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Diagnostics
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Autopsy Pathology's Paradigm Shift: Are AI and New Technologies Forging...
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Autopsy Pathology's Paradigm Shift: Are AI and New Technologies Forging a New Era?

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: 30 September 2026 | Viewed by 1923

Editor

Dr. Vincenzo Arena

E-Mail Website
Guest Editor
U.O.S. Coordinamento delle Attività di Settorato—Pathology Unit, Department of Woman, Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
Interests: cardiovascular pathology; autopsy pathology; placental pathology; surgical pathology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are pleased to announce the launch of a new Special Issue, entitled "Autopsy Pathology's Paradigm Shift: Are AI and New Technologies Forging a New Era?". This Special Issue provides the opportunity to contribute to the most relevant topics in autopsy pathology, providing a comprehensive appraisal of this diagnostic field in the era of AI.

Over the years, there has been a growing interest in research on immunohistochemical and molecular markers that can resolve, or help to resolve, even the most complex cases by revealing the presence or absence of specific molecules.

The search for new markers is of fundamental importance for anatomic pathology, for diagnostic, prognostic, and theranostic purposes. The inevitable variables related to the postmortem interval, the manner of death, and the circumstances of death all preclude the straightforward application of single-molecule expression testing to autopsy (forensic or non-forensic).

The macroscopic and microscopic knowledge acquired over centuries in autopsy pathology (even beyond strictly forensic contexts) remains a cornerstone of the discipline.

To better understand the potential role of AI in this field, we invite authors to submit articles exploring various aspects of autopsy pathology, assessing the current state of the art and give particular attention to the body of knowledge consolidated in the existing literature.

This systematic collection will provide a valuable tool for new generations of pathologists.

Articles on the sensitive topic of asphyxial deaths, arrhythmic deaths, and sudden deaths (adult and pediatric cases), as well as articles on fetoplacental pathology, are welcome.

For each paper submitted, the authors will need to demonstrate and compare the degree to which AI has contributed to the topic at hand as well as the purpose and extent that AI can be of help.

For this Special Issue, we invite investigators from different disciplines to contribute original research articles and reviews of key diagnostic topics, taking into account the solid evidence accumulated over centuries of research on the subject, and to propose the potential role of AI in the near future for this discipline.

Prof. Dr. Vincenzo Arena
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • autopsy pathology
  • AI
  • artificial intelligence
  • immunohistochemistry
  • molecular pathology

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Published Papers (2 papers)

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Research

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12 pages, 1314 KB  
Article
Prevalence and Morphological Classification of Persistent Metopic Suture in Adult Autopsy Cases: A Forensic Anatomical Study from Western Türkiye
by Gökmen Karabağ, Volkan Zeybek, Ahmet Küpeli, Mehmet Sunay Yavuz, Mahmut Aşırdizer, Ertuğrul Tatlısumak and Aslıhan Teyin
Diagnostics 2026, 16(3), 415; https://doi.org/10.3390/diagnostics16030415 - 30 Jan 2026
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Abstract
Background: Persistent metopic suture represents a normal anatomical variant that may persist into adulthood and can be misinterpreted as a frontal skull fracture, particularly in trauma-related forensic cases. Despite its clinical and medico-legal relevance, data derived from autopsy-based evaluations remain limited, with most [...] Read more.
Background: Persistent metopic suture represents a normal anatomical variant that may persist into adulthood and can be misinterpreted as a frontal skull fracture, particularly in trauma-related forensic cases. Despite its clinical and medico-legal relevance, data derived from autopsy-based evaluations remain limited, with most prevalence studies relying on dry skull collections or radiological series. This study aimed to determine the prevalence and morphological characteristics of persistent metopic suture in adult autopsy cases and to evaluate its distribution according to age, sex, and cause of death. Methods: This cross-sectional study included 500 consecutive adult autopsy cases (≥18 years). The frontal bone was directly inspected during autopsy for the presence of metopic suture, which was classified as complete or incomplete. Descriptive statistics were applied, and associations between metopism and sex, age group, and cause of death were analyzed using chi-square or Fisher’s exact test, as appropriate. Results: Complete metopism was identified in 7 of 500 cases, corresponding to a prevalence of 1.4% (95% confidence interval: approximately 0.6–2.9%). No incomplete metopic sutures were observed. Metopism was slightly more frequent in females than males; however, no statistically significant association was found between metopism and sex, age group, or cause of death (p > 0.05). Conclusions: Persistent metopic suture is an uncommon but clinically and forensically relevant anatomical variant in adults. Its recognition during forensic autopsy is essential to avoid misinterpretation as a cranial fracture, particularly in trauma-related deaths, thereby preventing diagnostic and medico-legal errors. Full article
(This article belongs to the Special Issue Autopsy Pathology's Paradigm Shift: Are AI and New Technologies Forging a New Era?)
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Review

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34 pages, 510 KB  
Review
Autopsy Pathology’s Paradigm Shift: Artificial Intelligence and Emerging Technologies in the Era of Digitally Integrated Death Investigation
by Ivan Dieb Miziara and Carmen Silvia Molleis Galego Miziara
Diagnostics 2026, 16(15), 2405; https://doi.org/10.3390/diagnostics16152405 - 30 Jul 2026
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Abstract
Background: Autopsy pathology remains the reference standard for determining the cause of death, reconstructing disease and injury mechanisms, ensuring diagnostic quality, and supporting medical education and forensic investigations. However, declining autopsy rates, workforce shortages, biosafety concerns, increasing diagnostic complexity, and the rapid evolution [...] Read more.
Background: Autopsy pathology remains the reference standard for determining the cause of death, reconstructing disease and injury mechanisms, ensuring diagnostic quality, and supporting medical education and forensic investigations. However, declining autopsy rates, workforce shortages, biosafety concerns, increasing diagnostic complexity, and the rapid evolution of digital technologies have stimulated the development of complementary investigative approaches. This review critically examines whether artificial intelligence (AI) and emerging technologies are driving a genuine paradigm shift toward digitally integrated death investigation. Methods: A structured narrative review informed by a systematic literature search was conducted in PubMed/MEDLINE, Embase, Scopus, and Web of Science, covering publications from January 2000 through June 2026. Evidence addressing postmortem imaging, virtopsy, digital pathology, computational pathology, molecular autopsy, robotics, artificial intelligence, machine learning, and emerging omics technologies was critically appraised. Owing to the methodological heterogeneity of the available literature, findings were synthesized qualitatively according to technological maturity, forensic applicability, validation status, and implementation readiness. Results: The reviewed evidence demonstrates substantial progress in postmortem computed tomography, postmortem CT angiography, postmortem magnetic resonance imaging, whole-slide imaging, molecular autopsy, robotic-assisted postmortem procedures, three-dimensional reconstruction, and AI-assisted forensic analysis. These technologies enhance trauma evaluation, vascular imaging, ballistic reconstruction, digital documentation, remote consultation, diagnostic reproducibility, and multimodal integration of forensic evidence. Nevertheless, the level of evidence varies considerably across technological domains. Postmortem imaging represents the most mature and extensively validated technology, whereas most AI applications remain supported predominantly by retrospective proof-of-concept studies with limited multicenter external validation. Current systematic evidence further indicates that AI should presently be regarded as an assistive technology that augments expert forensic interpretation rather than replacing conventional autopsy or autonomous medicolegal decision-making. Conclusions: Contemporary autopsy pathology is evolving toward a hybrid model of digitally integrated death investigation in which conventional autopsy, imaging, digital pathology, molecular diagnostics, robotics, and AI function as complementary components of a unified forensic workflow. Current evidence supports a conceptual paradigm shift characterized by transformation of evidence acquisition, preservation, interpretation, and integration, while reaffirming that conventional autopsy remains the indispensable biological reference standard for the development, validation, and medicolegal interpretation of all emerging technologies. Future implementation should prioritize multicenter validation, standardized forensic datasets, explainable AI, digital chain-of-custody procedures, and robust regulatory governance to ensure safe and scientifically reliable integration into forensic practice. Full article
(This article belongs to the Special Issue Autopsy Pathology's Paradigm Shift: Are AI and New Technologies Forging a New Era?)
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