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108 Chapter 6 techniques. There are different CTA approaches; it can be targeted at the coronary arteries by selective placement of the catheter at the level of the coronary ostia, or total-body CTA can be performed including multiphase scanning. 120,150,164,165 Wichman et al. applied total-body CTA in 50 ICU patients who died unexpectedly or within 48 hours of an event requiring resuscitation and found that CTA confirmed 93% of the clinical diagnoses, and autopsy confirmed 80%. In addition, CTA and CA identified 16 new major and 238 new minor diagnoses. They concluded that in cases of unexpected death CTA was a valuable addition to autopsy. Rutty et al. performed total-body CTA in 210 cases of natural and non-suspicious unnatural death and found that CTA established a cause of death in 92% of cases. The number of discrepancies with the final cause of death was not significantly different between autopsy and CTA, suggesting that total-body CTA is a feasible alternative to autopsy. 166,167 A drawback of CTA is that it requires specific training, technical equipment and contrast agents and is time-consuming due to extensive preparation of the body (e.g. intra- arterial and/or intravenous femoral access for catheter placement) prior to scanning. At the time of the study, the equipment was not available and professional expertise and scanner availability to perform CTA was lacking. Another noninvasive approach is the use of stand-alone MRI. Diffusion tensor imaging (DTI) is showing promising results in diagnosing myocardial ischemia in situ, correctly predicting MI (either acute or chronic) with an accuracy of 0.73, using fractional anisotropy and mean diffusivity. 168 First studies show that quantitative MRI can detect and differentiate between early and following stages of myocardial ischemia based on T1, T2 and proton density values. 169-171 They concluded that temperature-corrected quantitative MRI can diagnose early acute, acute and chronic MI, but histological confirmation is required. In the hospital setting an important part of every postmortem examination should be a thorough evaluation of the medical history and clinical circumstances prior to death. In our patients with known obstructive coronary artery disease, chronic and or acute MI was confirmed in 16 out of 20 cases by postmortem examination (both by MIA and conventional autopsy). Conventional autopsy found 22 new cases of acute MI, highlighting the lasting need for postmortem examinations. Today the use of postmortem imaging, mostly CT, is widely accepted as adjunct to the medicolegal autopsy. 48,148,166,167,172 In the hospital setting, there is a growing interest in postmortem imaging, however, expertise and logistics (e.g. access to scanners) are still important limitations.