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Current utilization of pediatric postmortem imaging in North America: a questionnaire-based survey

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Abstract

Background

Postmortem imaging is used more widely as the number of conventional autopsies has decreased over the last several decades. It is widely accepted in Europe, Asia and Oceania, but there has been a delay in acceptance in North America. Education, scanning protocols, resourcing and clinical incentives are needed to support this emerging field.

Objective

To determine the use of postmortem imaging and define perceived barriers to its implementation with the goal of expanding postmortem imaging in the United States and Canada.

Materials and methods

We sent an online survey to active members of the Society for Pediatric Radiology (SPR) addressing the use of postmortem imaging, indications, readers, practical aspects, anticipated barriers and potential solutions to more widespread use.

Results

More than 50% of the 50 institutions that returned surveys used postmortem computed tomography; 24% used postmortem magnetic resonance imaging. Most postmortem imaging cases were read by radiologists. Fewer than 50% had formal correlation with autopsy results or an established relationship with the local medical examiner. Seven institutions reported reimbursement for postmortem imaging. Major barriers to postmortem imaging included lack of funding and lack of interest among clinicians. Funding and education were seen as important issues requiring attention.

Conclusion

While most responding institutions provide pediatric postmortem imaging, the modalities, protocols, reporting procedures and clinical correlation vary widely. A lack of funding and few opportunities for education are limiting factors. Attention to these issues along with active support from the SPR are seen as potential solutions to recognize the value and promote widespread acceptance of postmortem imaging.

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Acknowledgements

We appreciate the assistance of the SPR in allowing us to use their Survey Monkey account and member database to perform the survey. We also are grateful to the ESPR for allowing us to present these results in a poster format at the International Pediatric Radiology 8th Conjoint Congress & Exhibition in Rome, Italy, in October 2021. We also acknowledge the radiologists who participated in the survey, without whom the survey would not have been possible, and Sara Weigele for editorial guidance.

Collaborators

The following people are, as members of the SPR Postmortem Imaging Committee, collaborators on this publication: Tatum Johnson, Jennifer Kucera, Sosamma Methratta, Nina Stein, Teresa Victoria.

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Authors and Affiliations

  1. Department of Radiology, Nemours Children’s Health, 1600 Rockland Road, Wilmington, DE, 19803, USA

    Mary P. Harty, Sharon W. Gould & H. Theodore Harcke

  2. Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA

    Mary P. Harty, Sharon W. Gould & H. Theodore Harcke

  3. Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK

    Owen J. Arthurs

  4. NIHR Great Ormond Street Hospital Biomedical Research Centre, Bloomsbury, London, UK

    Owen J. Arthurs

  5. Department of Medical Imaging, Children’s Hospital of Eastern Ontario, University of Ottawa, Ottawa, Canada

    Elka Miller

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  1. Mary P. Harty
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  2. Sharon W. Gould
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  3. Owen J. Arthurs
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  4. Elka Miller
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  5. H. Theodore Harcke
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Consortia

On behalf of the SPR Postmortem Imaging Committee

  • Tatum Johnson
  • , Jennifer Kucera
  • , Sosamma Methratta
  • , Nina Stein
  •  & Teresa Victoria

Corresponding author

Correspondence to Mary P. Harty.

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Harty, M.P., Gould, S.W., Arthurs, O.J. et al. Current utilization of pediatric postmortem imaging in North America: a questionnaire-based survey. Pediatr Radiol 53, 1135–1143 (2023). https://doi.org/10.1007/s00247-023-05586-w

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  • DOI: https://doi.org/10.1007/s00247-023-05586-w

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