Skip to main content
Erschienen in: International Journal of Legal Medicine 3/2014

01.05.2014 | Original Article

Differentiation of heroin and cocaine using dual-energy CT—an experimental study

verfasst von: Jochen Grimm, Ramona Wudy, Edvard Ziegeler, Stefan Wirth, Michael Uhl, Maximilian F. Reiser, Michael Scherr

Erschienen in: International Journal of Legal Medicine | Ausgabe 3/2014

Einloggen, um Zugang zu erhalten

Abstract

Objective

To evaluate if heroin and cocaine can be distinguished using dual-energy CT.

Materials and methods

Twenty samples of heroin and cocaine at different concentrations and standardized compression (SC) were scanned in dual-energy mode on a newest generation Dual Energy 64-row MDCT scanner. CT number, spectral graphs, and dual-energy index (DEI) were evaluated. Results were prospectively tested on six original samples from a body packer. Wilcoxon’s test was used for statistical evaluation.

Results

Values are given as median and range. Under SC, the CT number of cocaine samples (−29.87 Hounsfield unit (HU) [−125.85; 16.16 HU]) was higher than the CT number of heroin samples (−184.37 HU [−199.81; −159.25 HU]; p < 0.01). Slope of spectral curves for cocaine was −2.36 HU/keV [−7.15; −0.67 HU/keV], and for heroin, 1.75 HU/keV [1.28; 2.5 HU/keV] (p < 0.01). DEI was 0.0352 [0.0081; 0.0528] for cocaine and significantly higher than for heroin samples (−0.0127 [−0.0097; −0.0159]; p < 0.001). While CT number was inconclusive, all six original packs were correctly classified after evaluation of the spectral curve and DEI. In contrast to the CT number, slope of the spectral curve and DEI were independent of concentration and compression.

Conclusion

The slope of the spectral curve and the DEI from dual-energy CT data can be used to distinguish heroin and cocaine in vitro; these results are independent of compression and concentration in the measured range.
Literatur
2.
Zurück zum Zitat Bulstrode N, Banks F, Shrotria S (2002) The outcome of drug smuggling by ‘body packers’—the British experience. Ann R Coll Surg Engl 84(1):35–38PubMedCentralPubMed Bulstrode N, Banks F, Shrotria S (2002) The outcome of drug smuggling by ‘body packers’—the British experience. Ann R Coll Surg Engl 84(1):35–38PubMedCentralPubMed
5.
Zurück zum Zitat Claffey M (2002) Stampede of drug mules at Kennedy: after 9/11 lull, heroin and ecstasy busts soar. New York Daily News, May 5, 2002, p 1 Claffey M (2002) Stampede of drug mules at Kennedy: after 9/11 lull, heroin and ecstasy busts soar. New York Daily News, May 5, 2002, p 1
6.
Zurück zum Zitat de Bakker JK, Nanayakkara PW, Geeraedts LM Jr, de Lange ES, Mackintosh MO, Bonjer HJ (2012) Body packers: a plea for conservative treatment. Langenbeck’s Arch Surg 397(1):125–130. doi:10.1007/s00423-011-0846-z CrossRef de Bakker JK, Nanayakkara PW, Geeraedts LM Jr, de Lange ES, Mackintosh MO, Bonjer HJ (2012) Body packers: a plea for conservative treatment. Langenbeck’s Arch Surg 397(1):125–130. doi:10.​1007/​s00423-011-0846-z CrossRef
9.
Zurück zum Zitat Wackerle B, Rupp N, von Clarmann M, Kahn T, Heller H, Feuerbach S (1986) Detection of narcotic-containing packages in “body-packers” using imaging procedures. Studies in vitro and in vivo. Röfo 145(3):274–277. doi:10.1055/s-2008-1048932 PubMedCrossRef Wackerle B, Rupp N, von Clarmann M, Kahn T, Heller H, Feuerbach S (1986) Detection of narcotic-containing packages in “body-packers” using imaging procedures. Studies in vitro and in vivo. Röfo 145(3):274–277. doi:10.​1055/​s-2008-1048932 PubMedCrossRef
13.
Zurück zum Zitat Hutchins KD, Pierre-Louis PJ, Zaretski L, Williams AW, Lin RL, Natarajan GA (2000) Heroin body packing: three fatal cases of intestinal perforation. J Forensic Sci 45(1):42–47PubMed Hutchins KD, Pierre-Louis PJ, Zaretski L, Williams AW, Lin RL, Natarajan GA (2000) Heroin body packing: three fatal cases of intestinal perforation. J Forensic Sci 45(1):42–47PubMed
15.
Zurück zum Zitat Ziegeler EGJ, Wirth S, Uhl M, Reiser MF, Scherr M (2012) Computed tomography scout views vs. conventional radiography in body-packers—delineation of body-packs and radiation dose in a porcine model. Eur J Radiol. doi:10.1016/j.ejrad.2012.06.030 PubMed Ziegeler EGJ, Wirth S, Uhl M, Reiser MF, Scherr M (2012) Computed tomography scout views vs. conventional radiography in body-packers—delineation of body-packs and radiation dose in a porcine model. Eur J Radiol. doi:10.​1016/​j.​ejrad.​2012.​06.​030 PubMed
16.
Zurück zum Zitat Flach PM, Ross SG, Ampanozi G, Ebert L, Germerott T, Hatch GM, Thali MJ, Patak MA (2012) “Drug mules” as a radiological challenge: sensitivity and specificity in identifying internal cocaine in body packers, body pushers and body stuffers by computed tomography, plain radiography and Lodox. Eur J Radiol 81(10):2518–2526. doi:10.1016/j.ejrad.2011.11.025 PubMedCrossRef Flach PM, Ross SG, Ampanozi G, Ebert L, Germerott T, Hatch GM, Thali MJ, Patak MA (2012) “Drug mules” as a radiological challenge: sensitivity and specificity in identifying internal cocaine in body packers, body pushers and body stuffers by computed tomography, plain radiography and Lodox. Eur J Radiol 81(10):2518–2526. doi:10.​1016/​j.​ejrad.​2011.​11.​025 PubMedCrossRef
17.
Zurück zum Zitat Poletti PA, Canel L, Becker CD, Wolff H, Elger B, Lock E, Sarasin F, Bonfanti MS, Dupuis-Lozeron E, Perneger T, Platon A (2012) Screening of illegal intracorporeal containers (“body packing”): is abdominal radiography sufficiently accurate? A comparative study with low-dose CT. Radiology 265(3):772–779. doi:10.1148/radiol.12112767 PubMedCrossRef Poletti PA, Canel L, Becker CD, Wolff H, Elger B, Lock E, Sarasin F, Bonfanti MS, Dupuis-Lozeron E, Perneger T, Platon A (2012) Screening of illegal intracorporeal containers (“body packing”): is abdominal radiography sufficiently accurate? A comparative study with low-dose CT. Radiology 265(3):772–779. doi:10.​1148/​radiol.​12112767 PubMedCrossRef
18.
Zurück zum Zitat Brogdon BG, Vogel H, Algra PR (2010) Smuggling/border control. In: Brogdon’s forensic radiology, 2nd edn. CRC, pp 297–310. doi:10.1201/b10323-26 Brogdon BG, Vogel H, Algra PR (2010) Smuggling/border control. In: Brogdon’s forensic radiology, 2nd edn. CRC, pp 297–310. doi:10.​1201/​b10323-26
19.
Zurück zum Zitat Wetli CV, Mittlemann RE (1981) The “body packer syndrome”—toxicity following ingestion of illicit drugs packaged for transportation. J Forensic Sci 26(3):492–500PubMed Wetli CV, Mittlemann RE (1981) The “body packer syndrome”—toxicity following ingestion of illicit drugs packaged for transportation. J Forensic Sci 26(3):492–500PubMed
20.
21.
Zurück zum Zitat Mandava N, Chang RS, Wang JH, Bertocchi M, Yrad J, Allamaneni S, Aboian E, Lall MH, Mariano R, Richards N (2011) Establishment of a definitive protocol for the diagnosis and management of body packers (drug mules). Emerg Med J 28(2):98–101. doi:10.1136/emj.2008.059717 PubMedCrossRef Mandava N, Chang RS, Wang JH, Bertocchi M, Yrad J, Allamaneni S, Aboian E, Lall MH, Mariano R, Richards N (2011) Establishment of a definitive protocol for the diagnosis and management of body packers (drug mules). Emerg Med J 28(2):98–101. doi:10.​1136/​emj.​2008.​059717 PubMedCrossRef
23.
Zurück zum Zitat East JM (2005) Surgical complications of cocaine body-packing: a survey of Jamaican hospitals. West Indian Med J 54(1):38–41PubMedCrossRef East JM (2005) Surgical complications of cocaine body-packing: a survey of Jamaican hospitals. West Indian Med J 54(1):38–41PubMedCrossRef
24.
Zurück zum Zitat Raben AM, Phoa SS, Busch OR, Schultz MJ (2005) Case report of a smuggler’s dinner: carrots and asparagus, or bolitas? Med Sci Monit 11(12):CS79–CS81PubMed Raben AM, Phoa SS, Busch OR, Schultz MJ (2005) Case report of a smuggler’s dinner: carrots and asparagus, or bolitas? Med Sci Monit 11(12):CS79–CS81PubMed
25.
Zurück zum Zitat Novelline R (ed) (1997) Squire’s fundamentals of radiology, 5th edn. Harvard University Press, Boston Novelline R (ed) (1997) Squire’s fundamentals of radiology, 5th edn. Harvard University Press, Boston
27.
Zurück zum Zitat Pache G, Einhaus D, Bulla S, Baumann T, Langer M, Blanke P (2012) Low-dose computed tomography for the detection of cocaine body packs: clinical evaluation and legal issues. Röfo 184(2):122–129. doi:10.1055/s-0031-1281781 PubMedCrossRef Pache G, Einhaus D, Bulla S, Baumann T, Langer M, Blanke P (2012) Low-dose computed tomography for the detection of cocaine body packs: clinical evaluation and legal issues. Röfo 184(2):122–129. doi:10.​1055/​s-0031-1281781 PubMedCrossRef
28.
Zurück zum Zitat Leschka S, Fornaro J, Laberke P, Blum S, Alkadhi H, Niederer I, Meile C, Hibbeln D, Hausmann R, Wildermuth S, Eisenhart D (2013) Differentiation of cocaine from heroine body packs by computed tomography: impact of different tube voltages and the dual-energy index. J Forensic Radiol Imaging 1(2):46–50. doi:10.1016/j.jofri.2013.03.041 CrossRef Leschka S, Fornaro J, Laberke P, Blum S, Alkadhi H, Niederer I, Meile C, Hibbeln D, Hausmann R, Wildermuth S, Eisenhart D (2013) Differentiation of cocaine from heroine body packs by computed tomography: impact of different tube voltages and the dual-energy index. J Forensic Radiol Imaging 1(2):46–50. doi:10.​1016/​j.​jofri.​2013.​03.​041 CrossRef
29.
Zurück zum Zitat Coursey CA, Nelson RC, Boll DT, Paulson EK, Ho LM, Neville AM, Marin D, Gupta RT, Schindera ST (2010) Dual-energy multidetector CT: how does it work, what can it tell us, and when can we use it in abdominopelvic imaging? Radiographics 30(4):1037–1055. doi:10.1148/rg.304095175 PubMedCrossRef Coursey CA, Nelson RC, Boll DT, Paulson EK, Ho LM, Neville AM, Marin D, Gupta RT, Schindera ST (2010) Dual-energy multidetector CT: how does it work, what can it tell us, and when can we use it in abdominopelvic imaging? Radiographics 30(4):1037–1055. doi:10.​1148/​rg.​304095175 PubMedCrossRef
31.
Zurück zum Zitat Johnson TR, Krauss B, Sedlmair M, Grasruck M, Bruder H, Morhard D, Fink C, Weckbach S, Lenhard M, Schmidt B, Flohr T, Reiser MF, Becker CR (2007) Material differentiation by dual energy CT: initial experience. Eur Radiol 17(6):1510–1517. doi:10.1007/s00330-006-0517-6 PubMedCrossRef Johnson TR, Krauss B, Sedlmair M, Grasruck M, Bruder H, Morhard D, Fink C, Weckbach S, Lenhard M, Schmidt B, Flohr T, Reiser MF, Becker CR (2007) Material differentiation by dual energy CT: initial experience. Eur Radiol 17(6):1510–1517. doi:10.​1007/​s00330-006-0517-6 PubMedCrossRef
32.
Zurück zum Zitat Manglaviti G, Tresoldi S, Guerrer CS, Di Leo G, Montanari E, Sardanelli F, Cornalba G (2011) In vivo evaluation of the chemical composition of urinary stones using dual-energy CT. AJR Am J Roentgenol 197(1):W76–W83. doi:10.2214/AJR.10.5217 PubMedCrossRef Manglaviti G, Tresoldi S, Guerrer CS, Di Leo G, Montanari E, Sardanelli F, Cornalba G (2011) In vivo evaluation of the chemical composition of urinary stones using dual-energy CT. AJR Am J Roentgenol 197(1):W76–W83. doi:10.​2214/​AJR.​10.​5217 PubMedCrossRef
34.
Zurück zum Zitat Ruder TD, Thali Y, Bolliger SA, Somaini-Mathier S, Thali MJ, Hatch GM, Schindera ST (2013) Material differentiation in forensic radiology with single-source dual-energy computed tomography. Forensic Sci Med Pathol 9(2):163–169. doi:10.1007/s12024-012-9398-y PubMedCrossRef Ruder TD, Thali Y, Bolliger SA, Somaini-Mathier S, Thali MJ, Hatch GM, Schindera ST (2013) Material differentiation in forensic radiology with single-source dual-energy computed tomography. Forensic Sci Med Pathol 9(2):163–169. doi:10.​1007/​s12024-012-9398-y PubMedCrossRef
35.
Zurück zum Zitat Krauss B (2005) The dual-energy index. Siemens Healthcare AG, Siemens Medical 2005 Krauss B (2005) The dual-energy index. Siemens Healthcare AG, Siemens Medical 2005
Metadaten
Titel
Differentiation of heroin and cocaine using dual-energy CT—an experimental study
verfasst von
Jochen Grimm
Ramona Wudy
Edvard Ziegeler
Stefan Wirth
Michael Uhl
Maximilian F. Reiser
Michael Scherr
Publikationsdatum
01.05.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
International Journal of Legal Medicine / Ausgabe 3/2014
Print ISSN: 0937-9827
Elektronische ISSN: 1437-1596
DOI
https://doi.org/10.1007/s00414-014-0980-6

Weitere Artikel der Ausgabe 3/2014

International Journal of Legal Medicine 3/2014 Zur Ausgabe

Neu im Fachgebiet Rechtsmedizin

Molekularpathologische Untersuchungen im Wandel der Zeit

Open Access Biomarker Leitthema

Um auch an kleinen Gewebeproben zuverlässige und reproduzierbare Ergebnisse zu gewährleisten ist eine strenge Qualitätskontrolle in jedem Schritt des Arbeitsablaufs erforderlich. Eine nicht ordnungsgemäße Prüfung oder Behandlung des …

Vergleichende Pathologie in der onkologischen Forschung

Pathologie Leitthema

Die vergleichende experimentelle Pathologie („comparative experimental pathology“) ist ein Fachbereich an der Schnittstelle von Human- und Veterinärmedizin. Sie widmet sich der vergleichenden Erforschung von Gemeinsamkeiten und Unterschieden von …

Gastrointestinale Stromatumoren

Open Access GIST CME-Artikel

Gastrointestinale Stromatumoren (GIST) stellen seit über 20 Jahren ein Paradigma für die zielgerichtete Therapie mit Tyrosinkinaseinhibitoren dar. Eine elementare Voraussetzung für eine mögliche neoadjuvante oder adjuvante Behandlung bei …

Personalisierte Medizin in der Onkologie

Aufgrund des erheblichen technologischen Fortschritts in der molekularen und genetischen Diagnostik sowie zunehmender Erkenntnisse über die molekulare Pathogenese von Krankheiten hat in den letzten zwei Jahrzehnten ein grundlegender …