How to implement a Minimally Invasive Autopsy (MIA) procedure in a hospital setting; a practical guideline for radiologists

This poster is published under an open license. Please read the disclaimer for further details.

Congress:

ECR 2016

Poster Number:

C-1235

Type:

Educational Exhibit

Keywords:

Pathology, Education and training, Experimental investigations, Education, Biopsy, MR, CT-Angiography, CT, Forensic / Necropsy studies

Authors:

I. Wagensveld, B. Blokker, P. A. Wielopolski, R. Booij, W. Oosterhuis, G. P. Krestin, A. C. Weustink; Rotterdam/NL

DOI:

10.1594/ecr2016/C-1235

DOI-Link:

https://dx.doi.org/10.1594/ecr2016/C-1235

Fig. 1: Schematic overview of the MIA procedure.

Fig. 2: Flowchart of the MIA procedure.

Fig. 3: CT-parameters of old and new protocol.

Fig. 6: Positioning of the body.

Learning objectives

The aim of this presentation is to present a practical guideline for radiologists who have the intention to implement a Minimally Invasive Autopsy (MIA) procedure in a hospital setting.

Background

Autopsies are important, not only for identifying the cause of death and related pathology, but also for healthcare quality control, vital statistics and education. The steady decline of autopsy rates worldwide is worrying. (1,2)A possible explanation may be the invasive nature of the procedure. (3)Non-invasive or minimally invasive autopsy (MIA) procedures have been developed as alternatives to the invasive autopsy, and may be more acceptable to the next-of-kin. (4)As an advantage over the autopsy, the MIA provides a permanent integrated record of imaging and histology...

Findings and procedure details

MIA procedure in general In our hospital, consent for MIA from the next-of-kin is asked by the treating physician. Written and signed informed consent forms are then sent to the mortuary (Pathology Department), together with an autopsy request form including clinical information. The bodies are not embalmed prior to the MIA procedure and are stored in a standard refrigerated environment. The body is prepared for scanning at the mortuary (e.g. closure of open wounds, removal of metals from the body) and placed in an MRI-compatible...

Conclusion

In our experience, Minimally Invasive Autopsy (MIA) can be an alternative to conventional autopsy in a hospital setting. There are several logistical and technical issues that need to be addressed before a MIA procedure can be implemented. Further clinical studies on diagnostic performance and costs of MIA in comparison to the autopsy have to define the place of MIA is the hospital setting.

Personal information

References

1. Blokker, B.M., et al., 35 years of Dutch adult autopsy rates. Virchows Archiv, 2014. 465: p. S8-S8. 2. Shojania, K.G., et al., Changes in rates of autopsy-detected diagnostic errors over time - A systematic review. Jama-Journal of the American Medical Association, 2003. 289(21): p. 2849-2856. 3. Blokker, B.M., et al., Reasoning behind autopsy consents for in-hospital deceased adults. Virchows Archiv, 2014. 465: p. S8-S8. 4. Blokker, B., Non-invasive or minimally invasive autopsy compared to conventional autopsy of suspected natural deaths in adults: a systematic...