Optimization of a native cardiac scan protocol in the post mortem computed tomography

Congress:

ECR 2020

Poster Number:

C-08294

Type:

Scientific Exhibit

Keywords:

Image Quality, Cardiac, Forensic / Necropsy studies, Radiographers, CT, Comparative studies, Observer performance, Technical aspects, Forensics, Image verification, Outcomes, Prospective, Experimental, Performed at one institution

Authors:

D. Riegler; Vienna/AT

DOI:

10.26044/ecr2020/C-08294

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-08294

Table 1: Overview of all 5 cardiac scan protocols; While protocol A is the institute...

Fig. 1: Comparison of the five scan protocols in the first case (A-E); the red arrow...

Table 2: Reference values for Kendall's coefficient of concordance based on Landis and...

Fig. 2: Bar chart of the absolute frequencies; On the horizontal axis the individual...

Fig. 3: Box and whisker plot; On the x-axis the protocols are plotted and on the y-axis...

Purpose

Computed tomography (CT) is an essential imaging modality in radiology. In recent years, this method has also become an established practice in forensic imaging, in the living as well as in post mortem, where this method is called post-mortem CT (PMCT). For this reason, the number of published studies has increased rapidly, but the majority are case studies and deal with the usefulness of PMCT in general. In contrast to clinics only a small number of scientific publications on protocol optimization have been published to...

Methods and materials

Patient population: In this study five cases were included, advanced decomposition, torso injuries and excessive obesity had been exclusion criteria.The mean age of the studied group was 68.2 (±14.6) years, the mean weight was 63.6 (±19.4) kg and the mean body height was 173.2 (±9.5) cm. There were 3 male and 2 females human cadavers. Data acquisition: The radiological examination was carried out before autopsy on a 16-slice CT scanner.Based on the institute standard, four alternativeprotocols were created, which deviated from each otherin the scan...

Results

Absolute frequencies: Results show that the increase in slice thickness (Protocol D) was rated as subjectively the best image quality. This protocol most frequently was rated as "Very good" by the 4 radiologists. It also hadthe fewest low ratings. Furthermore, it can be seen that the protocol with the lowest dose (Protocol C), was rated worst. (Fig. 2). Box and whisker plot: Based on the absolute frequencies alone, it is difficult to determine which protocol has received a better or worse rating.For this reason, box...

Conclusion

Despite the clearresults, there are some limitations. One of the limitations concerns the small number of casesincluded in this study.Another limiting aspect is the lack of an additional post mortem CT angiography (PMCTA) to better assesscalcifications, as suggested in the forensic cardiac CT protocols. Furthermore, the protocols in the image data are labeled and arranged the same in all cases, which is why a bias of the assessors cannot be ruled out. Despite the existing limitations, the results are clear, since the radiologistsplaced the protocol...

Personal information and conflict of interest

D. Riegler, BSc; Vienna/AT - Author at Imed19 [email protected]

References

Vogl TJ, Reith W, Rummeny EJ.Diagnostische und interventionelle Radiologie. Springer-Verlag; 2011.1277 p. Grabherr S, Baumann P, Minoiu C, Fahrni S, Mangin P. Post-mortem imaging in forensic investigations: current utility, limitations, and ongoing developments [Internet]. Research and Reports in Forensic Medical Science. 2016 [cited 2018 May 9]. Westphal SE, Apitzsch JC, Penzkofer T, Kuhl CK, Mahnken AH, Knüchel R. Contrast-enhanced postmortem computed tomography in clinical pathology: enhanced value of 20 clinical autopsies. Hum Pathol. 2014 Sep;45(9):1813–23. Mayor A. Artefakte in der Computertomografie. Radiopraxis. 2015 Sep;8(03):145–60. Primak...