E1420. Building a Pediatric Postmortem Imaging Service
Authors
Elizabeth Snyder;
Vanderbilt University Medical Center
Neetika Gupta;
Children's Hospital of Eastern Ontario
Elka Miller;
Children's Hospital of Eastern Ontario
Owen Arthurs;
Great Ormond Street Hospital for Children
Teresa Victoria;
Massachusetts General Hospital
Background
Postmortem evaluations in fetuses and children remain an important component of clinical medicine. Determining the diagnosis in the case of a stillbirth or the cause and manner of death in an infant or child allows for accurate counseling, may help provide closure to families, and can contribute to medical knowledge at large. Although autopsy remains the gold standard for postmortem diagnosis, autopsy rates have been falling worldwide for decades for a variety of reasons. Postmortem imaging may provide further information about the cause of death in a minimally invasive manner that may be more acceptable to families. Although interest in postmortem imaging has recently increased, pediatric postmortem imaging remains a nascent field. Given the continued need for postmortem evaluations and the advancing knowledge about postmortem imaging, more institutions may consider establishing a postmortem imaging service. The aim of this educational exhibit is to review the practical components and considerations of setting up a pediatric postmortem imaging service.
Educational Goals / Teaching Points
First, the exhibit will discuss constructing a business case for setting up a postmortem imaging service, including demonstrating that the service is needed and determining who will deliver the service and how. Next, the exhibit will highlight practical issues such as best practices for transporting the body, obtaining consent, and issues of money and reimbursement. Finally, we will review the different imaging modalities that can be used in the postmortem evaluation including radiographs, ultrasound, MRI and CT, and discuss the pros and cons of each.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Constructing a business case with need prior to starting any new imaging service, a formal outline of benefits and costs to patients and enterprise, created to convince decision makes that service is necessary or valuable, most likely to be successful if key staff and consultants involved in new service are included in its development, and consider each step involved in implementation, planning, project implementation and evaluation.
Conclusion
Postmortem imaging services may provide information that can benefit both families and society as a whole. Implementing this new service, however, must be done in a strategic and thoughtful manner. Pediatric radiologists considering setting up a postmortem imaging service must be aware of many of the issues that are specific to postmortem imaging. Our educational exhibit will provide practical information and tips for institutions considering implementing a pediatric postmortem imaging service.
