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Implementation of pediatric and fetal postmortem imaging into clinical practice: a multi-society statement from the
Aurélie DʼHondt1,2, Stacy Goergen3,4, Elka Miller5,6
1Department of Diagnostic and Interventional Radiology, Hospital for Sick Children, University Avenue, Toronto, 555, ON, M5G1X8, Canada. aurelie.dhondt@sickkids.ca.
Insights
Postmortem imaging (PMI) offers a non-invasive alternative to autopsy for fetal and pediatric deaths. This statement addresses challenges and proposes recommendations for implementing pediatric PMI globally.
Area of Science:
- Medical Imaging
- Pediatric Pathology
- Forensic Medicine
Background:
- Postmortem imaging (PMI) is increasingly utilized as a non-invasive method for fetal, perinatal, and pediatric demise.
- Implementation challenges vary globally due to healthcare systems, funding, and regulations.
- Specific indications like intrauterine demise, termination of pregnancy, and forensic investigations present unique issues.
Purpose of the Study:
- To describe current international approaches to challenges in pediatric PMI.
- To propose universal consensus recommendations, enablers, and practical tips for PMI implementation.
- To facilitate the integration of fetal and pediatric PMI into medical imaging departments.
Main Methods:
- Multi-society position statement development.
- Analysis of international challenges and existing practices in pediatric PMI.
- Formulation of consensus-based recommendations and practical guidance.
Main Results:
- Identified significant barriers to pediatric PMI implementation across different regions.
- Outlined specific considerations for various pediatric PMI indications.
- Developed a framework for standardized PMI protocols and inter-center collaboration.
Conclusions:
- Standardized implementation of fetal and pediatric PMI is crucial for resource allocation and multi-center studies.
- Addressing identified challenges through consensus recommendations will enhance global adoption.
- Pediatric PMI can improve diagnostic accuracy and support clinical, ethical, and legal needs.
Abstract:
Postmortem imaging (PMI) following fetal, perinatal, and pediatric demise is increasingly requested and used in clinical practice, either as a non-invasive adjunct or alternative to conventional autopsy. Use of such techniques in clinical departments may face numerous barriers and challenges, varying between centers, countries, and continents, influenced by differences in healthcare systems, funding sources, and local regulations. Furthermore, different issues arise for each specific indication of pediatric PMI (such as intra-uterine demise, termination of pregnancy for confirmation of anatomical abnormalities, and forensic investigations of infants and childhood deaths) since the processes, goals of the investigation, and involved teams vary with indication and/or resource setting. This multi-society position statement describes how different countries currently deal with those challenges, and proposes universal consensus recommendations, enablers, and practical tips to facilitate the successful implementation of fetal and pediatric PMI across medical imaging departments. Implementation to a minimum standard will help resource allocation, collaboration between centers, and multi-center studies in a new field where patient data is scarce.
