PM imaging Task Force
At ESPR 2015 in Graz Austria, a new Post Mortem Imaging (PMI) Taskforce was established.
Paediatric and perinatal post mortem imaging is a new and rapidly growing field, with the recent introduction of post mortem (PM) cross-sectional imaging, including computed tomography (PMCT) and magnetic resonance imaging (PMMR).
Whilst conventional X-rays have long been used to evaluate the deceased, particularly for suspected fetal skeletal anomalies, and in evaluating suspicious childhood deaths, there is sufficient expertise, guidance and standardization already to cover this use of imaging. However, there is little agreement between practitioners regarding the best use, imaging protocols and potential yield of other imaging in the PM setting, including (but not limited to) ultrasound, PM CT and PMMR. The main focus of the taskforce is therefore the guidance and standardization of non-radiographic post mortem imaging, particularly PMCT and PMMR.
Most of the issues around post mortem imaging are different to other disciplines of paediatric imaging, as they do not relate to radiation dose nor attempts at childhood co-operation whilst in a scanner. Instead, they relate to the ethics of post mortem scanning, parental acceptability, protocol optimisation and access to machines.
Owen Arthurs (UK; chair), Rick van Rijn (NL), Elspeth Whitby (UK), Karl Johnson (UK), Elka Miller (CA) Martin Stenzel (DE), Andrew Watt (UK), Ajay Taranath (AU), David Perry (NZ), Chandra Y Gerrard (US), Susan Shelmerdine (UK), Willemijn Klein (NL), Michael Aertsen (BE), Christian Abel (AU)
1. Develop a PMI networked collaboration between paediatric radiologist and pathologists, and other disciplines
2. Establish a support network with a governance structure
3. Create implementable PMMR image acquisition protocols
4. Introduce best practice guidelines and standardize scenario-specific protocols e.g. use of PMCT in suspected physical abuse
5. Improve image sequence and quality by data sharing
6. Establish a training strategy for performing and interpreting paediatric PM imaging
7. Widen the availability of PM imaging through raising awareness
1. Establishing the baseline of where we begin, finalised, published (open access paper PRAD 2016).
2. Collect imaging protocols to establish consensus / best practice guidelines on use of PM CT – joint ESPR / ISFRI ongoing work (lead by Chandra Gerrard, University of New Mexico) – data analysis stage
3. Collect imaging protocols to establish consensus / best practice guidelines on use of PM MR – joint ESPR / ISFRI ongoing work (lead by Dr Elspeth Whitby, University of Sheffield) – data collection ongoing
4. Multicentre trial on PMCT for rib fracture diagnosis – almost complete, data analysis stage
Publications and recommendations:
1) “ESPR Post mortem Taskforce: where we begin” (submitted to PRAD 2016)
Arthurs OJ, van Rijn RR, Whitby EH, Johnson K, Miller E, Stenzel M, Watt A, Taranath A, Perry DH. Pediatr Radiol. 2016 Aug;46(9):1363-9. doi: 10.1007/s00247-016-3639-2. Epub 2016 Jul 13. Review. PMID: 27412272
“ESPR Post mortem Taskforce: where we begin”: