A New Kind of Autopsy Could Mean Far Fewer Dissections

It's hard to lose someone you love. It's even harder to think about the procedures a loved one's body might undergo to determine cause of death. But autopsies in the future may be less gruesome than they are today. Researchers say a combination of CT scans and X-rays can successfully identify the cause of natural death, eliminating the need for dissection. They published their findings in the medical journal The Lancet.

Lead researchers Guy Rutty and Bruno Morgan of the University of Leicester set out to solve a problem: reducing the need for the messy, almost primitive process of dissecting cadavers to determine cause of death. (The focus was natural death, though a small number of unnatural deaths were included in the study as well.) They aren’t the first; previous studies found some success with postmortem computed tomography (PMCT).

Speaking in a statement, Morgan explained that the technique works similar to CT scanning of living people. But PMCT has one major drawback: It can’t get a good picture of the heart or blood vessels.

“In clinical CT scanning, a contrast agent is injected into a vein and circulation delivers it around the body,” he said. “This allows the CT scan to show the state of blood vessels anywhere in the body. However, the lack of circulation in cadavers means these techniques cannot be used."

This is a pretty glaring issue, as coronary artery disease is currently the number one cause of natural death worldwide.

The team’s solution: adapting existing angiography (X-ray heart imaging) techniques to suit a body with no pulse. They discovered that injecting a combination of contrast fluid and air through a catheter into the coronary artery could create a clear picture—and it didn’t require opening the body up. "The insertion techniques are like those we use on patients every day in our clinics, with just the use of local anaesthetic to numb the skin," Morgan said.

The researchers combined this new minimally invasive angiography with PMCT and tested the new method—called PMCTA—on 240 cases of natural death.

The images produced were strong, clear, and clinically meaningful. In 92 percent of cases, PMCTA results were able to identify the cause of death, with diagnoses as accurate as those made by a coroner. Each method had its strengths and weaknesses; PMCTA was better at spotting trauma and hemorrhage, while dissection more easily identified pulmonary thromboembolisms. For difficult cases or those requiring a higher burden of proof, the paper's authors suggest using both methods.

They concluded by paying their respects to the participants who made their study possible. “We dedicate the success of our research to the families of Leicestershire,” they wrote, “who have consented for their loved ones to be involved in these studies, despite being in a period of bereavement."