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MS 16 - Virtual autopsy imaging in children: the role of pathologist vs radiologist, one big happy family?

Saturday, March 4, 16:00 - 17:30 Room: E1 Session Type: Multidisciplinary Session Topics: Education, Imaging Methods Digital Evaluation: Open Digital Evaluation for this Session Moderator: C. Owens (London/UK) Add session to my schedule In your schedule (remove)

A-779

Chairman's introduction

C. Owens; London/UK

Learning Objectives

1. To learn about the multidisciplinary nature of perinatal autopsy, with reference to the scientific contribution of radiology and pathology.
2. To learn about the limitations of both conventional autopsy, and conventional imaging techniques.
3. To appreciate the role that novel imaging and pathology techniques have to play in future service provision.

Abstract

In this session, we intend to present a multidisciplinary approach to state-of-the art virtopsy imaging in children. We have contributions from radiologists and pathologists, working in harmony to achieve the best possible outcome for bereaved parents, with a conjoint, highly accurate but sympathetic approach. Advances in postmortem imaging and tissue sampling techniques will be outlined to provide a comprehensive autopsy service in the most clinically appropriate setting, whilst respecting the bereaved parents' wishes.

A-780

Minimally invasive autopsy: setting the scene - why, how and by whom?

N. J. Sebire; London/UK

Learning Objectives

1. To learn about novel minimally invasive autopsy techniques.
2. To understand how imaging fits into a modern clinical autopsy service.

Abstract

The approach to standard paediatric autopsy has changed little over many years, remaining predominantly based on external examination, dissection and subsequent organ examination and then histological evaluation. Minimally invasive autopsy is a new approach encompassing external examination, non-invasive comprehensive cross-sectional postmortem imaging, and limited tissue sampling to permit the most appropriate tissue sampling techniques necessary to reach a final diagnosis or cause of death which is more acceptable to parents and families.

A-781

State-of-the-art post-mortem imaging: the way it works and how we do it

O. J. Arthurs; London/UK

Learning Objectives

1. To learn about the recent advances in cross-sectional imaging in a post-mortem setting.
2. To learn about the advantages and disadvantages of conventional PMCT and PMMR techniques.

Abstract

Postmortem (PM) magnetic resonance imaging (MRI) has high diagnostic accuracy for the majority of perinatal and paediatric diagnoses, when accompanied by other non-invasive investigations, and compared to traditional autopsy. Comprehensive whole body imaging using PM MRI performs particularly well for cardiac, neurological and abdominal diagnoses, but less well for thoracic and skeletal abnormalities. PM MRI performs better than PM CT in the same individual, although ventilated PMCT and CT angiography have been proposed to increase PMCT diagnostic detection rates. However, both modalities become increasingly non-diagnostic with reducing foetal size, typically below 500g body weight or at early foetal gestations. Postmortem ultrasound is yet to be assessed in a comprehensive trial.

A-782

Latest advances: the new kid on the block micro-CT - when and how?

J. C. Hutchinson; London/UK

Learning Objectives

1. To learn how novel techniques like micro-CT can be used in the perinatal autopsy setting.
2. To appreciate how micro-CT works.
3. To learn what high resolution imaging can offer within a clinical setting.

Abstract

Microfocus computed tomography has been proposed as an alternative to MR or CT in small specimen foetal imaging. Diagnostic accuracy is high for excised foetal hearts and kidneys, with appropriate tissue and image optimisation parameters. Whole body foetal autopsy may be possible with micro-CT in future. However, several issues remain to be addressed for widespread implementation of micro-CT scanning, including tissue colouration, distortion due to fixation, data storage of large files, and comprehensive reconstruction and post-processing.

Multidisciplinary case presentation and discussion

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