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

Mentink, Max G; Latten, Bartholomeus G. H.; Bakers, Frans C. H.; Mihl, Casper; Rennenberg, Roger J M W; Kubat, Bela; Hofman, Paul

doi:10.3390/ijerph17207572

Cited by 4 publications

(2 citation statements)

References 22 publications

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“…For example, Leth et al studied 67 traffic fatality victims and found that PMCT was superior for identifying skeletal injuries, while autopsy diagnosed more soft tissue injuries [28]. Mentink et al found that in‐hospital deaths studied by both PMCT and autopsy ( n = 57), unexpected findings were observed in 32% of the cases [29]. Further, 25% of the unexpected findings were reported by PMCT but not reported by autopsy.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of forensic pathologists in incorporating post‐mortem CT (PMCT) in forensic death investigation

Makino

Unuma

Nolte

et al. 2022

Journal of Forensic Sciences

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Post‐mortem computed tomography (PMCT) is now performed routinely in some medical examiner's offices, and the images are typically interpreted by forensic pathologists. In this study, the question of whether pathologists appropriately identify significant PMCT findings and incorporate them into the death investigation report and the cause and manner of death (COD and MOD) statements was addressed. We retrospectively reviewed 200 cases where PMCT was performed. The cases were divided into four categories: (1) full autopsy without radiology consultation (n = 77), (2) external exam without radiology consultation (n = 79), (3) full autopsy with radiology consultation (n = 26), (4) external exam with radiology consultation (n = 18). A radiologist (not the consult radiologist) read the PMCT images, and a pathologist (not the case pathologist) reviewed the case pathologist's post‐mortem examination report in tandem to determine any PMCT findings omitted from the report. Omitted findings were classified into error types according to a modified Goldman classification including Major 1: Unrecognized fatal injury or pathology that would change COD and/or MOD, and Major 2: Unrecognized fatal injury or pathology that would not change COD and/or MOD. A total of 13 Major errors were identified (6.5%), and none definitively changed the MOD. All four Major‐1 errors which could change the COD were found in Category 2. Of 9 Major‐2 errors, 2 occurred in Category 1, 6 occurred in Category 2, and 1 occurred in Category 4. In conclusion, forensic pathologists who routinely utilize computed tomography (CT) interpret CT images well enough to reliably certify the COD and MOD.

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Section: Discussionmentioning

confidence: 99%

Accuracy of forensic pathologists in incorporating post‐mortem CT (PMCT) in forensic death investigation

Makino

Unuma

Nolte

et al. 2022

Journal of Forensic Sciences

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“…Recently, several studies have proposed the use of PMCT to determine the cause of death [1][2][3][4][5][6][7][8][9][10]. The PMCT is considered the most feasible imaging modality because it is widely available.…”

Section: Case Historymentioning

confidence: 99%

Noninvasive postmortem investigation of cases refusing autopsy using computed tomography

Wasinrat,

Wasinrat

2023

ASEAN J Radiol

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Background: CT is a well-known tool to assess several conditions in living patients. The post-mortem CT (PMCT) has been introduced to determine the cause of death in dead subjects. CT is also the imaging modality of choice for the analysis of autopsy findings including fracture, hematoma, gas collection and gross tumor injury. The rate of standard autopsy is continuing to decline and there are several reasons for refusing autopsy. Objective: The current research endeavor is investigate the usefulness of computed tomography (CT) in cases refusing autopsy. Materials and Methods: In this study, the PMCT were evaluated in 150 subjects in different contexts of death. The causes of death were classified into four categories which include a definite cause of death, a possible cause of death, a minor pathological finding and no fatal findings. For the definite cause of death and the possible cause of death, the specific lesions are described in detail. Results: The definite cause of death was detected in 48 (32%) of the subjects. The possible cause of death was detected in 18 (12%) of the subjects. The remaining 84 subjects were classified into minor pathological findings and no fatal findings in 46 (30.7%) and 38 (25.3%) of the patients, respectively. The fatal lesions of PMCT were found in 93 lesions(48 subjects) that were demonstrated by anatomical locations into the traumatic bone, intracranial, spine, thoracic, heart leak and abdominal lesions. We found definite causes of death in 6 subjects, which had no history of trauma and malignancy and were mentioned about a cardiopulmonary failure as a cause of death at first. Conclusion: The PMCT is a useful tool for identifying the cause of death in many cases that have limitations for conventional autopsy. The morphological change such as intracranial hemorrhage is easily diagnosed with PMCT. The PMCT appears to be an alternative tool to assess the cause of death in any reason of objections.

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CT Forensic Imaging

Doyle¹,

Buxton²

2023

Computed Tomography

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

Cited by 4 publications

References 22 publications

Accuracy of forensic pathologists in incorporating post‐mortem CT (PMCT) in forensic death investigation

Accuracy of forensic pathologists in incorporating post‐mortem CT (PMCT) in forensic death investigation

Noninvasive postmortem investigation of cases refusing autopsy using computed tomography

CT Forensic Imaging

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