CT angiography better than standard autopsy for postmortem exams
A team of researchers found that postmortem computed tomography (CT) angiography detects more lesions in a human corpse than a standard CT or autopsy examination, according to a forensic multicenter study published May 1 in Radiology.
The researchers, led by Silke Grabherr, MD, PD, from the University Center of Legal Medicine Lausanne-Geneva in Switzerland, also found that combining postmortem CT angiography and autopsy reveals the most findings and may increase the quality of postmortem diagnosis.
"Our results show that postmortem CT angiography is superior to autopsy for all findings except essential soft-tissue findings," the researchers wrote. "The superiority of imaging over autopsy for the total and essential findings is strongly influenced by the significantly higher detection rates for bone and vascular lesions that together make up more than half of the findings."
According to study methods, the researchers performed postmortem CT angiography exams on 500 human corpses, followed by conventional autopsy. Nine European centers participated in the study conducted between February 2012 to August 2015.
One forensic pathologist and one radiologist, blinded to autopsy results, then read all CT images and recorded the findings. All findings were then recorded for each method and categorized by anatomic structure (bone, organ, parenchyma, soft tissue and vascular) as well as relative forensic importance, the researchers wrote.
A total of 18,654 findings were identified across the three methods, with postmortem CT angiography identifying 89.9 percent. Standard autopsies identified 61.3 percent and postmortem CT identified 76 percent, respectively.
Additionally, postmortem CT angiography identified the most skeletal lesions and vascular lesions, compared to autopsy. Autopsy also missed 23.4 percent of total findings while postmortem CT angiography only missed 9.7 percent.
The researchers asserted that combining CT angiography with autopsy is important considering the declining rate of autopsies performed around the world.
"A high-quality postmortem examination is important not only in forensic cases, but also for the evaluation of the quality of clinical diagnosis and therapy in clinical pathologic analysis," according to the researchers. "It is thus an important instrument for both justice and medical quality control; the importance of both aspects cannot be overestimated."
A recent graduate from Dominican University (IL) with a bachelor’s in journalism, Melissa joined TriMed’s Chicago team in 2017 covering all aspects of health imaging. She’s a fan of singing and playing guitar, elephants, a good cup of tea, and her golden retriever Cooper.