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Radiological investigation of gunshot wounds: a systematic review of published evidence

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Abstract

Introduction

Despite the constantly growing popularity of radiological imaging in forensic pathology, a systematic review investigating the efficiency and limits of radiological techniques, in comparison to forensic autopsy, was still missing.

Aim

The present review aims at providing an overview on the current role of radiology in the forensic investigation of fatal gunshot wounds without any restriction to specific radiological techniques.

Material and methods

A systematic literature search on three databases (PubMed, Web of Science, and Science Direct) was performed until December 2017. The Oxford Centre for Evidence Based Medicine (OCEBM) grading system for levels of evidence was applied, in order to weigh published evidence.

Results and discussion

Eighty-six papers (1.64% of the records) were included. Despite the quite limited general level of evidence, which contrasts with the abundance of the scientific literature on this topic, several recommendations/statements, coupled to their OCEBM grade, were distilled as for the identification of retained bullets, gunshot wounds detection, diagnosis of entrance and exit wounds, trajectories and internal injury detection and estimation of the firing distance.

Conclusions

Imaging radiological technologies represent the present and future of wound ballistics. However, traditional, micro and molecular imaging techniques require further validation through blinded cross-sectional studies with appropriate reference standards (e.g. forensic autopsy).

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Author notes

  1. Arianna Giorgetti and Chiara Giraudo equally contributed to the study and should be considered as co-first authors.

Authors and Affiliations

  1. Department of Legal and Occupational Medicine, Toxicology and Public Health, University of Padova, Via Falloppio 50, 35121, Padova, Italy

    Arianna Giorgetti, Alessia Viero, Marco Bisceglia, Massimo Montisci, Giovanni Cecchetto & Guido Viel

  2. Institute of Radiology, Department of Medicine (DiMED), University-Hospital Padova, Via Giustiniani 2, 35128, Padova, Italy

    Chiara Giraudo, Amalia Lupi & Emilio Quaia

  3. DIMEC, Department of Medical and Surgical Sciences, University of Bologna, 40126, Bologna, Italy

    Paolo Fais

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  1. Arianna Giorgetti
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  2. Chiara Giraudo
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Giorgetti, A., Giraudo, C., Viero, A. et al. Radiological investigation of gunshot wounds: a systematic review of published evidence. Int J Legal Med 133, 1149–1158 (2019). https://doi.org/10.1007/s00414-019-02071-8

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