Forensic Data Exchange HUKM Rev8

Ministry of Higher Education

Pembekalan Peralatan Dan Sistem ’Virtual Autopsy Technology’ (VAT) Di Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)

Virtual Autopsy Technology

Agenda

Virtual Autopsy TechnologyWhy Virtual Autopsy?

Components of Virtual Autopsy System

System Demo

The urgency of VAT is seriously required in order to fulfill the:

‘Fatwa Majlis Kebangsaan Bagi Hal Ehwal Agama Islam Malaysia kali ke-73 yang bersidang 4-6 April 2006’ which clearly stated:

“Penggunaan Kaedah Autopsi Maya (Virtual Autopsy) dalam bedah siasat mayat wajib di beri keutamaan selaras dengan keperluan, Hajat dan kemampuan berbanding kaedah bedah siasat yang diamalkan sekarang”

Enakmen Negeri Selangor

Project Background

It is a pilot turnkey project in Malaysia:-• Method of work/procedure is not defined• Focus of the project is on the outcome

Adhering to :- • Ethical guidelines• System Integrity do not impair and acceptable

by:– Forensics Practice Guidelines– Laws of Malaysia– Halal / Haram Protocol of handling Muslim and Non-

Muslim dead bodies

Project Highlights

• It is a technology of new protocols and imaging sequences in Computed Tomography

• The VAT was born from the desire to implement new technique in radiology for the benefits of forensic sciences and medicine

• It is the latest Technology in Multi-Slice Computed Tomography (MSCT) Technology increasing both contrast and resolution, possibilities of 2D and 3D reconstruction

Virtual Autopsy Technology (VAT)

• Reduce number of Conventional Post Mortems solving problem of acute shortage of Forensic Pathologists

• Autopsy done without traditional dissection on a dead body.

• Fast turnaround of Forensic Reports

• Speedy Release of Body for Burial

• Excellent Teaching Tool

• Facilitate and Expedite Medico-legal Cases

• Evidences recorded eliminating need for exhumation

Why Virtual Autopsy?

The ProposedVirtual Autopsy System

Components of Virtual Autopsy

Medical ImagingCT

Advanced Digital Imaging

Photography

LaboratoryToxicology

HistopathologyMicrobiologyEntomology

Forensic Information Management

TeraRecon System

Forensic Data Exchange

Identification

FingerprintDNA Fingerprinting

Odontology

Proposed System ComponentsNo Component Description

1 Forensic Information Management and Mortuary System (FIMMS)

To facilitate registration, storage and release of the deceased person; as well as notation for post mortems.

To register specimen and send requests for analysis.

2 Laboratory Information System (LIS)

To automate laboratory operation. Accepts investigation order and return results online.

3 Radiology Information System / Picture Archiving and Communication System (RIS/PACS)

To acquire, archive and report on CT images convert to DICOM format. Interface to FIMMS to receive orders and send results.. Able to accept JPEG file and

4 3D Image Visualization

To perform 3D reconstruct of CT images. Make use of thin client technology to deliver interactive 3D images to standard PCs.

5 Forensic Data Exchange

A platform which accepts imaging and laboratory data to display in consolidated format to the users. HIPPA compliance.

Body/Body Part arrives at Mortuary

Register Body / Body Part

Store Body in Freezer

Autopsy Required?

Identify & Claim Body

Issue Burial Permit

Document Claimant Details

Release Body

N

High Level Workflow

Virtual Autopsy Processes

Y

The accident scene in Cheras after a 10-tonne lorry rammed into seven vehicles, leaving two dead and seven injured. – The Star Online, 1 August, 2008

Virtual Autopsy ArchitectureVirtual Autopsy Architecture

CT Image

TeraRecon

6

Registration (FIMMS)

2

BID

Finger Printing

Image Upload

3

External PM

7

Radiology & Lab Reports

Forensic Pathologist Report (FIMMS)

89

PMR

CT Scan

5DICOMWorklist

CTImage

Lab

Lab Request

Lab Result

RIS/PACS

4

LIS

Ix / Dx

Request

1

Crime Scene/ Hospital

Authorities

InternetReport Viewing

Second Opinion

Forensic Data Exchange

10

Crime / Accident Scene Photos

Body ID - Fingerprinting

Unknown body Fingerprinting

AFIS (Automated Fingerprint Identification System)

Database SearchSearch Result Authorities

Body ID – DNA Fingerprinting

Body ID – Dental Record

Dental Chart Dental Record

Body Registration, Tagging & Exam

Register body(FIMMS)

Body Tagging

Assign Body StorageRecord Findings(FIMMS)

External PM

Print Body Tag(Barcoded)

Diagnostic Imaging

Image ArchiveCT Console

TeraReconReconstructed Images

Forensic Laboratory Services

Toxicology

LCMS

To aid medical or legal investigation of death, poisoning and drug use.

Entomology

Evident Field Kit

Use to detect drugs and poisons, determine the location of an incident, find the presence and time of the infliction of wounds.

Microbiology

Real Time PCR

Application of DNA testing to microorganisms. Use DNA sequencing to distinguish between strains of viruses.

Histopathology

Microscope

The application of histological techniques and examination to forensic pathology practice.

System Integration – LIS

LISFIMMS

Print

Barcoded Label

Label

Specimen Tubes

Sample Collection

Sample

Preparation

Perform

Test

FDX

Ix Request(HL7)

lx Result(HL7)

Ix Request

Ix Result

General Workflow for Laboratory Equipment that can be Interfaced

System Integration – LIS

LISFIMMS

Print

Barcoded Label

Label

Specimen Tubes

Sample Collection

Sample

Preparation

Perform

TestFDX

Ix Request(HL7)

lx Result(HL7)

Enter Result. Scan and upload signed reports and Images

General Workflow for Laboratory Equipment that cannot be Interfaced

System Integration – Terarecon

DICOM

Worklist

RIS

Dx Request(HL7)

Dx Result(XML)

PACS

TeraRecon

ArchiveCT Images

Reconstruct

CT Images

Perform report in RIS

FDX

FIMMS

Register

Body

Internet

Report Viewing

Second Opinion(Secured

VPN)

DICOMWorklist

CT Scanner

Equipment

Data

Information

Post Mortem Report

Medical Imaging Clinical Laboratory Services

Histo-pathology

DNA Finger Printing

ToxicologyImaging VisualTool

Ento-mology

Photo Odon-tology

Micro-biology

LCMS Genetic Analyzer

Microscope AFIS & CODIS

CT TeraRecon Evident Field Kit

Digital Camera

DentalInstrument

Real Time PCR

• Unknown male motorcyclist – BID, accompanied by

Police with PM Order• Involved in a RTA with multiple injuries to head and body• Forensic Pathologist performed External PM & Virtual

Autopsy • Pathologist access FIMMS

• To document PM findings• To request pathology & imaging investigations• To view laboratory results

• Pathologist access TeraRecon system, via FIMMS • To view CT images & CT reports

Demo Test Case