Postmortem-computed tomography and postmortem-computed tomography–angiography: a focused update

Busardò, Francesco Paolo; Frati, Paola; Guglielmi, Giuseppe; Grilli, Gianpaolo; Pinto, Antonio; Rotondò, Antonio; Panebianco, Valeria; Fineschi, Vittorio

doi:10.1007/s11547-015-0559-4

Cited by 29 publications

(9 citation statements)

References 90 publications

(112 reference statements)

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“…A search for alternative post-mortem diagnostics has followed the decline in clinical autopsy rates [ 1 ]. The literature dedicated to post-mortem imaging and its developments is expanding, especially in the field of forensic medicine [ 2 , 3 , 4 , 5 , 6 ]. However, post-mortem imaging remains underutilized in daily clinical practice, and as a consequence, the literature on the clinical application of post-mortem imaging is limited.…”

Section: Introductionmentioning

confidence: 99%

Clinical Relevance of Unexpected Findings of Post-Mortem Computed Tomography in Hospitalized Patients: An Observational Study

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Bakers

et al. 2020

IJERPH

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Background and objective: The current literature describing the use of minimally invasive autopsy in clinical care is mainly focused on the cause of death. However, the identification of unexpected findings is equally important for the evaluation and improvement of daily clinical care. The purpose of this study was to analyze unexpected post-mortem computed tomography (PMCT) findings of hospitalized patients and assess their clinical relevance. Materials and methods: This observational study included patients admitted to the internal medicine ward. Consent for PMCT and autopsy was requested from the next of kin. Decedents were included when consent for at least PMCT was obtained. Consent for autopsy was not obtained for all decedents. All findings reported by PMCT were coded with an International Classification of Diseases (ICD) code. Unexpected findings were identified and subsequently categorized for their clinical relevance by the Goldman classification. Goldman class I and III were considered clinically relevant. Additionally, correlation with autopsy results and ante-mortem imaging was performed. Results: In total, 120 decedents were included and evaluated for unexpected findings on PMCT. Of them, 57 decedents also underwent an autopsy. A total of 1020 findings were identified; 111 correlated with the cause of death (10.9%), 508 were previously reported (49.8%), 99 were interpreted as post-mortem changes (9.7%), and 302 were classified as unexpected findings (29.6%). After correlation with autopsy (in 57 decedents), 24 clinically relevant unexpected findings remained. These findings were reported in 18 of 57 decedents (32%). Interestingly, 25% of all unexpected findings were not reported by autopsy. Conclusion: Many unexpected findings are reported by PMCT in hospitalized patients, a substantial portion of which is clinically relevant. Additionally, PMCT is able to identify pathology and injuries not reported by conventional autopsy. A combination of PMCT and autopsy can thus be considered a more comprehensive and complete post-mortem examination.

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Section: Introductionmentioning

confidence: 99%

Clinical Relevance of Unexpected Findings of Post-Mortem Computed Tomography in Hospitalized Patients: An Observational Study

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et al. 2020

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“…Postmortem CT was introduced in 1977 for forensic use [6,19], with the first reported use for autopsy in 1983 for identifying gas in the brain of a Navy diver [19,31]. Postmortem CT was first suggested as a possible alternative to autopsy in 1994, although the authors described that the combination of CT and autopsy provided the most information [32].…”

Section: Introductionmentioning

confidence: 99%

“…Multidetector CT technique has replaced single-detector technique for postmortem imaging and appears to be most helpful for assessing skeletal pathology [2,12,20,33], and it might also be helpful in identifying intracranial hemorrhage [34,35]. Numerous authors have reported applications of postmortem CT angiography to investigate vascular pathology and determine sites of large vessel hemorrhage [31,36,37], and CT angiography has been used to evaluate congenital heart disease [19]. Ventilated postmortem CT is another variation of CT technique in adults that allows for better differentiation between postmortem lung changes and underlying antemortem lung pathology [38].…”

Section: Introductionmentioning

confidence: 99%

Pediatric postmortem computed tomography: initial experience at a children’s hospital in the United States

et al. 2019

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Postmortem CT might provide valuable information in determining the cause of death and understanding disease processes, particularly when combined with traditional autopsy. Pediatric applications of postmortem imaging represent a new and rapidly growing field. We describe our experience in establishing a pediatric postmortem CT program and present a discussion of the distinct challenges in developing this type of program in the United States of America, where forensic practice varies from other countries. We give a brief overview of recent literature along with the common imaging findings on postmortem CT that can simulate antemortem pathology.

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“…In the past 15 years, post-mortem computed tomography (PMCT) has emerged as an important imaging procedure in forensic pathology, especially to be able to provide necropsy detection of lesions and also determination of the cause of death [2,3]. Currently, transitional necropsy is considered as a gold standard and PMCT as an adjuvant method for investigation of the cause of death in both humans and animal.…”

Section: Introductionmentioning

confidence: 99%

A new method for the interpretation of veterinary forensic necropsy and PMCT finding with Bayesian decision theory

Massad

Shimozako

Ribas

et al. 2018

Journal of Forensic Radiology and Imaging

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This work proposes a novel approach to estimate the sensitivity of post-mortem computed tomography (PMCT) with respect to traditional necropsy (gold standard). Using concepts of Bayes theorem and the opinion of 57 veterinarians of how a relevant finding (RF) on PMCT or at necropsy can be a determinant in the animal's death, the general sensitivity was estimated. Such sensitivity can be interpreted as the probability to identify a specific RF in a necropsied animal. In the study, we included 18 animals that were subjected to traditional necropsy and underwent PMCT, which provided 48 different findings; all were assumed as a potential cause of death. This study aimed to understand the probability of death, given that a necropsied animal presented a specific RF. To estimate all contributions of the 48 RF, we designed a simple survey based on the Delphi method. In this survey, we invited veterinarians to evaluate the 48 NF and to assign a grade in a Likert scale from 0 to 10 for each of the RFs. In this scale, 0 (zero) indicates that the NF does not contribute to the animal's death, and 10 (ten) indicates that this NFdoes totally contributes to the animal's death. Therefore, each veterinarian, according to their own professional experience, assigns a grade describing how important each necroscopic finding is to the animal's death. Our results demonstrated that the problem of sensitivity analysis in the absence of a gold standard could be circumvented by the method proposed here.

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Postmortem-computed tomography and postmortem-computed tomography–angiography: a focused update

Cited by 29 publications

References 90 publications

Clinical Relevance of Unexpected Findings of Post-Mortem Computed Tomography in Hospitalized Patients: An Observational Study

Clinical Relevance of Unexpected Findings of Post-Mortem Computed Tomography in Hospitalized Patients: An Observational Study

Pediatric postmortem computed tomography: initial experience at a children’s hospital in the United States

A new method for the interpretation of veterinary forensic necropsy and PMCT finding with Bayesian decision theory

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