Assessing the use of magnetic resonance imaging virtopsy as an alternative to autopsy : a systematic review and meta-analysis
Ahmad, Mohammad Usman Sharif, Kamal Ali Qayyum, Haisum Ehsanullah, Bushra Balyasnikova, Svetlana Wale, Anita Shanmuganandan, Arun Siddiqui, Muhammad Rafay Sameem Athanasiou, Thanos Kemp, Graham John
Ahmad, Mohammad Usman
Sharif, Kamal Ali
Qayyum, Haisum
Ehsanullah, Bushra
Balyasnikova, Svetlana
Wale, Anita
Shanmuganandan, Arun
Siddiqui, Muhammad Rafay Sameem
Athanasiou, Thanos
Kemp, Graham John
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Affiliation
University of Liverpool; Tameside General Hospital, Ashton-Under-Lyne; South Warwickshire University NHS Foundation Trust; Imperial College London; The Royal Marsden NHS Foundation Trust, London; Croydon University Hospital;
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Publication date
2017-07-06
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Abstract
Background: The post mortem examination or autopsy is a trusted method of identifying the cause of death. Patients and their families may oppose an autopsy for a variety of reasons, including fear of mutilation or owing to religious and personal beliefs. Imaging alternatives to autopsy have been explored, which may provide a viable alternative.
Objective: To explore the possibility of using MRI virtopsy to establish the cause of death as an alternative to the traditional post mortem examination or autopsy.
Methods: Systematic review was carried out of all studies, without language restriction, identified from Medline, Cochrane (1960-2016) and Embase (1991-2016) up to December 2016. Further searches were performed using the bibliographies of articles and abstracts. All studies reporting the diagnosis of the cause of death by both MRI virtopsy and traditional autopsy were included.
Results: Five studies with 107 patients, contributed to a summative quantitative outcome in adults. The combined sensitivity of MRI virtopsy was 0.82 (95% CI 0.56 to 0.94) with a diagnostic odds ratio (DOR) of 11.1 (95% CI 2.2 to 57.0). There was no significant heterogeneity between studies (Q=1.96, df=4, p=0.75, I2=0). Eight studies, with 953 patients contributed to a summative quantitative outcome in children. The combined sensitivity of MRI virtopsy was 0.73 (95% CI 0.59 to 0.84) with a DOR of 6.44 (95% CI 1.36 to 30.51). There was significant heterogeneity between studies (Q=34.95, df=7, p<0.01, I2=80).
Conclusion: MRI virtopsy may offer a viable alternative to traditional autopsy. By using MRI virtopsy, a potential cost reduction of at least 33% is feasible, and therefore ought to be considered in eligible patients.
Keywords: MRI; autopsy; imaging; virtopsy.
Citation
Ahmad MU, Sharif KA, Qayyum H, Ehsanullah B, Balyasnikova S, Wale A, Shanmuganandan A, Siddiqui MRS, Athanasiou T, Kemp GJ. Assessing the use of magnetic resonance imaging virtopsy as an alternative to autopsy: a systematic review and meta-analysis. Postgrad Med J. 2017 Nov;93(1105):671-678. doi: 10.1136/postgradmedj-2017-134945. Epub 2017 Jul 6.
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Article