Joint European Society of Paediatric Radiology (ESPR) and International Society for Forensic Radiology and Imaging (ISFRI) guidelines: paediatric postmortem computed tomography imaging protocol

Andrew Watt,D Martin ,Lene Warner Thorup Boel,J Kroll ,Rosa Maria Martinez,David Perry,Owen J Arthurs,Rick R Van Rijn ,Aleksandra Borowska-Solonynko,Willemijn M Klein ,Karl Johnson,Scott M Brown ,Matthew Lynch,Laura Filograna,Ajay Taranath,Susan C Shelmerdine,Elspeth Whitby,Barry Daly,Odey Ukpo,Elka Miller,Padma Rao,Chandra Y Gerrard,Hideki Hyodoh

doi:10.1007/s00247-018-04340-x

Abstract

Postmortem CT for investigating childhood deaths is increasingly utilised as a noninvasive adjunct or alternative to standard autopsy; however there are no standardised published imaging protocols. This article describes a standardised imaging protocol that has been developed based on current practices of international postmortem imaging practitioners and experts. This recommendation is expected to be useful for postmortem imaging centres wishing to update their existing practices and for those starting paediatric postmortem CT as a new service.

Highlights

Postmortem CT is a relatively fast, inexpensive and widely accessible modality, commonly used in adults as part of routine postmortem examination [1, 2]
Few publications relate to the diagnostic accuracy rates of paediatric postmortem CT, those published report reasonable concordance rates with autopsy of between 57.1%
In the United Kingdom, the Royal College of Pathologists acknowledges the role that postmortem CT offers for the workup of sudden unexpected death in infancy, yet most referrals are performed on a case-by-case basis [9]

Summary

Introduction

Postmortem CT is a relatively fast, inexpensive and widely accessible modality, commonly used in adults as part of routine postmortem examination [1, 2]. The findings from the survey and pooled review of imaging protocols are described and summarised in Tables 2 and 3 Most centres in this survey performed their imaging on a CT scanner dedicated to forensic examinations (11/20, 55%), with the remainder based in a hospital or clinic environment (9/20, 45%). This could be achieved with minor modifications to most CT scanner models from all vendors at most centres. Whilst imaging of the extremities during paediatric postmortem CT is achievable and recommended, this is predominantly for bone assessment in the setting of trauma and might not be necessary where good-quality skeletal radiographs are available

Discussion

Findings

Conflicts of interest None