• Britt M Blokker, Annick C Weustink, Ivo M Wagensveld, Jan H von der Thüsen, Andrea Pezzato, Ruben Dammers, Jan Bakker, Nomdo S Renken, Michael A den Bakker, Folkert J van Kemenade, Gabriel P Krestin, Hunink M G Myriam MGM From the Departments of Pathology (B.M.B., A.C.W., I.M.W., J.H.v.d.T., M.A.d.B., F.J.v.K., J.W.O.), Radiology and Nuclear Medicine (B.M.B., A.C.W., , and J Wolter Oosterhuis.
• From the Departments of Pathology (B.M.B., A.C.W., I.M.W., J.H.v.d.T., M.A.d.B., F.J.v.K., J.W.O.), Radiology and Nuclear Medicine (B.M.B., A.C.W., I.M.W., A.P., G.P.K., M.G.M.H., J.W.O.), Neurosurgery, Brain Tumor Center (R.D.), Intensive Care Adults (J.B.), and Clinical Epidemiology (M.G.M.H.), Erasmus MC University Medical Center, 's-Gravendijkwal 230, 3015 CE, Rotterdam, the Netherlands; Center for Health Decision Science, Harvard T. H. Chan School of Public Health, Harvard University, Boston, Mass (M.G.M.H.); Department of Pulmonary and Critical Care, Columbia University Medical Center, New York, NY (J.B.); Department of Radiology, Reinier de Graaf Gasthuis, Delft, the Netherlands (N.S.R.); and Department of Pathology, Maasstad Ziekenhuis, Rotterdam, the Netherlands (M.A.d.B.).
• Radiology. 2018 Dec 1; 289 (3): 658-667.

AbstractPurpose To compare the diagnostic performance of minimally invasive autopsy with that of conventional autopsy. Materials and Methods For this prospective, single-center, cross-sectional study in an academic hospital, 295 of 2197 adult cadavers (mean age: 65 years [range, 18-99 years]; age range of male cadavers: 18-99 years; age range of female cadavers: 18-98 years) who died from 2012 through 2014 underwent conventional autopsy. Family consent for minimally invasive autopsy was obtained for 139 of the 295 cadavers; 99 of those 139 cadavers were included in this study. Those involved in minimally invasive autopsy and conventional autopsy were blinded to each other's findings. The minimally invasive autopsy procedure combined postmortem MRI, CT, and CT-guided biopsy of main organs and pathologic lesions. The primary outcome measure was performance of minimally invasive autopsy and conventional autopsy in establishing immediate cause of death, as compared with consensus cause of death. The secondary outcome measures were diagnostic yield of minimally invasive autopsy and conventional autopsy for all, major, and grouped major diagnoses; frequency of clinically unsuspected findings; and percentage of answered clinical questions. Results Cause of death determined with minimally invasive autopsy and conventional autopsy agreed in 91 of the 99 cadavers (92%). Agreement with consensus cause of death occurred in 96 of 99 cadavers (97%) with minimally invasive autopsy and in 94 of 99 cadavers (95%) with conventional autopsy (P = .73). All 288 grouped major diagnoses were related to consensus cause of death. Minimally invasive autopsy enabled diagnosis of 259 of them (90%) and conventional autopsy 224 (78%); 200 (69%) were found with both methods. At clinical examination, the cause of death was not suspected in 17 of the 99 cadavers (17%), and 124 of 288 grouped major diagnoses (43%) were not established. There were 219 additional clinical questions; 189 (86%) were answered with minimally invasive autopsy and 182 (83%) were answered with conventional autopsy (P = .35). Conclusion The performance of minimally invasive autopsy in the detection of cause of death was similar to that of conventional autopsy; however, minimally invasive autopsy has a higher yield of diagnoses. © RSNA, 2018 Online supplemental material is available for this article. See also the editorial by Krombach in this issue.

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