45% Fewer Autopsies: How Postmortem CT Is Changing Death Investigation in the U.S.

Episode notes

Postmortem CT is not theoretical. It is operational and growing. In this episode of Rethink Imaging, Dr. Kalpana Kanal and Dr. Jonathan Medverd share the real-world story behind launching a collaborative forensic imaging program between the University of Washington and King County’s Medical Examiner Office. What began as a pilot project six years ago has evolved into a structured clinical pathway that has scanned 184 decedents since July 2022. The results are striking. In roughly 45% of cases, CT findings were sufficient to determine cause of death, eliminating the need for traditional autopsy. In early validation cases, imaging diagnoses including precise identification of a ruptured aorta were confirmed at autopsy, demonstrating strong radiologic-pathologic correlation. Beyond clinical accuracy, the episode dives into the operational realities: aligning two different governance structures, navigating IT firewalls between hospital PACS and county systems, securing funding for scanner installation, building trust between specialties, and operating without a billable CPT code for postmortem imaging.