You are here

Article Text

Article menu
Download PDFPDF
PostScript
Correspondence
The effects of postmortem CT scanning all cases entering a UK public mortuary: a 3-month pilot
  1. S Kim Suvarna1,
  2. Panagiota Kitsanta1,
  3. Julian L Burton2
  1. 1 Histopathology Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
  2. 2 Academic Unit of Pathology, University of Sheffield, Sheffield, UK
  1. Correspondence to Dr S Kim Suvarna; s.k.suvarna{at}sheffield.ac.uk

https://doi.org/10.1136/jclinpath-2017-204505

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Autopsy work is currently principally used in the UK to derive a cause of death and/or investigate the pathologies leading to death on the instruction of a medicolegal authority.1 Traditionally, this has involved a variable degree of opening the body, direct observation, tissue sampling and special tests (histology, microbiology, toxicology, etc), generally termed an invasive autopsy.2

    At the start, it is fully accepted that those practising forensic pathology, where a full autopsy and a wide range of ancillary tests, will generate a very high degree of confidence in the autopsy findings. However, society does not request this level of confirmation with regard to community and hospital deaths—unless there is a medicolegal/criminal issue under consideration.

    It is also accepted that medically certified causes of death have an appreciable error rate with missed significant diagnoses when compared with a full invasive autopsy.3 Given that it would be impractical to subject every single death in this country to a full invasive/forensic autopsy, a pragmatic balance needs to be sought for society. A clinical impression formed over a period of time, variably supported by antemortem tests, remains sufficient for natural hospital and community/general practitioner cause of death certification.

    Non-invasive postmortem CT scan radiology autopsy review (PM-CT) in the last 10 years has been increasingly used in the UK, mainly on an episodic relative-request basis, rather than as a tool applied to all mortuary cases.4 Some work on the accuracy of such studies has been performed, and it has been seen that non-invasive and minimally invasive autopsy methods may serve as an adjunct or alternative to conventional autopsies. They are more acceptable to relatives, but are less accurate than the reference standard (ie, a full open/invasive autopsy with fully histology and other tests).5

    The use of PM-CT requires a slightly …

    View Full Text

    Footnotes

    • Handling editor Tahir S Pillay

    • Contributors All three authors have been the drivers for this study and performed work on the project and manuscript.

    • Competing interests None declared.

    • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement There is no additional data to consider here beyond the scan and cause of death data.