Study finds promising alternative to invasive post-mortem
7 August 2009
A study led by Dr Sudhin Thayyil from the UCL Institute of Child Health published today in The Lancet today has shown that a less invasive approach to post-mortem is effective in the diagnostic study of small human foetuses.
It is hoped that the breakthrough approach, which uses high resolution (also known as high-field) Magnetic Resonance Imaging' (MRI) offers an alternative to traditional autopsy - an invasive technique that is subject to low rates of parental consent in the UK. Post-mortem examination is key to giving experts an understanding of why fpetuses don't survive in pregnancy and contributes to the development of improved assessments for antenatal diagnosis.
Whole-body MRI was performed on 18 foetuses of less than 22 weeks gestation before a traditional autopsy was performed. Images from the MRI were compared with the findings of invasive autopsy and assessed for diagnostic accuracy and image quality by a team of specialist paediatric radiologists.
Dr Sudhin Thayyil, a researcher at the UCL Institute of Child Health and the Cardiology unit at Great Ormond Street Hospital for Children NHS Trust, led the preliminary study. He explained the results: "Overall, the diagnostic data from high-field MRI was similar to that provided by the invasive autopsy in these selected cases. In some cases, the data was even of a superior quality."
With 'high-field' MRI it may be possible to obtain high quality images for diagnosis of structural defects. This method offers particular advantages for investigating the heart and brain, due to the complexity of these organs and difficulty with traditional techniques.
This preliminary study is part of an ongoing, larger scale project that aims to develop a complete minimally invasive autopsy. However, many diagnoses will always require tissue to be obtained and examined under the microscope, and imaging techniques like MRI will not be able to serve this purpose.
Neil Sebire, Professor of Paediatric and Developmental Pathology at Great Ormond Street Hospital, said: "We recognise that this is an emotive area of research and the subject of post-mortem examination will always remain extremely difficult for grieving parents. However, it is our hope that this type of advancement towards a less invasive examination will help to make this process a little easier for families and contribute to an increase in consent rates for autopsy research."
Image: The UCL Institute of Child Health
The UCL Institute of Child Health and the Great Ormond Street Hospital for Children NHS Trust together form an international centre of excellence for treating sick children, and teaching and training children's specialists. Combined they constitute the largest centre for research into childhood illness outside the United States.