Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
Pediatric Radiology
Published in: Pediatric Radiology 6/2021

01-05-2021 | Autopsy | Child abuse imaging

Navigating the perils and pitfalls of pediatric forensic postmortem imaging in the United States

Authors: Mary P. Harty, Sharon W. Gould, Howard T. Harcke

Published in: Pediatric Radiology | Issue 6/2021

Login to get access

Abstract

Postmortem CT is widely used in the general adult and military populations. It is used extensively in pediatric death investigations in Europe and Asia, but distinctive challenges are encountered when launching a postmortem imaging program in the United States. We describe the issues we have encountered specific to establishing a pediatric postmortem imaging service in this country and propose potential solutions.
Literature
1.
Goldman L (2018) Autopsy 2018: still necessary, even if occasionally not sufficient. Circulation 137:2686–2688
2.
Kumar P, Taxy J, Angst DB, Mangurten HH (1998) Autopsies in children: are they still useful? Arch Pediatr Adolesc Med 152:558–563
3.
Thayyil S, Sebire NJ, Chitty LS et al (2011) Post mortem magnetic resonance imaging in the fetus, infant and child: a comparative study with conventional autopsy (MaRIAS protocol.). BMC Pediatr 11:120
4.
Lewis C, Latif Z, Hill M et al (2018) “We might get a lot more families who will agree”: Muslim and Jewish perspectives on less invasive perinatal and paediatric autopsy. PLoS One 13:e0202023
5.
Bauchner H, Vinci R (2001) What have we learnt from the Alder Hey affair? That monitoring physicians’ performance is necessary to ensure good practice. BMJ 322:309–310
6.
Sullivan J, Monagle P (2011) Bereaved parents’ perceptions of the autopsy examination of their child. Pediatrics 127:e1013–e1020
7.
Brogdon BG, Lichtenstein JE (2000) Forensic radiology in historical perspective. Crit Rev Diagn Imaging 41:13–42
8.
Cox J, Kirkpatrick RC (1896) The new photography with report of a case in which a bullet was photographed in the leg. Montreal Med J 24:661–665
9.
Hanaway J, Cruess RL, Darragh J (2006) McGill medicine: the second half century, 1885–1936. McGill-Queen University Press, Quebec, pp 168–169
10.
Gourincour G, Sarda-Quarello L, Laurent PE et al (2015) The future of pediatric and perinatal postmortem imaging. Pediatr Radiol 45:509–516
11.
Arthurs OJ, van Rijn RR, Sebire NJ (2014) Current status of paediatric post-mortem imaging: an ESPR questionnaire-based survey. Pediatr Radiol 44:244–251
12.
Arthurs OJ, Guy A, Kiho L, Sebire NJ (2015) Ventilated postmortem computed tomography in children: feasibility and initial experience. Int J Legal Med 129:1113–1120
13.
Shelmerdine SC, Hutchinson JC, Ward L et al (2019) INTACT (INcision-less TArgeted Core tissue) biopsy procedure for perinatal autopsy: initial feasibility. Ultrasound Obstet Gynecol 55:667–675
14.
15.
Arthurs OJ, van Rijn RR (2015) Paediatric and perinatal postmortem imaging: mortui vivos docent. Pediatr Radiol 45:476–477
16.
Chapman S (2015) What are the greatest challenges and/or barriers to applying postmortem imaging in paediatric radiology? Pediatr Radiol 45:478
17.
Ruder TD (2015) What are the greatest challenges or barriers to applying post-mortem imaging in pediatric radiology? Pediatr Radiol 45:479
18.
Hatch GM (2015) What are the greatest challenges or barriers to applying post-mortem imaging in pediatric radiology? Pediatr Radiol 45:480
19.
Cain TM (2015) What are the greatest challenges or barriers to applying postmortem imaging in paediatric radiology? Pediatr Radiol 45:481
20.
Alison M (2015) Postmortem imaging in paediatric radiology — the French perspective. Pediatr Radiol 45:482
21.
Arthurs OJ, van Rijn RR, Taylor AM, Sebire NJ (2015) Paediatric and perinatal postmortem imaging: the need for a subspecialty approach. Pediatr Radiol 45:483–490
22.
Arthurs OJ, Taylor AM, Sebire NJ (2015) Indications, advantages and limitations of perinatal postmortem imaging in clinical practice. Pediatr Radiol 45:491–500
23.
Cohen MC, Whitby EH, Fink MA et al (2015) Running a postmortem service — a business case and clinical experience. Pediatr Radiol 45:501–508
24.
Klein WM, Bosboom DG, Koopmanschap DH et al (2015) Normal pediatric postmortem CT appearances. Pediatr Radiol 45:517–526
25.
Arthurs OJ, Barber JL, Taylor AM, Sebire NJ (2015) Normal perinatal and paediatric postmortem magnetic resonance imaging appearances. Pediatr Radiol 45:527–535
26.
Calder AD, Offiah AC (2015) Foetal radiography for suspected skeletal dysplasia: technique, normal appearances, diagnostic approach. Pediatr Radiol 45:536–548
27.
Taylor AM, Arthurs OJ, Sebire NJ (2015) Postmortem cardiac imaging in fetuses and children. Pediatr Radiol 45:549–555
28.
Arthurs OJ, Chitty LS, Judge-Kronis L, Sebire NJ (2015) Postmortem magnetic resonance appearances of congenital high airway obstruction syndrome. Pediatr Radiol 45:556–561
29.
Arthurs OJ, van Rijn RR, Whitby EH et al (2016) ESPR postmortem imaging task force: where we begin. Pediatr Radiol 46:1363–1369
30.
Gould SW, Harty MP, Givler NE et al (2019) Pediatric postmortem computed tomography: initial experience at a children’s hospital in the United States. Pediatr Radiol 49:1113–1129
31.
Hanzlick R (2007) The conversion of coroner systems to medical examiner systems in the United States: a lull in the action. Am J Forensic Med Pathol 28:279–283
32.
[No authors listed] (2017) QuickStats: percentage of deaths from external causes, by age group — United States, 2017. MMWR Morb Mortal Wkly Rep 68:710
33.
34.
Levy AD, Harcke HT (2017) Postmortem radiology and imaging. In: Collins KA (ed) Autopsy performance & reporting, 3rd edn. College of American Pathologists, Northfield, pp 351–368
35.
Covington TM (2011) The U.S. national child death review case reporting system. Inj Prev 17:i34–i37
36.
Harty MP, Gould SW, Harcke TH (2020) Postmortem imaging techniques and challenges. 2020 SPR Child Abuse Imaging Course, Dallas
37.
38.
Harcke HT (2010) The case for postmortem imaging. Pediatr Radiol 40:138–140
39.
Flach PM, Gascho D, Schweitzer W et al (2014) Imaging in forensic radiology: an illustrated guide for postmortem computed tomography technique and protocols. Forensic Sci Med Pathol 10:583–606
40.
Flach PM, Thali MJ, Germerott T (2014) Times have changed! Forensic radiology — a new challenge for radiology and forensic pathology. AJR Am J Roentgenol 202:W325–W334
41.
O’Donnell C, Woodford N (2008) Post-mortem radiology — a new sub-specialty? Clin Radiol 63:1189–1194
42.
Arthurs OJ, Hutchinson JC, Sebire NJ (2017) Current issues in postmortem imaging of perinatal and forensic childhood deaths. Forensic Sci Med Pathol 13:58–66
43.
Levy AD, Harcke HT (2010) Essentials of forensic injury. A text-atlas. CRC Press, Boca Raton
44.
Thali MJ, Yen K, Schweitzer W et al (2003) Virtopsy, a new imaging horizon in forensic pathology: virtual autopsy by postmortem multislice computed tomography (MSCT) and magnetic resonance imaging (MRI) — a feasibility study. J Forensic Sci 48:386–403
45.
Levy AD, Harcke HT, Mallak CT (2010) Postmortem imaging: MDCT features of postmortem change and decomposition. Am J Forensic Med Pathol 31:12–17
46.
Ruder TD, Thali MJ, Hatch GM (2014) Essentials of forensic post-mortem MR imaging in adults. Br J Radiol 87(1036):20130567
47.
Ishida M, Gonoi W, Okuma H et al (2015) Common postmortem computed tomography findings following atraumatic death: differentiation between normal postmortem changes and pathologic lesions. Korean J Radiol 16:798–809
48.
Offiah CE, Dean J (2016) Post-mortem CT and MRI: appropriate post-mortem imaging appearances and changes related to cardiopulmonary resuscitation. Br J Radiol 89(1058):20150851
49.
van Grinsven T, Lafebre SJ, Kubat B, Klein WM (2017) Postmortem changes in musculoskeletal and subcutaneous tissue. J Forensic Radiol Imaging 10:29–36
50.
Kobayashi T, Shiotani S, Kaga K et al (2010) Characteristic signal intensity changes on postmortem magnetic resonance imaging of the brain. Jpn J Radiol 28:8–14
51.
Smith AB, Lattin GE Jr, Berran P, Harcke HT (2012) Common and expected postmortem CT observations involving the brain: mimics of antemortem pathology. AJNR Am J Neuroradiol 33:1387–1391
52.
Sieswerda-Hoogendoorn T, Beenen LF, van Rijn RR (2015) Normal cranial postmortem CT findings in children. Forensic Sci Int 246:43–49
53.
Case ME (2014) Distinguishing accidental from inflicted head trauma at autopsy. Pediatr Radiol 44:S632–S640
54.
Biljardt S, Brummel A, Tijhuis R et al (2015) Post-mortem fluid stasis in the sinus, trachea and mainstem bronchi; a computed tomography study in adults and children. J Forensic Radiol Imaging 3:162–166
55.
Ruder TD, Ross SG, Hatch GM (2013) Second congress of the International Society of Forensic Radiology and Imaging (ISFRI) — towards a joint future in forensic imaging. J Forensic Radiol Imaging 1:146–148
56.
Ruder TD (2013) What are the key objectives of the ISFRI? — evaluation of the ISFRI member survey. J Forensic Radiol Imaging 1:142–145
57.
Rutty GN, Brogdon G, Dedouit F et al (2013) Terminology used in publications for post-mortem cross-sectional imaging. Int J Legal Med 127:465–466
58.
Thayyil S, Sabire NJ, Chitty LS et al (2013) Post-mortem MRI versus conventional autopsy in fetuses and children: a prospective validation study. Lancet 382:223–233
59.
Harcke HT, Curtin RN, Harty MP et al (2020) Tibial intraosseous insertion in pediatric emergency care: a review based upon postmortem computed tomography. Prehosp Emerg Care 7:1–7
60.
Roberts IS, Benamore RE, Benbow EW et al (2012) Post-mortem imaging as an alternative to autopsy in the diagnosis of adult death: a validation study. Lancet 379:136–142
61.
Eriksson A, Gustafsson T, Hoistad M et al (2017) Diagnostic accuracy of postmortem imaging vs autopsy — a systematic review. Eur J Radiol 89:249–269
62.
Wijetunga C, O’Donnell C, So TY et al (2020) Injury detection in traumatic death: postmortem computed tomography vs. open autopsy. Forensic Imaging 20:100349
63.
Hong TS, Reyes JA, Moineddin R et al (2011) Value of postmortem thoracic CT over radiography in imaging of pediatric rib fractures. Pediatr Radiol 41:736–748
64.
Shelmerdine SC, Langan D, Hutchinson JC et al (2018) Chest radiographs versus CT for the detection of rib fractures in children (DRIFT): a diagnostic accuracy observational study. Lancet Child Adolesc Health 2:802–811
65.
Proisy M, Marchand AJ, Loget P et al (2013) Whole-body post-mortem computed tomography compared with autopsy in the investigation of unexpected death in infants and children. Eur Radiol 23:1711–1719
66.
Sieswerda-Hoogendoorn T, Soerdjbalie-Maikoe V, de Bakker H, van Rijn RR (2014) Postmortem CT compared to autopsy in children; concordance in a forensic setting. Int J Legal Med 128:957–965
67.
Krentz BV, Alamo L, Grimm J et al (2016) Performance of post-mortem CT compared to autopsy in children. Int J Legal Med 130:1089–1099
68.
Arthurs OJ, Guy A, Thayyil S et al (2016) Comparison of diagnostic performance for perinatal and paediatric post-mortem imaging: CT versus MRI. Eur Radiol 26:2327–2336
69.
Shelmerdine SC, Davendralingam N, Palm L et al (2019) Diagnostic accuracy of postmortem CT of children: a retrospective single-center study. AJR Am J Roentgenol 212:1335–1347
70.
Zerlauth JB, Doenz F, Dominguez A et al (2013) Surgical interventions with fatal outcome: utility of multi-phase postmortem CT angiography. Forensic Sci Int 225:32–41
71.
Rutty GN, Morgan B, Robinson C et al (2017) Diagnostic accuracy of post-mortem CT with targeted coronary angiography versus autopsy for coroner-requested post-mortem investigations: a prospective, masked, comparison study. Lancet 390:154
72.
Proisy M, Loget P, Bouvet R et al (2015) Non-specific post-mortem modifications on whole-body post-mortem computed tomography in sudden unexpected death in infancy. J Forensic Radiol Imaging 3:16–23
73.
74.
American College of Radiology (2006) ACR practice guideline for skeletal surveys in children (res. 47, 17, 35). In: American College of Radiology: ACR standards. American College of Radiology, Reston, pp. 203–207
75.
Shelmerdine SC, Gerrard CY, Rao P et al (2019) Joint European Society of Paediatric Radiology (ESPR) and International Society for Forensic Radiology and Imaging (ISFRI) guidelines: paediatric postmortem computed tomography imaging protocol. Pediatr Radiol 49:694–701
76.
Schmit P (2016) Pediatric image assisted autopsy (PIAA): North American perspective. RSNA Annual Meeting, Chicago
Metadata
Title
Navigating the perils and pitfalls of pediatric forensic postmortem imaging in the United States
Authors
Mary P. Harty
Sharon W. Gould
Howard T. Harcke
Publication date
01-05-2021
Publisher
Springer Berlin Heidelberg
Keyword
Autopsy
Published in
Pediatric Radiology / Issue 6/2021
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-020-04833-8

Other articles of this Issue 6/2021

Pediatric Radiology 6/2021 Go to the issue

Child abuse imaging

Birth-related subdural hemorrhage: prevalence and imaging morphology

Child abuse imaging

Macrocephaly and subdural collections

Child abuse imaging

Fractures of child abuse

Child abuse imaging

Preparing for court testimony

Child abuse imaging

Preventing abusive head trauma: can educating parents reduce the incidence?

Child abuse imaging

Spinal ligamentous injury in abusive head trauma: a pictorial review