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Biggest leap in child pathology for 100 years

Minimally invasive postmortem examinations for children have made the biggest leap in pathology, following charity-funded research in Sheffield.

A study, funded by The Children’s Hospital Charity, has found keyhole access autopsy with MRI scanning is as effective at finding answers after a sudden or unexplained death as conventional methods.

Dr Marta Cohen, consultant pathologist at Sheffield Children’s Hospital, who led the research with Dr Chitra Sethuraman said the minimally invasive procedure can help families who have tragically lost their child and are uncomfortable with the standard autopsy procedure.

She said: “An autopsy is a legal requirement in some cases, so families don’t have a choice. Some want answers, but others don’t like the idea of an invasive process. This makes it easier for them when the decision is out of their hands, as we can give them this option.

“Unlike in areas like genetics where there has been an explosion of techniques and development, pathology has remained static. The autopsy is the same now as it was 100 years ago. Minimally invasive autopsy is the big step that pathology has needed.”

David Vernon-Edwards, director of The Children’s Hospital Charity, said: “These findings can make the most horrific moment any parent could ever face that much more bearable. Thanks to the generosity of our supporters, Dr Cohen and her team have made the first step in giving families a choice about how their child’s death is investigated.”

The new procedure uses viewing tubes for the chest and stomach (thoracoscopy and laparoscopy), with the rest of the information obtained through use of an MRI.

The research, carried out by Dr Cohen alongside Dr Sethuraman, Dr Elspeth Whitby, Mr Sean Marven and Mr Richard Lindley, involved carrying out a minimally invasive autopsy and a conventional autopsy and comparing the findings. It was found to be as effective, and can be used in two thirds of cases where autopsy is required.

Dr Cohen, who is recognised in the Pathologist’s international power 100 list, added: “We wouldn’t have been able to do this without the support of the charity.

“Using molecular analysis through minimal invasion and MRI is the future of pathology.

The technique can be used in most cases, although not currently for forensic autopsy or in the case of heart or brain malformation.”

She presented her findings to the Society of Paediatric Pathology in Seattle last year and is now preparing a paper for publication.

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