S C Shelmerdine1,2, J C Hutchinson1,2, S Al-Sarraj3, N Cary4, T Dawson5, D Du Plessis6, P G Ince7, S McLaughlin8, L Palm1, C Smith9, N Stoodley10, R van Rijn11, O J Arthurs1,2, T S Jacques1,2. 1. Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK. 2. Great Ormond, Street Institute of Child Health, UCL, London, UK. 3. Department of Clinical Neuropathology, Kings College Hospital, London, UK. 4. Forensic Pathology Services, Wantage, Oxfordshire, UK. 5. Department of Neuropathology, Lancashire Teaching Hospitals NHS trust, Preston, UK. 6. Department of Neuropathology, Salford Royal Hospital, Greater Manchester, UK. 7. Sheffield Institute for Translational Neuroscience, Sheffield University, Sheffield, UK. 8. Edinburgh Forensic Radiology and Anthropology Imaging Centre, Royal Infirmary of Edinburgh, Edinburgh, UK. 9. Academic Department of Neuropathology, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK. 10. Department of Paediatric Neuroradiology, Frenchay Hospital, Bristol, UK. 11. Department of Radiology, Academic Medical Center, Emma Children's Hospital, Amsterdam, The Netherlands.
Abstract
AIMS: To develop an expert consensus statement regarding appropriate clinical and forensic post mortem neurological imaging. METHODS: An expert panel of clinicians were recruited from registered members of the British Neuropathological Society (BNS) and the International Society of Forensic Radiology and Imaging (ISFRI) with post mortem expertise. Following a focus group meeting, 16 core statements were incorporated into an online modified Delphi survey and each panellist was asked to score their level of agreement. Following the first iteration, two statements that failed to reach consensus were modified and re-rated. Consensus was predefined as 75% agreement across responders. RESULTS: Seventeen experts joined the panel and 12 (70.6%) attended the focus group meeting; 14 (82%) completed both iterations of the survey. Consensus was reached for need of adequate clinical history, multidisciplinary discussion, establishment of special interest groups to discuss cases, gathering further evidence to inform imaging choices, establishment of methods for quality assessment in reporting standards and adequate funding for imaging services. The panel agreed that pathologists should be responsible for neuroimaging referrals, collating results of ancillary tests, and producing the final post mortem report. Areas requiring further discussion include the impact of double reporting, indications for neuroimaging and utilities of three-dimensional printing. CONCLUSION: The BNS/ISFRI statement represents current views of an expert panel of health professionals engaged in post-mortem neuroimaging. We hope this provides a working guideline for less experienced operators, stimulates discussion and highlights the most pressing clinical and research questions.
AIMS: To develop an expert consensus statement regarding appropriate clinical and forensic post mortem neurological imaging. METHODS: An expert panel of clinicians were recruited from registered members of the British Neuropathological Society (BNS) and the International Society of Forensic Radiology and Imaging (ISFRI) with post mortem expertise. Following a focus group meeting, 16 core statements were incorporated into an online modified Delphi survey and each panellist was asked to score their level of agreement. Following the first iteration, two statements that failed to reach consensus were modified and re-rated. Consensus was predefined as 75% agreement across responders. RESULTS: Seventeen experts joined the panel and 12 (70.6%) attended the focus group meeting; 14 (82%) completed both iterations of the survey. Consensus was reached for need of adequate clinical history, multidisciplinary discussion, establishment of special interest groups to discuss cases, gathering further evidence to inform imaging choices, establishment of methods for quality assessment in reporting standards and adequate funding for imaging services. The panel agreed that pathologists should be responsible for neuroimaging referrals, collating results of ancillary tests, and producing the final post mortem report. Areas requiring further discussion include the impact of double reporting, indications for neuroimaging and utilities of three-dimensional printing. CONCLUSION: The BNS/ISFRI statement represents current views of an expert panel of health professionals engaged in post-mortem neuroimaging. We hope this provides a working guideline for less experienced operators, stimulates discussion and highlights the most pressing clinical and research questions.
Authors: Susan C Shelmerdine; Chandra Y Gerrard; Padma Rao; Matthew Lynch; Jeroen Kroll; Dan Martin; Elka Miller; Laura Filograna; Rosa Maria Martinez; Odey Ukpo; Barry Daly; Hideki Hyodoh; Karl Johnson; Andrew Watt; Ajay Taranath; Scott Brown; David Perry; Lene Warner Thorup Boel; Aleksandra Borowska-Solonynko; Rick van Rijn; Willemijn Klein; Elspeth Whitby; Owen J Arthurs Journal: Pediatr Radiol Date: 2019-02-28