Autopsies that are minimally invasive by method of MRI scans and other techniques like blood tests can determine the cause of death in babies and fetuses just as accurately as conventional autopsies.

The finding, published today in the British medical journal The Lancet, came from a research team led by Dr Sudhin Thayyil and Professor Andrew Taylor of University College London and Great Ormond Street Hospital, in London, UK. The study was the first of its kind to examine the accuracy of minimally invasive autopsy methods compared with traditional methods on a large-scale.

The researchers examined outcomes from 400 fetuses, children, and babies who were scheduled for an autopsy and conducted both traditional and minimally invasive autopsies for each one. They wanted to pinpoint whether the cause of death concluded by the two autopsy methods was the same.

Among babies and fetuses under the age of one, the minimally invasive autopsy determined the same cause of death as the traditional autopsy for 92% of the cases observed.

For kids between 1 and 16 years of age, the minimally invasive autopsy methods were not as accurate – only slightly over half (54%) of the two kinds of autopsies on children in this age group had the same causes of death. The authors believe this is because MRIs are unable to identify the infections which were more likely to be the cause of death for children among this age group.

According to Dr Thayyil and Professor Taylor:

“The next step is to establish rigorous criteria which would allow doctors to judge when a minimally invasive autopsy might be appropriate. Information provided by autopsies is important, not just for determining an individual’s cause of death, but because it can sometimes answer more detailed questions about recurrence risks, implications for other family members, advancing medical research and knowledge.”

In the UK, rates for consent for child autopsies have decreased in past years, even though more parents have been offered them. Consent rates fell from 55% in 2000 to 45% in 2007 for fetuses, and from 28% to 21% for newborn babies.

When an autopsy is not performed it is usually because the parent(s) has not given his/her (their) consent. The investigators believe minimally invasive methods could provide a more tolerable choice to traditional autopsy in fetuses and some children.

Corinne Fligner and Manjiri Dighe of the University of Washington Medical Centre, Seattle, USA, in a linked comment said:

“Crucial to success of an integrated post-mortem diagnostic programme will be clear performance standards, regular audits, physician training, and sufficient and stable funding to attract, train, and retain specialists and provide state-of-the-art resources for radiology and pathology.”

A separate study conducted in 2011 and also published in The Lancet suggested that two-thirds of deaths referred to the coroner can be identified by post-mortem imaging. The findings also suggested that CT scans were more accurate than MRI.

Written by Kelly Fitzgerald