Conventional Autopsy versus Minimally Invasive Autopsy with Postmortem MRI, CT, and CT-guided Biopsy: Comparison of Diagnostic Performance
| Autor: | Ivo M. Wagensveld, Michael A. den Bakker, Andrea Pezzato, J. Wolter Oosterhuis, Annick C. Weustink, M. G. Myriam Hunink, Folkert J. van Kemenade, Jan H. von der Thüsen, Britt M. Blokker, Ruben Dammers, Jan Bakker, Gabriel P. Krestin, Nomdo S. Renken |
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| Přispěvatelé: | Pathology, Radiology & Nuclear Medicine, Neurosurgery, Intensive Care, Epidemiology |
| Rok vydání: | 2018 |
| Předmět: |
Adult
Image-Guided Biopsy Male medicine.medical_specialty Adolescent Radiography Autopsy Physical examination Radiography Interventional 030218 nuclear medicine & medical imaging 03 medical and health sciences Young Adult 0302 clinical medicine Cause of Death Biopsy medicine Cadaver Humans Radiology Nuclear Medicine and imaging Prospective Studies Young adult Prospective cohort study Cause of death Aged Aged 80 and over medicine.diagnostic_test business.industry Conventional autopsy Reproducibility of Results Middle Aged Magnetic Resonance Imaging Cross-Sectional Studies 030220 oncology & carcinogenesis Female Radiology business Tomography X-Ray Computed |
| Zdroj: | Radiology, 289(3), 658-667. Radiological Society of North America Inc. |
| ISSN: | 1527-1315 0033-8419 |
| Popis: | Purpose To compare the diagnostic performance of minimally invasive autopsy with that of conventional autopsy. Materials and Methods For this prospective, single-center, cross-sectional study in an academic hospital, 295 of 2197 adult cadavers (mean age: 65 years [range, 18-99 years]; age range of male cadavers: 18-99 years; age range of female cadavers: 18-98 years) who died from 2012 through 2014 underwent conventional autopsy. Family consent for minimally invasive autopsy was obtained for 139 of the 295 cadavers; 99 of those 139 cadavers were included in this study. Those involved in minimally invasive autopsy and conventional autopsy were blinded to each other's findings. The minimally invasive autopsy procedure combined postmortem MRI, CT, and CT-guided biopsy of main organs and pathologic lesions. The primary outcome measure was performance of minimally invasive autopsy and conventional autopsy in establishing immediate cause of death, as compared with consensus cause of death. The secondary outcome measures were diagnostic yield of minimally invasive autopsy and conventional autopsy for all, major, and grouped major diagnoses; frequency of clinically unsuspected findings; and percentage of answered clinical questions. Results Cause of death determined with minimally invasive autopsy and conventional autopsy agreed in 91 of the 99 cadavers (92%). Agreement with consensus cause of death occurred in 96 of 99 cadavers (97%) with minimally invasive autopsy and in 94 of 99 cadavers (95%) with conventional autopsy (P = .73). All 288 grouped major diagnoses were related to consensus cause of death. Minimally invasive autopsy enabled diagnosis of 259 of them (90%) and conventional autopsy 224 (78%); 200 (69%) were found with both methods. At clinical examination, the cause of death was not suspected in 17 of the 99 cadavers (17%), and 124 of 288 grouped major diagnoses (43%) were not established. There were 219 additional clinical questions; 189 (86%) were answered with minimally invasive autopsy and 182 (83%) were answered with conventional autopsy (P = .35). Conclusion The performance of minimally invasive autopsy in the detection of cause of death was similar to that of conventional autopsy; however, minimally invasive autopsy has a higher yield of diagnoses. © RSNA, 2018 Online supplemental material is available for this article. See also the editorial by Krombach in this issue. |
| Databáze: | OpenAIRE |
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