Title: Development of advanced paediatric forensic imaging.
Funder: Department of Health and Social Care

Abstract: The death of a child is a devastating tragedy for parents. As well as coping with their loss, parents want to know why their baby died, and if there is a risk that existing children or future pregnancies will be affected. A post mortem (PM) examination may provide this information, but less than 20% of parents currently agree to a traditional invasive PM which involves large incisions and organ examination, as they feel that their child has been through enough already. Modern imaging techniques such as MRI may now be able to give similar information, so that a full PM may no longer be required. Great Ormond Street Hospital NHS for Children Foundation Trust has just completed the largest study in the world on imaging in childhood deaths, and this shows that while MRI is very good at helping parents in this situation, there are now some areas which need improving, such as damage to the brain and heart. This next project aims to continue this work, in order to develop robust national clinical pathways, so that the maximum amount of information can be given to parents and clinicians in the best possible way, ideally with only a limited autopsy being required. We also intend to develop more advanced MRI-based techniques which can tell us how long a body has been dead, whether bones have developed normally. This information will help us when children have fractured bones or have died in suspicioius circumstances. In combination, this project will help us maximise each individual post mortem examination for each individual family's circumstance.

Lay abstract: The death of a child is a devastating tragedy for parents. As well as coping with their loss, parents want to know why their baby died, and if there is a risk that existing children or future pregnancies will be affected. A post mortem (PM) examination may provide this information, but less than 20% of parents currently agree to a traditional invasive PM which involves large incisions and organ examination, as they feel that their child has been through enough already. Modern imaging techniques such as MRI may now be able to give similar information, so that a full PM may no longer be required. Great Ormond Street Hospital NHS for Children Foundation Trust has just completed the largest study in the world on imaging in childhood deaths, and this shows that while MRI is very good at helping parents in this situation, there are now some areas which need improving, such as damage to the brain and heart. This next project aims to continue this work, in order to develop robust national clinical pathways, so that the maximum amount of information can be given to parents and clinicians in the best possible way, ideally with only a limited autopsy being required. We also intend to develop more advanced MRI-based techniques which can tell us how long a body has been dead, whether bones have developed normally. This information will help us when children have fractured bones or have died in suspicioius circumstances. In combination, this project will help us maximise each individual post mortem examination for each individual family's circumstance.

Research activity codes: 4.2 EVALUATION OF MARKERS AND TECHNOLOGIES;7.3 MANAGEMENT AND DECISION MAKING
Health categories: GENERIC HEALTH RELEVANCE