A study to investigate misdiagnosis patterns of postmortem CT and improve the quality of interpretation

In recent years, image examination acquisition of cadavers has become more and more common in both clinical and forensic filed due to a combination of factors such as decrease in autopsy rate, widespread availability of imaging devices, and development of diagnostic imaging.
However, the assignment of responsibility for these images remains a vaguely answered question. The misinterpretation of postmortem CT images, especially by doctors who are neither forensic pathologists nor radiologists, is frequent. Two aspects must be kept in mind while judging a diagnosis. Firstly, comparison with the autopsy results is indispensable.
However, in Japan, the autopsy rate is extremely low and as a consequence, the chances of comparison are rare. At our institution, we perform postmortem CT prior to all autopsies, and the interpretation of the postmortem CT results is always compared with that of autopsy results. Therefore, the patterns associated with all types of misdiagnosis can be identified through this process. Secondly, we believe that forensic radiologists, who are basically radiologists with a knowledge of postmortem changes that could occur on images, could play a critical role in interpreting diagnosis and detecting errors. Dr. Yohsuke Makino and I are two such specialists who engage in research and practice in this field.

Maiko Yoshida