SINGAPORE Aug 21 Malaysian entrepreneur Matt
Chandran wants to revive the moribund post-mortem by replacing
the scalpel with a scanner and the autopsy slab with a
He believes his so-called digital autopsy could largely
displace the centuries-old traditional knife-bound one, speeding
up investigations, reducing the stress on grieving families and
placating religious sensibilities.
He is confident there's money in what he calls his Autopsy
as a Service, and hopes to launch the first of at least 18
digital autopsy facilities in Britain in October, working
closely with local authorities.
Around 70 million people die each year, says Chandran, and
around a tenth of those deaths are medico-legal cases that
require an autopsy. "That's a huge number, so we're of the view
that this is a major line of services that is shaping up around
the world," he said in an interview.
The poor common perception of autopsies has undermined their
commercial appeal. "Unfortunately, because the process of the
post-mortem is seen as gruesome, one tends to ignore that," says
Humans have been cutting each other open for at least 3,000
years to learn more about death, but the autopsy has never been
widely embraced outside TV crime dramas. Surgeons in 18th
century Britain, for example, robbed graves for corpses to
dissect, some even commissioning murders when supplies dried
By the 1950s, the autopsy was at its zenith, with
pathologists performing post-mortems on more than 60 percent of
those who died in the United States and Europe - helping uncover
more than 80 major, and perhaps thousands of minor, medical
But the number of autopsies has fallen steadily: Today,
fewer than 20 percent of deaths in Britain are followed by
autopsy, and most of these are ordered by coroners in cases
where the cause of death is unclear or disputed.
The fall has been blamed on a growing distaste for a
procedure regarded by some as crude and outdated - a feeling
fanned by the public discovery in Britain in 1999 that medical
institutions had been retaining organs and tissue after
post-mortems for decades.
Chandran, 45, wants to change all this by simply connecting
his company iGene's 3D imaging software to any standard medical
CT or MRI scanner. An expert can then inspect the virtual
cadaver in 3D, removing layers of cloth, skin and bone with a
mouse or by gestures on a tabletop touchscreen.
The advantages, Chandran says, are considerable.
The digital evidence remains intact and can be reviewed;
experts can more easily spot and identify fracture, foreign
objects such as bullets, and the tips of knife wounds; and
grieving families can swiftly learn how their loved ones died
and without having to cut open the body.
iGene isn't the first to run a scanner over a corpse.
Radiology has been used on skulls for 30 years, and Israel first
introduced the concept of a virtual autopsy in 1994. The U.S.
military started conducting CT scans of all soldiers killed in
Iraq and Afghanistan in 2004 in addition to traditional
The results have been encouraging. Researchers from
University College London concluded that in fetuses and
individuals aged 16 and younger, a minimally invasive autopsy
incorporating an MRI scan identified the same cause of death as
90 percent of traditional autopsies.
But iGene is, Chandran says, the first to package the
process and offer it commercially as a suite of services that
stretches from the moment of death to the delivery of a
His company provides a software suite that uses existing
medical scanners from the likes of Siemens, General
Electric, Toshiba and Philips. These
form the heart of iGene's digital autopsy facilities which the
company plans to build close to UK mortuaries. The first will
open in October in the northern English city of Sheffield.
A spokesperson for Sheffield City Council confirmed it was
working with iGene on such a centre, but declined to give
Chandran says his company will spend around $77 million to
build and run the facilities and will make its money from those
cases where a coroner demands a post-mortem. About 200,000
deaths require autopsies each year in Britain, he said.
Next of kin will be given the option of a classical autopsy,
paid for by the state, or a digital autopsy, costing about 500
pounds ($780) and paid for by the family.
Not everyone believes the digital autopsy is ready for prime
time. Some question whether it can spot some diseases. And even
a pioneer like Guy Rutty, chief forensic pathologist at the
University of Leicester and the first to use CT images as
evidence in a criminal trial, says that while demand may be
growing there are limits to what a digital autopsy can do -
particularly determining where and in some cases when a patient
"There are centres providing such services, but others have
been more cautious and are still at a research stage," he said
in an email interview.
Chandran and his team are undeterred. They say the digital
autopsy facility combines with other non-invasive diagnostic
tools such as angiography and toxicology.
Pramod Bagali, chief operations officer of iGene's parent
company InfoValley, says the system is "a complementary method,
not a complete replacement" to traditional autopsies, but could
handle 70 percent of routine cases. The others could be done
digitally to start with and then a decision could be made about
whether to open up the body. "It's not replacing one flawed
system with another," he says.
Crucially, iGene offers a business model that overcomes
concerns that scanning corpses is expensive, says Chandran. He
estimates his UK operation will be profitable within three
years. But that, he says, is just the start. By then, he says,
he hopes to have built at least 10 more facilities in his native
Malaysia, with interest also from the Middle East, Latin America
and elsewhere in Asia.
"The potential for this is global," said Mark Rozario, CEO
of Agensi Inovasi Malaysia, a government body which this year
bought a 20 percent stake in iGene for $21.5 million.
Chandran and his supporters see this as the beginning of his
innovation, not the end of it. The digital autopsy facilities
are nodes in a broader ecosystem Chandran likens to Apple Inc's
Michael Thali, a Swiss academic who has been promoting a
"virtual autopsy" for more than a decade, said he tried and
failed to get the scanner makers interested in developing such
services. Now an adviser to iGene, Thali says this leaves open
the field to other companies to deliver improvements in the
chain of examination.
"The future will be for smaller companies who are bringing a
service for this niche," he says. "The most important thing is
that you have a real chain based on IT."
This is some way off - and may never happen.
Milos Todorovic, lead analyst at Lux Research and a
specialist in medical innovation, says that while iGene's
approach is intriguing, it faces hurdles - not least the fact
that the company is starting from scratch in an expensive
business. "A lot of things would have to fall into place for
them to be able to succeed with something like this," he said.
That isn't stopping Chandran from dreaming big - including
the idea of scanning the living as part of any regular medical
"Just like a birth certificate starts with the birth of a
baby, the end of a person's life will end with a report in which
the 3D body of a person is captured," he said. "In that way we
can archive every person born on this planet."