befunde und eröffnen damit ganz neue Horizonte und Dimensionen. Zudem ermöglichen sie es auch dem technischen Laien, eine bildliche Vorstellung der komplexen unfalldynamischen Abläufe zu geben. Im vorliegenden Beitrag wird anhand eines Falles die interdisziplinäre Fallanalyse und morphometrische 3D-Rekonstruktion vorgestellt und erläutert. Dieser Fall wurde Jahre nach dem Ereignis in Auftrag gegeben zur Klärung der Frage, wer den PW zum Unfallzeitpunkt gelenkt hatte. Die morphometrische 3D-Rekonstruktion umfasst die Ermittlung des Unfallhergangs, des biomechanischen Verhaltens der Fahrzeuginsassen und der Entstehung ihrer Verletzungen sowie der Entstehung der Blutspuren und weiterer Spuren und Beschädigungen im Fahrzeuginneren. Die Fahrzeuginsassen werden mittels Photogrammetrie und optischem 3D-Oberflächenscanning dreidimensional dokumentiert. Von verletzten Insassen werden zusätzlich die Daten klinischer radiologischer Untersuchungen von verstorbenen die vor der Obduktion durchgeführte Computertomographie (CT) und Magnetresonanztomographie (MRT) in die 3D-Analyse integriert. Das Fahrzeug und alle unfallrelevanten Objekte werden ebenfalls mittels Photogrammetrie und 3D-Oberflächenscanning erfasst. Ein 3D- Situationsplan der Örtlichkeit mit allen Spuren wird von der Polizei mittels Photogrammetrie und Laserscanning erstellt und in die Auswertung integriert. Anhand dieser 3D-Daten, insbesondere der Spuren am Unfallort und der Beschädigungen des Fahrzeuges, wird der Unfallablauf und daraus resultierend das biomechanische Verhalten der Fahrzeuginsassen rekonstruiert und in der Animationssoftware 3DS Max Design nachgestellt. Basierend auf den gewonnenen Erkenntnissen können morphometrische Vergleiche der Verletzungen mit den relevanten Strukturen im Fahrzeuginneren durchgeführt und so ermittelt werden, wie diese Verletzungen entstanden sind und auf welchen Sitzen die Insassen während des Unfalles sassen. Neben den Verletzungen können auch die Körpergrössen der Insassen Hinweise zur Ermittlung des Lenkers geben. Die Möglichkeiten der morphometrischen Rekonstruktion mittels der 3D-Techniken sind weitreichend und können oft entscheidende Erkenntnisse für das Ermittlungsverfahren liefern.