Contrast-enhanced postmortem computed tomography in clinical pathology: enhanced value of 20 clinical autopsies

Westphal, Saskia; Apitzsch, Jonas; Penzkofer, Tobias; Kuhl, Christiane K.; Mahnken, Andreas H.; Knüchel, Ruth

doi:10.1016/j.humpath.2014.05.007

Cited by 28 publications

(22 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, some studies have noted that the accuracy of clinical diagnosis of the immediate cause of death is lower than that of the primary cause of death, based upon hospital autopsy data [ 22 – 24 ]. Recent literature indicates that the correspondence rate of the immediate cause of death as determined by postmortem CT and hospital autopsy reaches approximately 70 % [ 25 , 26 ], indicating that the accuracy of the determination of the immediate cause of death by postmortem CT is superior to that by clinical diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Postmortem CT is more accurate than clinical diagnosis for identifying the immediate cause of death in hospitalized patients: a prospective autopsy-based study

et al. 2016

View full text Add to dashboard Cite

Despite 75 to 90 % physician accuracy in determining the underlying cause of death, precision of determination of the immediate cause of death is approximately 40 %. In contrast, two thirds of immediate causes of death in hospitalized patients are correctly diagnosed by postmortem computed tomography (CT). Postmortem CT might provide an alternative approach to verifying the immediate cause of death. To evaluate the effectiveness of postmortem CT as an alternative method to determine the immediate cause of death in hospitalized patients, an autopsy-based prospective study was performed. Of 563 deaths from September 2011 to August 2013, 50 consecutive cadavers undergoing hospital autopsies with consent for additional postmortem CT at the University of Fukui were enrolled. The accuracy of determination of the immediate cause of death by postmortem CT was evaluated in these patients. Diagnostic discrepancy was also compared between radiologists and attending physicians. The immediate cause of death was correctly diagnosed in 37 of 50 subjects using postmortem CT (74 %), concerning 29 cases of respiratory failure, 4 of hemorrhage, 3 of liver failure and 1 of septic shock. Six cases of organ failure involving 13 patients were not identified as the cause of death by postmortem CT. Regarding the immediate cause of death, accuracy of clinical diagnosis was significantly lower than that of postmortem CT (46 vs 74 %, P < 0.01). Postmortem CT may be more useful than clinical diagnosis for identifying the immediate cause of death in hospitalized patients not undergoing autopsy.Electronic supplementary materialThe online version of this article (doi:10.1007/s00428-016-1937-6) contains supplementary material, which is available to authorized users.

show abstract

Section: Introductionmentioning

confidence: 99%

Postmortem CT is more accurate than clinical diagnosis for identifying the immediate cause of death in hospitalized patients: a prospective autopsy-based study

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Consequently, various postmortem angiographic techniques have been developed (10)(11)(12)(13)(14)(15)(16)(17)(18)(19). Probably the most widespread single approach for postmortem angiography today is multiphase postmortem CT angiography (20)(21)(22)(23)(24)(25)(26)(27), first described in 2011 (14).…”

mentioning

confidence: 99%

Postmortem CT Angiography Compared with Autopsy: A Forensic Multicenter Study

Grabherr¹,

Heinemann²,

Vogel³

et al. 2018

Radiology

116

View full text Add to dashboard Cite

Purpose: To determine if postmortem computed tomography (CT) and postmortem CT angiography help to detect more lesions than autopsy in postmortem examinations, to evaluate the strengths and weaknesses of each method, and to define their indications. Materials and Methods:Postmortem CT angiography was performed on 500 human corpses and followed by conventional autopsy. Nine centers were involved. All CT images were read by an experienced team including one forensic pathologist and one radiologist, blinded to the autopsy results. All findings were recorded for each method and categorized by anatomic structure (bone, organ parenchyma, soft tissue, and vascular) and relative importance in the forensic case (essential, useful, and unimportant).

show abstract

“…Recent studies investigated the additional value of CT angiography. The study by Westphal et al (19) achieved an accuracy of 80% for cardiac causes of death (19). In a selected group of 50 cases, Wichmann et al (20) compared diagnoses (not cause of death) identified with CT angiography or conventional autopsy.…”

Section: Discussionmentioning

confidence: 99%

Conventional Autopsy versus Minimally Invasive Autopsy with Postmortem MRI, CT, and CT-guided Biopsy: Comparison of Diagnostic Performance

Blokker¹,

Weustink²,

Wagensveld³

et al. 2018

Radiology

View full text Add to dashboard Cite

onventional autopsy is a valuable tool, particularly for quality control in health care (1-3). Nevertheless, autopsy rates have been rapidly decreasing for various reasons, such as lack of interest of clinicians and next of kin due to overconfidence in premortem diagnostics, reluctance of family members to provide consent to autopsy because of the invasiveness of the procedure, reluctance of pathologists to perform autopsies, budgetary issues, and ideological opposition to postmortem investigation (4-11). Hence, noninvasive or minimally invasive alternative autopsy methods are being developed (12). The entire body can be visualized with postmortem CT and MRI (13-15), and imaging-guided biopsy can be performed to obtain tissue for histologic examination (16). In addition, CT angiography can be performed (17-23). Some of these methods are already used to support or even substitute for the forensic autopsy (24-26). In the clinical setting, noninvasive or minimally invasive autopsies of fetuses, newborns, and infants (27) have gained acceptance with parents and physicians along with political and public interest (28). However, they are still rarely applied in adult patients.

show abstract

Contrast-enhanced postmortem computed tomography in clinical pathology: enhanced value of 20 clinical autopsies

Cited by 28 publications

References 13 publications

Postmortem CT is more accurate than clinical diagnosis for identifying the immediate cause of death in hospitalized patients: a prospective autopsy-based study

Postmortem CT is more accurate than clinical diagnosis for identifying the immediate cause of death in hospitalized patients: a prospective autopsy-based study

Postmortem CT Angiography Compared with Autopsy: A Forensic Multicenter Study

Conventional Autopsy versus Minimally Invasive Autopsy with Postmortem MRI, CT, and CT-guided Biopsy: Comparison of Diagnostic Performance

Contact Info

Product

Resources

About