Minimally invasive autopsy with CT and MRI performs as well as conventional autopsy in detecting the cause of death and has the advantage of yielding more diagnoses, according to a study published in the journal Radiology.

Conventional autopsies are valuable tools that yield a wealth of information. Autopsies give insights into new diseases and the side effects of drugs while providing data for health statistics and epidemiologic studies and tissue for molecular studies.

They are important for teaching pathology in medical school and training medical specialists. Perhaps most importantly, autopsies can answer central questions surrounding the cause of death, said the study's senior author, J. Wolter Oosterhuis, M.D., from the Department of Pathology at Erasmus University Medical Center in Rotterdam, the Netherlands.

Cause of death

"Since in about 15% of cases autopsy reveals an unexpected cause of death, it provides important feedback to clinicians, to the benefit of future patients," Oosterhuis said.

Despite the importance of conventional autopsies, rates have been rapidly declining, the study authors said, for a variety of reasons, including the reluctance of next-of-kin due to the invasiveness of the procedure.

In the face of this trend, non-invasive or minimally invasive alternative autopsy methods have emerged as potentially valuable options. Postmortem CT and MRI enable visualization of the entire body, and image-guided tissue biopsies can be obtained for further examination. Dr. Oosterhuis and colleagues recently compared the performance of minimally invasive autopsy to that of conventional autopsy in 99 deceased humans.

The minimally invasive autopsy procedure combined post-mortem MRI, CT and CT-guided biopsies of the main organs and pathological lesions—abnormalities caused by disease or trauma.

The two methods showed similar performance in determining the immediate cause of death. The researchers found agreement between minimally invasive autopsy and conventional autopsy for cause of death in 92% of the cases.

There was agreement with the consensus cause of death in 96 of 99 of the cases of the minimally invasive autopsy, compared with 94 of 99 for a conventional autopsy.

The total number of diagnoses established by minimally invasive autopsy was higher than that of the regular autopsy. The deceased patients had a total of 288 major diagnoses related to the consensus cause of death, and minimally invasive autopsy diagnosed 259 of those, or 90%, compared with 78% for the conventional autopsy.

"With minimally invasive autopsy, the body is investigated from top to toe, and with regular autopsy usually only the torso and, if consented by next-of-kin, the brain," Dr. Oosterhuis said.

"Moreover, postmortem CT and MRI demonstrate pathology, in particular of the skeleton and soft tissues; the regular autopsy easily misses that," Dr. Oosterhuis said.