Table 4.

Advantages and disadvantages of non-invasive and minimally invasive autopsy methods using radiological techniques

	Advantages	Disadvantages
Ultrasound [40, 41]	Logistics: High availability Operator friendly	Image quality and diagnose: Inferior to MRI and CT in image quality Inferior to MRI and CT in biopsy guidance Limited visualisation of the vascular system (no flow) Operator dependent
	Cost: Inexpensive
CT [38, 64, 65]	Logistics: High availability Rapid whole body examination Repeated scanning possible Possibility of biopsy guidance	Logistics: Limited availability during regular working hours (interferes with scanning of the living)
	Cost: Relatively inexpensive (compared to MRI)	Image quality and diagnose: Limited visualisation of pathology in soft tissues and organ parenchyma Limited differentiation of normal postmortem changes (e.g., clotting, sedimentation) and pathology (e.g., pulmonary thromboembolism) Limited ability to diagnose cardiac causes of death (e.g., patency of coronaries, acute myocardial infarction) Image artefacts (e.g., metal from dental filling, prosthetic valves)
	Image quality and diagnose: Good visualization of bone (e.g., fractures), lung parenchyma disease, calcifications (stones, atherosclerosis), acute haemorrhage, air/ gas (e.g., pneumothorax, pneumatosis intestinalis, free air) High in-plane resolution (e.g. ,small lung nodules) Isovolumetric multi-planar and 3-D reconstructions
MRI [38, 65, 66]	Logistics: Possibility of biopsy guidance	Logistics: Limited availability during regular working hours (interferes with scanning of the living) Relatively time consuming examination (depending on scan protocol) Requires dedicated postmortem scan protocols (e.g., adjusting scan parameters for the body temperature) Requires MRI compatible body bags (e.g. ,no metal)
	Image quality and diagnose: Good, detailed visualization of organ parenchyma (e.g., brain, heart and myocardial infarct age), soft tissue (e.g., muscle injury), fluids (e.g,. pleural/ pericardial), nervous system (e.g., spinal canal disorders), bone marrow disorders, metabolic diseases (e.g., hemochromatosis), large vessels (e.g., aortic dissection) Good differentiation between postmortem changes and pathology	Cost: Relatively expensive Requires dedicated training of technicians
		Image quality and diagnose: Image artefacts (e.g., metal from dental filling)
CT Angiography [32, 49, 64, 65, 67]	Image quality and diagnose: Good detection (of the origin) of haemorrhages (e.g., aortic rupture) Good detection of cardiovascular conditions (e.g., coronary stenosis)	Logistics: Limited availability of dedicated equipment and contrast agents Time consuming and complicated examination (e.g., achieving optimal contrast timing and full enhancement is difficult)
		Cost: Expensive (longer procedure time, contrast agents, dedicated equipment*) Requires dedicated training
		Image quality and diagnose: Differentiation between post-mortem clotting and embolus is difficult Lack of circulation and insufficient mixing of blood and contrast
Targeted CT (coronary) angiography [32, 58, 59]	Cost: Relatively inexpensive equipment (compared to whole body angiography) Cannulation and scanning can be performed with minimal training	Logistics: Time consuming examination (e.g., positioning catheter, turning the corpse)
	Image quality and diagnose: Less expensive than whole body angiography	Image quality and diagnose: Images restricted to coronary arteries Limited visualisation of internal mammary grafts, due to balloon position in the ascending aorta

* Less expensive if out-dated equipment were used