Assessing the use of magnetic resonance imaging virtopsy as an alternative to autopsy: a systematic review and meta-analysis.

Abstract:

BACKGROUND:The post mortem examination or autopsy is a trusted method of identifying the cause of death. Patients and their families may oppose an autopsy for a variety of reasons, including fear of mutilation or owing to religious and personal beliefs. Imaging alternatives to autopsy have been explored, which may provide a viable alternative. OBJECTIVE:To explore the possibility of using MRI virtopsy to establish the cause of death as an alternative to the traditional post mortem examination or autopsy. METHODS:Systematic review was carried out of all studies, without language restriction, identified from Medline, Cochrane (1960-2016) and Embase (1991-2016) up to December 2016. Further searches were performed using the bibliographies of articles and abstracts. All studies reporting the diagnosis of the cause of death by both MRI virtopsy and traditional autopsy were included. RESULTS:Five studies with 107 patients, contributed to a summative quantitative outcome in adults. The combined sensitivity of MRI virtopsy was 0.82 (95% CI 0.56 to 0.94) with a diagnostic odds ratio (DOR) of 11.1 (95% CI 2.2 to 57.0). There was no significant heterogeneity between studies (Q=1.96, df=4, p=0.75, I2=0). Eight studies, with 953 patients contributed to a summative quantitative outcome in children. The combined sensitivity of MRI virtopsy was 0.73 (95% CI 0.59 to 0.84) with a DOR of 6.44 (95% CI 1.36 to 30.51). There was significant heterogeneity between studies (Q=34.95, df=7, p<0.01, I2=80). CONCLUSION:MRI virtopsy may offer a viable alternative to traditional autopsy. By using MRI virtopsy, a potential cost reduction of at least 33% is feasible, and therefore ought to be considered in eligible patients.

journal_name

Postgrad Med J

authors

Ahmad MU,Sharif KA,Qayyum H,Ehsanullah B,Balyasnikova S,Wale A,Shanmuganandan A,Siddiqui MRS,Athanasiou T,Kemp GJ

doi

10.1136/postgradmedj-2017-134945

subject

Has Abstract

pub_date

2017-11-01 00:00:00

pages

671-678

issue

1105

eissn

0032-5473

issn

1469-0756

pii

postgradmedj-2017-134945

journal_volume

93

pub_type

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