The greatest barrier to applying post-mortem imaging in pediatric radiology is the lack of best-practice standards. Today the use of post-mortem pediatric imaging often depends on local habits, jurisdiction, logistics and financial resources rather than case circumstances. These parameters also determine whether post-mortem pediatric imaging studies are interpreted by general or pediatric radiologists, or by non-radiologists such as neonatologists and forensic pathologists. Quality levels vary in function of professional background, training, experience and resources of each expert.

Pediatric death investigations are grievous matters, but they are essential to counsel parents or to rule out child abuse. The literature indicates that parents favor imaging over autopsy in pediatric death investigations [1, 2]. However, until we as a scientific community have agreed on best-practice standards regarding training, experience and certification in post-mortem pediatric radiology, we will remain unable to offer high-quality imaging as potential alternative to autopsy in pediatric death investigations.

Several subcommittees of the International Society of Forensic Radiology and Imaging (www.isfri.org) are working on consensus papers regarding best practice in post-mortem imaging, and I am convinced that international, interdisciplinary cooperation is the key to overcoming current challenges in post-mortem imaging in both adults and children.