Diagnosis by consensus: A case study in the importance of interdisciplinary interpretation of mummified remains.

OBJECTIVE: The goal of this study is to demonstrate the need for interdisciplinary consensus and inclusion of mummy radiology specialists in analyses of mummified remains. MATERIALS: This study uses paleoimaging data for an ancient Egyptian mummy at the Museum of Human Anatomy "Filippo Civinini". METHODS: This study demonstrates the benefit of evaluation of mummified remains in a multi-disciplinary interpretive team. RESULTS: The authors propose a diagnosis of DISH, additional signs of undifferentiated spondyloarthropathy, and lumbarisation of S1. CONCLUSIONS: The process of diagnosis by consensus is essential to the analysis of mummified remains, which are complexly altered through natural and anthropogenic processes in the millennia subsequent to the individual's death. SIGNIFICANCE: Mummy paleoimaging and paleopathology lacks a unifying set of standards. We present an example of the value to be found in the multi-disciplinary diagnosis by consensus approach. LIMITATIONS: We discuss numerous challenges to accurate and meaningful interpretation that radiography of mummified remains pose. SUGGESTIONS FOR FURTHER RESEARCH: While the authors do not seek to impose any single set of standards, we do recommend a larger discussion on the topic of (culture-specific) standardisation in mummy paleoimaging and paleopathology. We further recommend the development of an international, multi-disciplinary panel of paleoimaging interpreters.

MUMAB: A Conversation With the Past.

In May of 1994, Drs. Bob Brier and Ronn Wade produced the first modern mummy embalmed in the ancient Egyptian tradition. MUMAB (Mummy, University of Maryland At Baltimore) has been studied over the intervening 18 years as part of the Mummy Replication Project, including high-resolution computed tomography scanning, magnetic resonance imaging, and histological examination. The radiological study of MUMAB is combined here with the firsthand discussion of the processes that resulted in the mummy's radiographic appearance. This allows for a close examination of the assumptions made in the radiological study of ancient Egyptian mummified human remains in a way not possible for the ancient remains themselves.

Forensic considerations for preprocessing effects on clinical MDCT scans.

Manipulation of digital photographs destined for medico-legal inquiry must be thoroughly documented and presented with explanation of any manipulations. Unlike digital photography, computed tomography (CT) data must pass through an additional step before viewing. Reconstruction of raw data involves reconstruction algorithms to preprocess the raw information into display data. Preprocessing of raw data, although it occurs at the source, alters the images and must be accounted for in the same way as postprocessing. Repeated CT scans of a gunshot wound phantom were made using the Toshiba Aquilion 64-slice multidetector CT scanner. The appearance of fragments, high-density inclusion artifacts, and soft tissue were assessed. Preprocessing with different algorithms results in substantial differences in image output. It is important to appreciate that preprocessing affects the image, that it does so differently in the presence of high-density inclusions, and that preprocessing algorithms and scanning parameters may be used to overcome the resulting artifacts.

Scenes from the past: multidetector CT of Egyptian mummies of the Redpath Museum.

As a nondestructive method of historical and anthropologic inquiry, imaging has played an important role in mummy studies over the past several decades. Recent technologic advances have made multidetector computed tomography (CT) an especially useful means for deepening the present understanding of ancient cultures by examining preserved human remains. In April 2011, three ancient Egyptian human mummies from the Redpath Museum of McGill University were examined with 320-section multidetector CT as part of the IMPACT Radiological Mummy Database project headquartered at the University of Western Ontario. Whole-body scanning was performed with a section thickness of 0.5 mm and a peak voltage of 120 kVp, and the raw CT datasets were postprocessed by using smooth body and high-resolution bone convolution filters. Two of the mummies were scanned at different energy levels (80 and 135 keV). The high-resolution CT scans revealed the details of mummification and allowed observations about the socioeconomic and health status of the human subjects based on both the mummification technique used and the appearance of the remains, particularly the bones and teeth. The paleopathologic information obtained from the scans confirmed some findings in studies performed in the same mummies in the late 19th and 20th centuries. The CT scans also demonstrated a high degree of variability in Egyptian mortuary practice, variability that is not generally recognized in the literature. Unusual features that were observed included a relatively uncommon retained heart in mummy RM2718, retained lungs in a mummy from which the heart had been extracted (RM2720), and a cartonnage plaque placed over the left abdomen of a mummy that had been eviscerated transperineally (RM2717).

Early dental intervention in the Redpath Ptolemaic Theban Male.

A computed tomography study of the remains of a Ptolemaic male mummy from Thebes (RM2718; 350-60 BCE), one of three ancient Egyptian human mummies curated at McGill University's Redpath Museum, demonstrates the packing of a large interproximal carious lesion with a protective linen barrier. The dental packing described here is unique among ancient Egyptian mummies studied to date, and represents one of only a few recorded dental interventions in ancient Egypt. Such a finding lends further support for the existence of a group of dental specialists practicing interventional medicine in ancient Egypt. While the physical evidence, to date for other interventions, may be scarce, the findings presented here should underline the need to continue to look for evidence of dental packing as well as other therapeutic dental interventions in the ancient world.

A synthetic radiological study of brain treatment in ancient Egyptian mummies.

Variability in brain treatment, as a part of the Egyptian mummification process, is poorly appreciated in the literature, as variability in the details of excerebration have not been addressed comprehensively nor with respect to social, geographic, and temporal variation. The description of Egyptian mummification commonly used in the popular and academic literature is derived largely from accounts by Herodotus and Diodorus Siculus. However, this normative description does not acknowledge the existence of a wide range of mummification techniques practiced and so stifles the study of geographic and chronological changes in the practice and their causes. Therefore, the goal of this study is to use the classical description as a hypothesis for empirical testing, using published literature and primary radiographic data, with a specific focus on the practice of excerebration. Three primary treatments of the brain in mummification, and their variation over time and across social strata, are discussed in relation to their treatment in the literature, their radiological indicators, and their technical considerations. In order to examine Egyptian mummy excerebration, this study makes use of two samples: (1) a literature-based sample of 125 mummies, and (2) a sample of 6 mummies examined directly using computed tomography. In spite of an apparent high degree of variability, the literature continues to focus on modern and classical stereotypes rather than the rich variability in the Egyptian mummification tradition. Detailed, large-scale examination of this and other mummification traditions, and their meanings, is required to further our understanding of this important early complex society.