Bengaluru hospital takes hi-tech path with virtual autopsy

Virtual autopsy, which requires zero to minimal cutting of the body, has been adopted by St John’s Hospital in Bengaluru, becoming the first in the south and only the third medical institution in the country to embrace the technology.

Used in the West, virtual autopsies have their advantages — safety from infection for the mortuary staff as well as being less traumatic for relatives being two examples — but have struggled to take off in India as the technology is expensive.

In a virtual autopsy, a CT scanner is used to scan the whole body and the images are fed into a software that will create 3D visuals of organs.

“Bone and soft tissue injuries can all be visualised in 3D format,” Dr Varghese P S, who heads St John’s Forensic Medicine department.

“Our finding so far is that bone injuries can be visualised better by virtual rather than conventional autopsies. For example, vertebrae are difficult to dissect, and bone injuries in areas like the pelvis are difficult to detect in regular autopsies.”

The department has so far conducted virtual as well as conventional autopsies in eight cases to understand the new technology better.

However, technology can’t entirely replace conventional autopsy. “In case of natural deaths or poisoning cases, we will have to take tissue out for histopathological examination. Or in case of a heart attack, we will have to do a post-mortem angiogram. But the cuts will be minimal,” said Dr Varghese.

Major Dr Pramod Bagali, founder of Digispired Pvt Ltd that provided St John’s hospital with the software and training, said India has been late to catch up though the technology has been around in the USA, the UK and Switzerland for the last 10 to 15 years.

Currently, two government institutions — AIIMS Delhi and NEIGRIHMS in Meghalaya — are doing virtual autopsies. According to Dr Bagali, one reason for the low uptake could be the low priority hospitals generally give to forensic departments.

The cost of a CT scanner comes to Rs 1.5 to Rs 2 crore, and hospitals may be reluctant to spend as much.

The advantages of technology include safety from any infection for the mortuary staff as the body can remain in the bag, clear 3D reconstruction and evidence for court in case of gunshot wounds, and less emotional distress for the family.

At St John’s, Dr Varghese believes that at least 10% of the 700 autopsies done here annually can become virtual.

A senior forensic doctor at a prominent government hospital in Bengaluru said the technology is good, but adoption may be challenging in a government set-up.

“In government hospitals, a majority of autopsy cases will be of unknown bodies, so a lot of machines and expertise will be needed. Forensic doctors would have to be trained in radiology,” he said.

Besides there’s no regulatory framework in India on whether courts would accept the results of virtual autopsies, the doctor said.

“Even in AIIMS Delhi, only around 300 virtual autopsies have been done so far, and these were mainly to confirm the cause in natural deaths only,” he added.