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Multidisciplinary approach to postmortem diagnostics
- Authors: Lozina M.V.1, Shiripenko I.A.1,2, Sidorova O.A.1, Soldatova A.A.1, Tarasova P.A.3, Kuznetsov V.A.1, Malygin B.V.1
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Affiliations:
- N.I. Pirogov Russian National Research Medical University
- Avtsyn Research Institute of Human Morphology of Federal state budgetary scientific institution “Petrovsky National Research Center of Surgery”
- RUDN University
- Issue: Vol 4, No 1S (2023)
- Pages: 87-89
- Section: Conference proceedings
- URL: https://jdigitaldiagnostics.com/DD/article/view/430354
- DOI: https://doi.org/10.17816/DD430354
- ID: 430354
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Abstract
BACKGROUND: The technique that allows detecting various pathologies and clearly identifying the cause of death and other associated diseases without disturbing the integrity of the skin refers to postmortem radiological diagnostics and is called “virtopsy”. The number of autopsies decreases worldwide, which creates the need to use alternative non-invasive methods, including virtopsy. The main method of postmortem radiology is multislice computed tomography (CT), with its advantages including high sensitivity to bone pathology. Postmortem radiological diagnostics allow supplementing the classical autopsy. This multidisciplinary approach helps visualize a wide variety of pathologies and assist the pathologist in the diagnostic search.
AIM: To assess the possibility of applying radiological diagnostic methods in the pathological anatomical practice and features of non-invasive autopsy (virtopsy) and its differences from the classical autopsy.
METHODS: The archival material including macro preparations of two lower limbs with tumor-like masses of unclear genesis (the upper third of the femur and the calcaneal tuber) was used. The biomaterial was previously encased in a specially treated gelatin medium, which ensured its preservation and left parts of the CT scanner intact. Multislice CT was used for radiological assessment of the preparations. From the primary CT sequences obtained, scans with the best visualization in the bone and soft tissue windows were selected, and three-dimensional (3D) reconstruction was applied. Scans and 3D reconstructions of images of tumor-like masses of the heel and thigh bones were obtained. Interpretation of the borders of the mass, characteristics of morphology and possible source of growth of the neoplasm allowed assuming a malignant nature of the tumor, suggesting its bone origin. Further histologic examination in both cases confirmed the neoplasm (osteogenic sarcoma).
RESULTS: CT scans and 3D reconstructions of images of tumour-like masses in the heel and femur were obtained. The interpretation of the boundaries of the mass, the morphological characteristics and the possible source of growth of the neoplasm suggested a malignant nature of the tumour, suggesting a bony origin. Further histological evaluation in both cases confirmed the nature of the neoplasm (osteogenic sarcoma).
CONCLUSIONS: The use of postmortem radiological diagnostic elements provides a sufficiently accurate verification of the nature of some pathologies. However, the absence of tissue damage and disturbances of intact topographic characteristics play not the least role in the postmortem diagnosis. In contrast to autopsy, this technique allows to return to the original appearance of the structures examined and, if necessary, start the diagnostic search anew. Moreover, specialists from other regions can be remotely involved by sending the data of CT scanning.
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Full Text
BACKGROUND: The technique that allows detecting various pathologies and clearly identifying the cause of death and other associated diseases without disturbing the integrity of the skin refers to postmortem radiological diagnostics and is called “virtopsy”. The number of autopsies decreases worldwide, which creates the need to use alternative non-invasive methods, including virtopsy. The main method of postmortem radiology is multislice computed tomography (CT), with its advantages including high sensitivity to bone pathology. Postmortem radiological diagnostics allow supplementing the classical autopsy. This multidisciplinary approach helps visualize a wide variety of pathologies and assist the pathologist in the diagnostic search.
AIM: To assess the possibility of applying radiological diagnostic methods in the pathological anatomical practice and features of non-invasive autopsy (virtopsy) and its differences from the classical autopsy.
METHODS: The archival material including macro preparations of two lower limbs with tumor-like masses of unclear genesis (the upper third of the femur and the calcaneal tuber) was used. The biomaterial was previously encased in a specially treated gelatin medium, which ensured its preservation and left parts of the CT scanner intact. Multislice CT was used for radiological assessment of the preparations. From the primary CT sequences obtained, scans with the best visualization in the bone and soft tissue windows were selected, and three-dimensional (3D) reconstruction was applied. Scans and 3D reconstructions of images of tumor-like masses of the heel and thigh bones were obtained. Interpretation of the borders of the mass, characteristics of morphology and possible source of growth of the neoplasm allowed assuming a malignant nature of the tumor, suggesting its bone origin. Further histologic examination in both cases confirmed the neoplasm (osteogenic sarcoma).
RESULTS: CT scans and 3D reconstructions of images of tumour-like masses in the heel and femur were obtained. The interpretation of the boundaries of the mass, the morphological characteristics and the possible source of growth of the neoplasm suggested a malignant nature of the tumour, suggesting a bony origin. Further histological evaluation in both cases confirmed the nature of the neoplasm (osteogenic sarcoma).
CONCLUSIONS: The use of postmortem radiological diagnostic elements provides a sufficiently accurate verification of the nature of some pathologies. However, the absence of tissue damage and disturbances of intact topographic characteristics play not the least role in the postmortem diagnosis. In contrast to autopsy, this technique allows to return to the original appearance of the structures examined and, if necessary, start the diagnostic search anew. Moreover, specialists from other regions can be remotely involved by sending the data of CT scanning.
About the authors
Milena V. Lozina
N.I. Pirogov Russian National Research Medical University
Author for correspondence.
Email: puzar.mila@yandex.ru
ORCID iD: 0000-0003-1102-1133
Russian Federation, Moscow
Ivan A. Shiripenko
N.I. Pirogov Russian National Research Medical University; Avtsyn Research Institute of Human Morphology of Federal state budgetary scientific institution “Petrovsky National Research Center of Surgery”
Email: hikkiwahikki@gmail.com
ORCID iD: 0000-0002-5947-1523
Russian Federation, Moscow; Moscow
Olga A. Sidorova
N.I. Pirogov Russian National Research Medical University
Email: sidela25@yandex.ru
ORCID iD: 0000-0002-4024-2747
Russian Federation, Moscow
Antonina A. Soldatova
N.I. Pirogov Russian National Research Medical University
Email: soldatova.am@mail.ru
ORCID iD: 0000-0002-7941-1210
Russian Federation, Moscow
Polina A. Tarasova
RUDN University
Email: doc.polina.tarasova@gmail.com
ORCID iD: 0000-0003-1838-5802
Russian Federation, Moscow
Vasiliy A. Kuznetsov
N.I. Pirogov Russian National Research Medical University
Email: fibonachi0123@gmail.com
ORCID iD: 0000-0001-6133-8425
Russian Federation, Moscow
Bulat V. Malygin
N.I. Pirogov Russian National Research Medical University
Email: bulatkuku@gmail.com
ORCID iD: 0009-0002-4461-2319
Russian Federation, Moscow
References
- Osipenkova-Vichtomova T.K. Sudebno-meditsinskaya ekspertiza kostei. Moscow: BINOM; 2017. 272 p. (In Russ).
- Kovalev AV, Kinle AF, Kokov LS., et al. Actual possibilities of postmortem imaging in forensic medicine practice. Consilium Medicum. 2016;18(13): 9–25. (In Russ). doi: 10.26442/2075-1753_2016.13.9-25
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