Virtual Autopsy in Medicolegal Investigations: A Systematic Review of Accuracy and Practical Utility

Virtual autopsy is a significant innovation in the field of forensic medicine and medicolegal investigations. This systematic review aims to evaluate the accuracy and practical utility of virtual autopsy in medicolegal investigations. The Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines were followed in the conduct of this systematic review. The literature search encompassed an extensive database including PubMed, ScienceDirect, Cochrane Library, and Google Scholar. Studies published from 2014 to 2024 were included in the analysis. The quality of the included studies was evaluated using the proper tools suited to the study design. The synthesis and analysis of data included a narrative summary of study characteristics, aims and objectives, techniques, and main findings of the study. Sample sizes in the selected studies ranged from 16 to 145 cases. The most common virtual autopsy techniques used were postmortem computed tomography (PMCT). Some studies used PMCT and conventional autopsy, while some studies used only PMCT, and a few studies applied combinations of PMCT and conventional autopsy, along with other techniques such as postmortem magnetic resonance, PMCT angiography, and traditional invasive autopsy to evaluate various conditions in medicolegal investigations. This systematic review concludes that virtual autopsy offers significant benefits, such as noninvasiveness and the ability to document findings digitally, but its limitations in differentiating ante mortem and postmortem changes, lack of tissue sampling, and challenges in soft tissue analysis restrict its ability to fully replace conventional autopsies.