Consent of the recently bereaved to post-mortem targeted angiography research: 207 adult cases.

AIMS: To present our experience of prospective telephone consenting for post-mortem CT angiography (PMCT-A) research using HM coroners' cases. METHODS: Local ethics committee, research and development office, and local HM coroners gave their permission for the families of the deceased, in cases where a 'routine' coroner's autopsy had been authorised, to be approached for their consent to PMCT-A research before the autopsy examination. A forensic pathologist or trial consenter telephoned the next of kin, discussed the nature of the study and obtained verbal informed consent for post-mortem imaging, angiography, case-dependent histological and toxicology sampling and for the use of the images for teaching and training. Thematic analyses of the reasons for giving or refusing consent are provided. RESULTS: Of the 207 cases approached, seven relatives refused to enter their next of kin into the study (96.6% consent rate). CONCLUSIONS: This study shows that prospective consenting for HM coroners' cases to be used for autopsy research is feasible in adults, and can be done ethically, and in the limited time available, by obtaining the consent of the next of kin by telephone before autopsy.

Targeted post-mortem computed tomography cardiac angiography: proof of concept.

With the increasing use and availability of multi-detector computed tomography and magnetic resonance imaging in autopsy practice, there has been an international push towards the development of the so-called near virtual autopsy. However, currently, a significant obstacle to the consideration as to whether or not near virtual autopsies could one day replace the conventional invasive autopsy is the failure of post-mortem imaging to yield detailed information concerning the coronary arteries. To date, a cost-effective, practical solution to allow high throughput imaging has not been presented within the forensic literature. We present a proof of concept paper describing a simple, quick, cost-effective, manual, targeted in situ post-mortem cardiac angiography method using a minimally invasive approach, to be used with multi-detector computed tomography for high throughput cadaveric imaging which can be used in permanent or temporary mortuaries.

Post-mortem computed tomography angiography: past, present and future.

The role of imaging has been long established in forensic practice as an adjunct to the conventional autopsy. Recently with the development of MDCT, there has been a large international push towards the development of the so called "near virtual autopsy." Currently a large obstacle to the acceptance of "near virtual autopsies" is the failure of post-mortem imaging to yield detailed information about the coronary arteries. This is a major deficiency of post-mortem MDCT and MRI compared to conventional autopsy as standard clinical angiography relies on circulation. One possible way to overcome this is by the use of post-mortem MDCT angiography. This review paper considers the past, current and future advances in cadaver cardiac imaging which, if successful, will take radiological imaging one step closer to the widespread introduction of near virtual autopsies.