Pathological analysis of cadavers for educational dissection by using postmortem imaging

Abstract

This study was performed primarily to clarify whether pathological analysis of cadavers for anatomical dissection is possible using postmortem imaging (PMI), and whether this is worthwhile. A total of 33 cadavers that underwent systematic anatomical dissection at our medical school also underwent PMI. Fixative solution was injected into the corpus 3–4 days after death. PMI was then performed using an 8‐slice multi‐detector CT scanner 3 months before dissection. Before dissection, a conference was held to discuss the findings of the PMI. First, two radiologists read the postmortem images without any medical information and deduced the immediate cause of death. Then, the anatomy instructor revealed the medical information available. Based on this information, the radiologist, anatomy instructor, and pathologists suggested candidate sampling sites for pathological examination. On the last day of the dissection period, the pathologists resected the sample tissues and processed them for pathological examination. In 12 of 33 cases, the presumed causes of death could be determined based on PMI alone, and revision of the cause of death described in the death certificate was considered in five (15.2%) cases, based on PMI and pathological analysis. This article presents a novel method of pathological analysis of cadavers for anatomical dissection using PMI without disturbing the anatomy education of medical students.

A Summary of Concepts, Procedures and Techniques Used by Forensic Entomologists and Proxies

“…Furthermore, the sequence of these invertebrates invading a carcass can vary based on external and internal influences, such as changes in the carcass characteristics (size, nutrient composition, existing decomposition stage, and xenobiotics), abiotic (temperature and humidity), and biotic (terrestrial and aquatic habitats) factors [26]. Typically, the minPMI for early stages of carcass decomposition (i.e., 3-72 h following death) is estimated by pathological methods [20]. However, after this period, fly eggs, larval, and pupal specimens become one of the most reliable indices for the age determination of a carcass [21,22].…”

“…Typically, the minPMI for early stages of carcass decomposition (i.e., 3–72 h following death) is estimated by pathological methods [ 20 ]. However, after this period, fly eggs, larval, and pupal specimens become one of the most reliable indices for the age determination of a carcass [ 21 , 22 ].…”

The question of dissection in medical training: Not just “if,” but “when”? A student perspective

“…Voluntary (Larkin & McAndrew, 2013 ), optional (Pais et al, 2017 ; Eppler et al, 2018 ), and extracurricular (Chambers & Emlyn‐Jones, 2009 ; Whelan et al, 2018 ) dissection opportunities have been created to give interested students the opportunity to dissect while minimizing impact upon the formal curriculum schedule. Another strategy has been to optimize the integration of dissection and its clinical relevance within the curriculum by sequencing it with other teaching and learning activities such as problem‐based learning (PBL) cases (Thompson et al, 2019 ), medical imaging (Murakami et al, 2014 ; Wilson et al, 2018b ), pathology (Geldenhuys et al, 2016 ; Noriki et al, 2019 ), and surgical techniques (Jeyakumar et al, 2020 ). In some institutions, students take turns to participate in dissection in order to continue to offer dissection opportunities to all students despite the reduced curricular time available, increasing student numbers, reduced staff numbers, and/or limited availability of cadavers (McWhorter & Forester, 2004 ; Bentley & Hill, 2009 ; Kim et al, 2019 ).…”

Changes in magnetic resonance imaging relaxation time on postmortem magnetic resonance imaging of formalin-fixed human normal heart tissue

“…It is also known in different countries as “forensic radiology” [ 3 ] or “virtual autopsy” [ 4 , 5 ] and, in Japan, it has been widely used and reported as “autopsy imaging” (Ai) since the turn of the millennium [ 6 ]. We ourselves have installed CT and MRI scanners specifically for postmortem use in a building adjacent to our university hospital, where we have engaged mainly in the Ai of autopsy patients from both within and outside the hospital, and we have conducted postmortem radiology-pathology correlation studies [ 7 – 11 ].…”