Impact of increasing levels of adaptive statistical iterative reconstruction on image quality in oil-based postmortem CT angiography in coronary arteries

Steuwe, Andrea; Boeven, Judith; Cordes, Lena; Draisci, Stefano; Boos, Johannes; Grabherr, Silke; Bruguier, Christine; Dalyanoĝlu, Hannan; Antoch, Gerald; Aissa, Joel

doi:10.1007/s00414-021-02530-1

Cited by 4 publications

(2 citation statements)

References 36 publications

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“…In the future, it should also be investigated whether an adaptation of the reconstruction techniques, as already available for PMCTAs with oily contrast agent [ 27 ], can also be applied to PMCTAs with PEG-Accupaque.…”

Section: Discussionmentioning

confidence: 99%

Development of a protocol for standardized use of a water-soluble contrast agent with polyethylene glycol in post-mortem CT angiography

Bruch,

Grabherr,

Bruguier

et al. 2024

Int J Legal Med

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Computed tomography angiography (PMCTA) is increasingly used in postmortem cases. Standardized validated protocols permit to compare different PMCTA images and make it more easily to defend a case in court. In addition to the well-known technique by Grabherr et al. (2011) which is using paraffin oil as a carrier substance, water-soluble polyethylene glycol 200 (PEG200) can be used in combination with the contrast agent Accupaque® 300. As to date, there exists no standardized protocol for the use of this contrast agent mixture, the aim of this study was to develop a protocol using it. Between 2012 and 2022, 23 PMCTA with PEG200 and Accupaque®300 were performed at the University Centre of Legal Medicine Lausanne (Switzerland) and the Institute of Forensic Medicine Munich (Germany). The images obtained were evaluated regarding the opacification of the vessels and possible artefacts. The best image quality was obtained with a mixing ratio of 1:15 (Accupaque®300:PEG200) and a perfusion volume of 1000 ml in the arterial, 1400 ml in the venous and 350 ml in the dynamic phase. The infusion rates described by Grabherr et al. were confirmed for the three phases. Overall, the opacification of the vessels was diagnostically sufficient. In 13 cases no opacification of the right coronary artery was observed due to a stratification artefact. By using the PMCTA protocol with PEG200 as a carrier, a good overall image quality can be achieved. This protocol offers the possibility to standardize PMCTA with PEG200.

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Section: Discussionmentioning

confidence: 99%

Development of a protocol for standardized use of a water-soluble contrast agent with polyethylene glycol in post-mortem CT angiography

Bruch,

Grabherr,

Bruguier

et al. 2024

Int J Legal Med

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“…PMCTA is known to be useful for investigation of arterial structure. Its advantages include high spatial and contrast resolution, as well as capabilities for modulation or reconstruction of data [22]. However, access to a CT scanner that can be used for forensic purposes is sometimes limited at many facilities worldwide [8,23].…”

Section: Discussionmentioning

confidence: 99%

Usefulness of a tissue optical clearing technique for forensic autopsy

Takahashi

Hayakawa

Sano

et al. 2022

Journal of Forensic Sciences

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Forensic pathologists are required to investigate lethal trauma or disease at autopsy. In addition to massive contusions of various organs, a number of small features with potentially fatal implications also need to be sought. Since such lesions may need microscopic examinations for detailed evaluation, it is important to select suitable anatomic locations for tissue sampling. For practical screening of small lesions, we have developed a tissue optical clearing (TOC) technique for forensic autopsy. The technique involves clearing with a non‐toxic organic solvent, ethyl cinnamate, which renders excised organs transparent, while hemorrhages or blood‐containing vessels remain opaque. Using this technique, tiny hemorrhages in the spinal cord were able to be identified by gross examination, allowing proper selection of locations for tissue sampling. Subsequent histopathological evaluation was successfully performed with no apparent artifacts related with the TOC procedure. In addition, a combination of TOC and targeted CT angiography allowed feasible examination of the arterial occlusive lesion in the superior mesenteric artery, and when combined with micro‐CT scanning it was useful for evaluating the lumen of the coronary artery with stent implantation. The results obtained so far indicated that TOC could complement routine forensic autopsy procedures when detailed evaluation of small lesions is required.

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Changes in tissues and organs through PMCTA carrier substances

Bruch,

Feldmann,

Fischer

et al. 2024

Int J Legal Med

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To date, lipophilic contrast agents mixed with oil, usually paraffin oil, are the most commonly used contrast agents in post-mortem computed tomography angiography (PMCTA). Iodine-based hydrophilic contrast media in combination with a water-soluble carrier, e.g. polyethylene glycol (PEG), are also common. However, their influence on different tissues and organs is poorly understood. In order to analyse the changes in the cadavers caused by the different carrier substances, we evaluated the effects of PEG 200 and oil on the different tissues and organs. Therefore, during a forensic autopsy, liquid femoral vein blood and samples of different organs and vessels were taken and preserved at room temperature in the two liquids mentioned. The condition of the samples was documented during the autopsy and 24, 48 and 72 h after preservation. Microscopic examination took place after 72 h. After 24 h, the samples placed in PEG 200 already showed a clear solidification of almost all structures. Crumbly blood agglomerates had formed in the previously liquid blood. In contrast, the samples stored in oil showed signs of classic cadaveric decomposition after 24 h, which increased with time. The microscopic and immunohistochemical evaluation of the samples stored in PEG showed a good diagnostic quality. The analysis of tissues stored in oil was much more difficult due to putrefaction. PEG and oil show significantly different effects on human tissues, mainly conservation and dehydration are affected. It is crucial to be aware of these differences in order to choose the most appropriate PMCTA method for each forensic case.

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Impact of increasing levels of adaptive statistical iterative reconstruction on image quality in oil-based postmortem CT angiography in coronary arteries

Cited by 4 publications

References 36 publications

Development of a protocol for standardized use of a water-soluble contrast agent with polyethylene glycol in post-mortem CT angiography

Development of a protocol for standardized use of a water-soluble contrast agent with polyethylene glycol in post-mortem CT angiography

Usefulness of a tissue optical clearing technique for forensic autopsy

Changes in tissues and organs through PMCTA carrier substances

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