Owen J Arthurs1, Sudhin Thayyil2, Catherine M Owens3, Oystein E Olsen4, Angie Wade5, Shea Addison6, Rod Jones7, Wendy Norman8, Rosemary J Scott9, Nicola J Robertson10, Andrew M Taylor11, Lyn S Chitty12, Neil J Sebire13. 1. Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK; Institute of Child Health, UCL, London, UK. Electronic address: owen.arthurs@gosh.nhs.uk. 2. Perinatal Neurology and Neonatology, Imperial College London, London, UK. Electronic address: s.thayyil@imperial.ac.uk. 3. Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK; Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science, London, UK; Cardiorespiratory Division, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK. Electronic address: Catherine.owens@gosh.nhs.uk. 4. Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK; Institute of Child Health, UCL, London, UK. Electronic address: oystein.olsen@gosh.nhs.uk. 5. Clinical Epidemiology, Nutrition and Biostatistics Section, UCL Institute of Child health, London, UK. Electronic address: a.wade@ucl.ac.uk. 6. Perinatal Neurology and Neonatology, Imperial College London, London, UK. Electronic address: shea.addison@imperial.ac.uk. 7. Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science, London, UK; Cardiorespiratory Division, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK. Electronic address: rod.jones@gosh.nhs.uk. 8. Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science, London, UK; Cardiorespiratory Division, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK. Electronic address: wendy.norman@gosh.nhs.uk. 9. Department of Histopathology, University College London Hospital NHS Trust, London, UK. Electronic address: rosemary.scott@uclh.nhs.uk. 10. Academic Neonatology, UCL Institute for Women's Health, London, UK. Electronic address: n.robertson@ucl.ac.uk. 11. Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science, London, UK; Cardiorespiratory Division, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK. Electronic address: a.taylor76@ucl.ac.uk. 12. Genetics and Genomic Medicine, UCL Institute of Child Health, London, Great Ormond Street Hospital for Children NHS Foundation Trust, London, and UCLH NHS Foundation Trusts, London, UK. Electronic address: l.chitty@ucl.ac.uk. 13. Department of Histopathology, UCL Institute of Child Health & Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK. Electronic address: neil.sebire@gosh.nhs.uk.
Abstract
BACKGROUND: To compare the diagnostic accuracy of post-mortem magnetic resonance imaging (PMMR) specifically for abdominal pathology in foetuses and children, compared to conventional autopsy. METHODS: Institutional ethics approval and parental consent was obtained. 400 unselected foetuses and children underwent PMMR using a 1.5T Siemens Avanto MR scanner before conventional autopsy. PMMR images and autopsy findings were reported blinded to the other data respectively. RESULTS: Abdominal abnormalities were found in 70/400 (12%) autopsies. Overall sensitivity and specificity (95% confidence interval) of PMMR for abdominal pathology was 72.5% (61.0, 81.6) and 90.8% (87.0, 93.6), with positive (PPV) and negative predictive values (NPV) of 64.1% (53.0, 73.9) and 93.6% (90.2, 95.8) respectively. PMMR was good at detecting renal abnormalities (sensitivity 80%), particularly in foetuses, and relatively poor at detecting intestinal abnormalities (sensitivity 50%). Overall accuracy was 87.4% (83.6, 90.4). CONCLUSIONS: PMMR has high overall accuracy for abdominal pathology in foetuses, newborns and children. PMMR is particularly good at detecting renal abnormalities, and relatively poor at detecting intestinal abnormalities. In clinical practice, PMMR may be a useful alternative or adjunct to conventional autopsy in foetuses and children for detecting abdominal abnormalities.
BACKGROUND: To compare the diagnostic accuracy of post-mortem magnetic resonance imaging (PMMR) specifically for abdominal pathology in foetuses and children, compared to conventional autopsy. METHODS: Institutional ethics approval and parental consent was obtained. 400 unselected foetuses and children underwent PMMR using a 1.5T Siemens Avanto MR scanner before conventional autopsy. PMMR images and autopsy findings were reported blinded to the other data respectively. RESULTS:Abdominal abnormalities were found in 70/400 (12%) autopsies. Overall sensitivity and specificity (95% confidence interval) of PMMR for abdominal pathology was 72.5% (61.0, 81.6) and 90.8% (87.0, 93.6), with positive (PPV) and negative predictive values (NPV) of 64.1% (53.0, 73.9) and 93.6% (90.2, 95.8) respectively. PMMR was good at detecting renal abnormalities (sensitivity 80%), particularly in foetuses, and relatively poor at detecting intestinal abnormalities (sensitivity 50%). Overall accuracy was 87.4% (83.6, 90.4). CONCLUSIONS: PMMR has high overall accuracy for abdominal pathology in foetuses, newborns and children. PMMR is particularly good at detecting renal abnormalities, and relatively poor at detecting intestinal abnormalities. In clinical practice, PMMR may be a useful alternative or adjunct to conventional autopsy in foetuses and children for detecting abdominal abnormalities.
Authors: Owen J Arthurs; Rick R van Rijn; Elspeth H Whitby; Karl Johnson; Elka Miller; Martin Stenzel; Andrew Watt; Ajay Taranath; David H Perry Journal: Pediatr Radiol Date: 2016-07-13
Authors: Ian C Simcock; Susan C Shelmerdine; J Ciaran Hutchinson; Neil J Sebire; Owen J Arthurs Journal: Nat Protoc Date: 2021-04-14 Impact factor: 13.491
Authors: L J P Sonnemans; M E M Vester; E E M Kolsteren; J J H M Erwich; P G J Nikkels; P A M Kint; R R van Rijn; W M Klein Journal: Eur J Pediatr Date: 2018-04-19 Impact factor: 3.183
Authors: P Montaldo; S Addison; V Oliveira; P J Lally; A M Taylor; N J Sebire; S Thayyil; O J Arthurs Journal: BMC Med Imaging Date: 2016-04-27 Impact factor: 1.930
Authors: K Z Leadbetter; Z A Vesoulis; F V White; R E Schmidt; G Khanna; J S Shimony; A M Mathur Journal: J Perinatol Date: 2016-09-22 Impact factor: 2.521
Authors: Aurélie D'Hondt; Marie Cassart; Raymond De Maubeuge; Gustavo Soto Ares; Jacques Rommens; E Fred Avni Journal: Insights Imaging Date: 2018-06-04