Hospital implementation of minimally invasive autopsy: A prospective cohort study of clinical performance and costs
| Autor: | Folkert J. van Kemenade, Britt M. Blokker, Annick C. Weustink, Ivo M. Wagensveld, Gabriel P. Krestin, Piotr A. Wielopolski, M. G. Myriam Hunink, J. Wolter Oosterhuis |
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| Přispěvatelé: | Pathology, Radiology & Nuclear Medicine, Epidemiology |
| Rok vydání: | 2019 |
| Předmět: |
Male
Biopsy Myocardial Infarction Autopsy Lung and Intrathoracic Tumors 030218 nuclear medicine & medical imaging Diagnostic Radiology 0302 clinical medicine Cause of Death Medicine and Health Sciences Myocardial infarction Prospective Studies Medical diagnosis Prospective cohort study Tomography Cause of death Aged 80 and over Multidisciplinary medicine.diagnostic_test Radiology and Imaging Heart Middle Aged Magnetic Resonance Imaging Hospitals Oncology 030220 oncology & carcinogenesis Medicine Female Radiology Anatomy Research Article Adult Image-Guided Biopsy medicine.medical_specialty Adolescent Imaging Techniques Science Cardiology Surgical and Invasive Medical Procedures Neuroimaging Research and Analysis Methods 03 medical and health sciences Young Adult Diagnostic Medicine medicine Humans Aged business.industry Biology and Life Sciences Cancers and Neoplasms Reproducibility of Results Magnetic resonance imaging medicine.disease Computed Axial Tomography Gastrointestinal Tract Cardiovascular Anatomy business Tomography X-Ray Computed Digestive System Brain metastasis Neuroscience |
| Zdroj: | PLoS ONE PLoS ONE, Vol 14, Iss 7, p e0219291 (2019) PLoS One (print), 14(7):e0219291. Public Library of Science |
| ISSN: | 1932-6203 |
| DOI: | 10.1371/journal.pone.0219291 |
| Popis: | ObjectivesAutopsy rates worldwide have dropped significantly over the last decades and imaging-based autopsies are increasingly used as an alternative to conventional autopsy. Our aim was to evaluate the clinical performance and cost of minimally invasive autopsy.MethodsThis study was part of a prospective cohort study evaluating a newly implemented minimally invasive autopsy consisting of MRI, CT, and biopsies. We calculated diagnostic yield and clinical utility-defined as the percentage successfully answered clinical questions-of minimally invasive autopsy. We performed minimally invasive autopsy in 46 deceased (30 men, 16 women; mean age 62.9±17.5, min-max: 18-91).ResultsNinety-six major diagnoses were found with the minimally invasive autopsy of which 47/96 (49.0%) were new diagnoses. CT found 65/96 (67.7%) major diagnoses and MRI found 82/96 (85.4%) major diagnoses. Eighty-four clinical questions were asked in all cases. Seventy-one (84.5%) of these questions could be answered with minimally invasive autopsy. CT successfully answered 34/84 (40.5%) clinical questions; in 23/84 (27.4%) without the need for biopsies, and in 11/84 (13.0%) a biopsy was required. MRI successfully answered 60/84 (71.4%) clinical questions, in 27/84 (32.1%) without the need for biopsies, and in 33/84 (39.8%) a biopsy was required. The mean cost of a minimally invasive autopsy was €1296 including brain biopsies and €1087 without brain biopsies. Mean cost of CT was €187 and of MRI €284.ConclusionsA minimally invasive autopsy, consisting of CT, MRI and CT-guided biopsies, performs well in answering clinical questions and detecting major diagnoses. However, the diagnostic yield and clinical utility were quite low for postmortem CT and MRI as standalone modalities. |
| Databáze: | OpenAIRE |
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