BOdy PAckages in spectral imaging CT - experimental study to differentiate between various illicit drugs in vitro and in a porcine model with dual energy based spectral imaging CT (SICT)

Congress:

ECR 2011

Poster Number:

C-1523

Type:

Scientific Paper

Keywords:

Forensic / Necropsy studies, Abdomen, CT, Experimental, Diagnostic procedure, Foreign bodies, Forensics, Drugs / Reactions

Authors:

M. Scherr, J. Grimm, S. Wirth, E. Ziegeler, M. Uhl, M. F. Reiser; Munich/DE

DOI:

10.1594/ecr2011/C-1523

DOI-Link:

https://dx.doi.org/10.1594/ecr2011/C-1523

Fig. 1: Preparing a sample of cocain

Fig. 2: 16 different samples of drugs ready for in vitro CT scan

Fig. 3: 125 kg pig cadaver with drug sample placed in rectum

Fig. 4: Drug sample (78% cocain) placed in pig's rectum

Fig. 5: Different appearance of drug samples in spectral imaging CT

Fig. 6: Chart of all compounds investigated in vitro and after placement in pig's rectum

Purpose

To evaluate in vitro and in a porcine model the differentiability between different substances in packages containing illicit drugs via Spectral Imaging CT (SICT) of a body packer. (Study BOPACT III) Background: Due to increasing lagguage security at airports and postage control at customs there is an increase in body packers swallowing packages of illicit drugs or insert them into the rectum/vagina for transportation and smuggling. Radiologists are confronted with body packers in two typical scenarios: As patients, who may present with severe and live...

Methods and Materials

16 samples containing illicit drugs (cocaine, heroin and hashish in different concentrations/compressions) typical mixture of acetaminophen/caffeine (used to dilute heroin) and a blank sample (water) were supplied by by state authorities and repacked in standardized ovoid plastic containers of approximately 4 cm length and 3 cm diameter available as “Kinder®Surprise Egg” and examined in vitro. The drug samples were either packed loosely or manually compressed and sealed with adhesive tape. 10/16 drug samples (DS) were wrapped in a condom and examined one after another placedin...

Results

Given the resulting SICT curves, the most obvious results are: There is a big difference in spectral appearance of the different drug compounds, the water and the diluent. In vitro as well as in the pig's rectum the mean HU levels of a substance is greatly affected by its concentrationand level of compression (upward shift of curves with higher concentration/compression). Density (HU levels) of different drugs and substances show overlapof the curves at typical diagnostic keV levels. In vitro: The curve for cocaine shows a...

Conclusion

Illicit incorporated drugs appear not to be differentiated with sufficient certainty only by their density in HU. SICT may aid in the identification and differentiation of incorporated substances in a body packer using the slope and level of the spectral HU curve. SICT could be a radiologic feature in examination of body packer, where it is important not only to detect, but to identify the incorporated substance. The feasibility of heroin antagonisation in case of body pack rupture might be predicted. Beyond the study: Findings...

References

(1) Hergan K et al. Eur Radiol. 2004;14(4):736-742 (2) Traub SJ et al. N Engl J Med. 2003;349(26):2519-2626 (3) Wackerle B et al. RoeFo. 1986;145(3):274-277 (4) Graser A et al. Invest Radiol 2008;43(2):112–9 (5) Bauer R et al. Eur J Radiol. 2010;75(1):74-80

Personal Information

Meet me for discussion at my further presentation on the BOPACT II study „Body packages in low dose CT: identification of packages containing illicit drugs using low dose (LD) computed tomography in an experimental study using a porcine body packer model“ Session SS 1601b „(GI) Imaging of non-neoplastic conditions of the GI tract“ on Monday Mar 7, 2011 10:30 AM - 12:00 PM or contact me via E-mail: [email protected] Dr. med. Michael Scherr Department of Clinical Radiologiy - University of Munich Downtown Campus Nussbaumstreet 20...