Unveiling the diagnostic accuracy of PMCT: Detection of pneumonia considering postmortem changes and time intervals

IF 0.8 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Forensic Imaging Pub Date : 2024-11-20 DOI:10.1016/j.fri.2024.200617
Max G. Mentink , Bartholomeus G.H. Latten , Frans C.H. Bakers , Casper Mihl , Lisa M. Hillen , Paul A.M. Hofman
{"title":"Unveiling the diagnostic accuracy of PMCT: Detection of pneumonia considering postmortem changes and time intervals","authors":"Max G. Mentink ,&nbsp;Bartholomeus G.H. Latten ,&nbsp;Frans C.H. Bakers ,&nbsp;Casper Mihl ,&nbsp;Lisa M. Hillen ,&nbsp;Paul A.M. Hofman","doi":"10.1016/j.fri.2024.200617","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>Postmortem CT (PMCT) faces challenges in assessing lung parenchyma due to images being acquired in expiratory state, leading to varying severity of pulmonary edema redistribution with gravity-dependent attenuation ranging from ground glass to full opacification. This retrospective study assessed the effect of gravity-dependent attenuation and the postmortem time interval (PTI) on the diagnostic accuracy of PMCT for detecting acute pneumonia.</div></div><div><h3>Materials and methods</h3><div>Deceased patients who underwent PMCT and autopsy were included. Consensus evaluations by two radiologists and two pathologists re-examined images and histological samples of separate lung lobes. Scores were assigned for radiological and histological findings, including the presence of acute pneumonia, gravity-dependent attenuation severity, and pulmonary edema. PTI was calculated and correlated with gravity-dependent attenuation severity. Crosstabs were created to calculate diagnostic parameters.</div></div><div><h3>Results</h3><div>Fifty-seven patients were included, with four excluded and 44 fully opacified lung lobes. 168 lung lobes remained for analysis. The average PTI was 22 hours and 47 min. A weak correlation was observed between PTI and gravity-dependent attenuation severity (τb = 0.125, p = 0.016). Acute pneumonia prevalence was 24,4 %, with sensitivity and specificity of PMCT for all lung lobes at 31,71 % and 85,83 %, respectively. PMCT performed better in subgroups with none or slight gravity-dependent attenuation and in patients scanned within 16 hours after death.</div></div><div><h3>Conclusion</h3><div>Interpretation of lung parenchyma with PMCT is challenging. Statistical power was limited due to a limited sample size. PMCT is more suited for excluding acute pneumonia than detecting its presence. Prolonging PTI should be avoided, as increasing gravity-dependent attenuation severity over time limits PMCT sensitivity.</div></div>","PeriodicalId":40763,"journal":{"name":"Forensic Imaging","volume":"40 ","pages":"Article 200617"},"PeriodicalIF":0.8000,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Forensic Imaging","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S266622562400040X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0

Abstract

Purpose

Postmortem CT (PMCT) faces challenges in assessing lung parenchyma due to images being acquired in expiratory state, leading to varying severity of pulmonary edema redistribution with gravity-dependent attenuation ranging from ground glass to full opacification. This retrospective study assessed the effect of gravity-dependent attenuation and the postmortem time interval (PTI) on the diagnostic accuracy of PMCT for detecting acute pneumonia.

Materials and methods

Deceased patients who underwent PMCT and autopsy were included. Consensus evaluations by two radiologists and two pathologists re-examined images and histological samples of separate lung lobes. Scores were assigned for radiological and histological findings, including the presence of acute pneumonia, gravity-dependent attenuation severity, and pulmonary edema. PTI was calculated and correlated with gravity-dependent attenuation severity. Crosstabs were created to calculate diagnostic parameters.

Results

Fifty-seven patients were included, with four excluded and 44 fully opacified lung lobes. 168 lung lobes remained for analysis. The average PTI was 22 hours and 47 min. A weak correlation was observed between PTI and gravity-dependent attenuation severity (τb = 0.125, p = 0.016). Acute pneumonia prevalence was 24,4 %, with sensitivity and specificity of PMCT for all lung lobes at 31,71 % and 85,83 %, respectively. PMCT performed better in subgroups with none or slight gravity-dependent attenuation and in patients scanned within 16 hours after death.

Conclusion

Interpretation of lung parenchyma with PMCT is challenging. Statistical power was limited due to a limited sample size. PMCT is more suited for excluding acute pneumonia than detecting its presence. Prolonging PTI should be avoided, as increasing gravity-dependent attenuation severity over time limits PMCT sensitivity.
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
求助全文
约1分钟内获得全文 去求助
来源期刊
Forensic Imaging
Forensic Imaging RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
2.20
自引率
27.30%
发文量
39
期刊最新文献
Closed iris, long exposure photography improves three-dimensional photogrammetric bone reconstructions Cranial surgical approaches in the 21st Century Identified Skeletal Collection Unveiling the diagnostic accuracy of PMCT: Detection of pneumonia considering postmortem changes and time intervals Exploring lightweight convolution neural networks for segmenting striation marks from firearm bullet images Age estimation based on sternebral fusion in a sample of Egyptian population using three-dimensional computed tomography scanning
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1