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Establishment of proper interpretation and imaging methods for postmortem CT in deaths associated with medical practice

Research Project

Project/Area Number 19K19482
Research Category

Grant-in-Aid for Early-Career Scientists

Allocation TypeMulti-year Fund
Review Section Basic Section 58040:Forensics medicine-related
Research InstitutionTokyo Medical University (2023)
The University of Tokyo (2019-2022)

Principal Investigator

Ishida Masanori  東京医科大学, 医学部, 准教授 (40822367)

Project Period (FY) 2019-04-01 – 2024-03-31
Project Status Completed (Fiscal Year 2023)
Budget Amount *help
¥3,120,000 (Direct Cost: ¥2,400,000、Indirect Cost: ¥720,000)
Fiscal Year 2022: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000)
Fiscal Year 2021: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000)
Fiscal Year 2020: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000)
Fiscal Year 2019: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000)
Keywords死後画像診断 / 死亡時画像診断 / Autopsy imaging / Postmortem imaging / Forensic radiology
Outline of Research at the Start

今日の本邦では、死亡時画像診断(Ai; Autopsy imaging)が解剖を補完する死因推定手段として死後CTを中心に施行されている。死後CTには、生前に見られなかったり、生前であれば病的と診断されたりする特異的な画像所見が存在する。死後CTの読影は生前CTとは異なる解釈・基準の確立が必要であり、未解明の臓器や病態ごとの死後CT所見を解明する。本研究は適切な死後CT読影を可能にし、死因推定での死後CTの寄与度を高めると考える。

Outline of Final Research Achievements

We investigated the usefulness of postmortem CT findings for estimating cause of death and antermortem pathology by comparing the clinical course - antemortem CT - postmortem CT - autopsy findings in cases of in-hospital deaths. The research subjects were (1) diagnostic performance of postmortem CT in neonates and infants, (2) postmortem CT findings of pulmonary shadows, (3) postmortem CT findings of ascites, (4) postmortem CT findings of the liver, (5) postmortem CT findings of pulmonary vasculature, (6) postmortem CT findings of cerebrospinal fluid, (7) postmortem CT findings of gastrointestinal bleeding (manuscript under submission), and we clarified imaging characteristics of postmortem CT. Furthermore, we conducted a comprehensive analysis of postmortem CT findings and cause-of-death assessment in cases of in-hospital deaths. The results of this study will contribute to improving the accuracy of cause-of-death diagnosis.

Academic Significance and Societal Importance of the Research Achievements

死後画像診断の適正な施行は、死因推定の精度向上、医療の発展、犯罪の見逃し減少、医事紛争の早期解決などにつながり、社会的な恩恵が期待できる。しかし、死後画像所見の解釈や限界に関する研究は依然十分ではなく、知見のない臓器や疾患も多数存在し、適切な画像評価と死因診断のエビデンス蓄積が急務である。今回の研究では、死後CT所見と生前の病態の関連についての複数の知見を出すことができた。さらに院内死亡症例の死後CT所見を整理した。これらの結果は、重要な死因推定手段のひとつである死後CTの適切な解釈方法の一助になると考えられる。

Report

(6 results)
  • 2023 Annual Research Report   Final Research Report ( PDF )
  • 2022 Research-status Report
  • 2021 Research-status Report
  • 2020 Research-status Report
  • 2019 Research-status Report
  • Research Products

    (25 results)

All 2023 2022 2021 2020 2019 Other

All Journal Article (9 results) (of which Int'l Joint Research: 2 results,  Peer Reviewed: 9 results,  Open Access: 3 results) Presentation (14 results) (of which Int'l Joint Research: 2 results,  Invited: 8 results) Book (1 results) Remarks (1 results)

  • [Journal Article] Essence of postmortem computed tomography for in-hospital deaths: what clinical radiologists should know2023

    • Author(s)
      Ishida Masanori、Gonoi Wataru、Abe Hiroyuki、Ushiku Tetsuo、Abe Osamu
    • Journal Title

      Japanese Journal of Radiology

      Volume: 41 Issue: 10 Pages: 1039-1050

    • DOI

      10.1007/s11604-023-01443-w

    • Related Report
      2023 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Association between postmortem computed tomography value of cerebrospinal fluid and time after death: A longitudinal study of antemortem and postmortem computed tomography2023

    • Author(s)
      Fujimoto Kotaro、Gonoi Wataru、Ishida Masanori、Okimoto Naomasa、Nyunoya Keisuke、Abe Hiroyuki、Ushiku Tetsuo、Abe Osamu
    • Journal Title

      Journal of Forensic and Legal Medicine

      Volume: 93 Pages: 102461-102461

    • DOI

      10.1016/j.jflm.2022.102461

    • Related Report
      2022 Research-status Report
    • Peer Reviewed
  • [Journal Article] Early postmortem changes in the pulmonary artery and veins: An antemortem and postmortem computed tomography study2022

    • Author(s)
      Gonoi Wataru、Watanabe Yusuke、Nyunoya Keisuke、Shirota Go、Okimoto Naomasa、Fujimoto Kotaro、Abe Hiroyuki、Ushiku Tetsuo、Abe Osamu、Ishida Masanori
    • Journal Title

      Forensic Imaging

      Volume: 28 Pages: 200497-200497

    • DOI

      10.1016/j.fri.2022.200497

    • Related Report
      2021 Research-status Report
    • Peer Reviewed
  • [Journal Article] Early Postmortem Changes in Liver Volume and CT Value: An Antemortem and Postmortem Computed Tomography Study2021

    • Author(s)
      Kotaro Fujimoto, Wataru Gonoi, Masanori Ishida, Naomasa Okimoto, Keisuke Nyunoya, Hiroyuki Abe, Tetsuo Ushiku, Osamu Abe
    • Journal Title

      International Journal of Radiology & Medical Imaging

      Volume: ⑦ Pages: 131-131

    • Related Report
      2021 Research-status Report
    • Peer Reviewed
  • [Journal Article] Longitudinal comparison of ascites attenuation between antemortem and postmortem computed tomography2021

    • Author(s)
      Masanori Ishida, Wataru Gonoi, Hiroyuki Abe, Go Shirota, Kotaro Fujimoto, Naomasa Okimoto, Tetsuo Ushiku, Osamu Abe
    • Journal Title

      Forensic Science International

      Volume: 321 Pages: 110727-110727

    • DOI

      10.1016/j.forsciint.2021.110727

    • Related Report
      2020 Research-status Report
    • Peer Reviewed
  • [Journal Article] Delayed cerebral enhancement on post-mortem computed tomography due to residual contrast medium administered shortly before death2021

    • Author(s)
      Naomasa Okimoto, Masanori Ishida, Hiroyuki Abe, Masako Ikemura, Kotaro Fujimoto, Noriko Kanemaru, Tetsuo Ushiku, Osamu Abe, Wataru Gonoi
    • Journal Title

      Radiology Case Reports

      Volume: in press

    • Related Report
      2020 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Pulmonary postmortem computed tomography of bacterial pneumonia and pulmonary edema in patients following non-traumatic in-hospital death2020

    • Author(s)
      Gonoi Wataru、Watanabe Yusuke、Shirota Go、Abe Hiroyuki、Okuma Hidemi、Shintani-Domoto Yukako、Tajima Taku、Fukayama Masashi、Abe Osamu、Ishida Masanori
    • Journal Title

      Legal Medicine

      Volume: 45 Pages: 101716-101716

    • DOI

      10.1016/j.legalmed.2020.101716

    • Related Report
      2020 Research-status Report
    • Peer Reviewed
  • [Journal Article] Multiple intracerebral hemorrhages associated with lipohyalinosis: a case report.2020

    • Author(s)
      Suguru Torimitsu, Hiroyuki Abe, Masako Ikemura, Wataru Gonoi, Masanori Ishida, Yohsuke Makino, Hirotaro Iwase
    • Journal Title

      Forensic Imaging

      Volume: 21 Pages: 200375-200375

    • DOI

      10.1016/j.fri.2020.200375

    • Related Report
      2019 Research-status Report
    • Peer Reviewed / Int'l Joint Research
  • [Journal Article] Utility of unenhanced postmortem computed tomography for investigation of in-hospital nontraumatic death in children up to 3 years of age at a single Japanese tertiary care hospital2020

    • Author(s)
      Masanori Ishida, Wataru Gonoi, Go Shirota, Hiroyuki Abe, Yukako Shintani-Domoto, Masako Ikemura, Tetsuo Ushiku, Osamu Abe
    • Journal Title

      Medicine (Baltimore)

      Volume: 99 Issue: 19 Pages: e20130-e20130

    • DOI

      10.1097/md.0000000000020130

    • Related Report
      2019 Research-status Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Presentation] 死後CTのミニマム・エッセンシャルズ2023

    • Author(s)
      石田 尚利
    • Organizer
      第51回断層映像研究会
    • Related Report
      2023 Annual Research Report
    • Invited
  • [Presentation] 死亡時画像診断(Ai)における画像診断①(総論)2023

    • Author(s)
      石田 尚利
    • Organizer
      日本医師会, 日本診療放射線技師会, Ai学会 令和5年度 死亡時画像診断(Ai)研修会
    • Related Report
      2023 Annual Research Report
    • Invited
  • [Presentation] 画像診断の奥深さを顧みる2023

    • Author(s)
      石田 尚利
    • Organizer
      第1回 西新宿最新画像診断研究会
    • Related Report
      2023 Annual Research Report
    • Invited
  • [Presentation] 通常の死後変化について2023

    • Author(s)
      石田 尚利
    • Organizer
      第82回日本医学放射線学会総会 JRC2023合同企画 ハンズオンセミナー「死後画像読影ワークショップ」
    • Related Report
      2023 Annual Research Report
    • Invited
  • [Presentation] 死後CT症例レビュー:画像から死因に迫る2022

    • Author(s)
      石田 尚利, 五ノ井 渉, 阿部 浩幸, 槇野 陽介, 岩瀬 博太郎, 牛久 哲男, 阿部 修
    • Organizer
      第58回日本医学放射線学会秋季臨床大会
    • Related Report
      2022 Research-status Report
    • Invited
  • [Presentation] 死亡時画像診断(Ai)における画像診断①(総論)2022

    • Author(s)
      石田 尚利
    • Organizer
      日本医師会, 日本診療放射線技師会, Ai学会 令和4年度 死亡時画像診断(Ai)研修会(招待講演)
    • Related Report
      2022 Research-status Report
    • Invited
  • [Presentation] Aiにおける画像診断1 総論2022

    • Author(s)
      石田 尚利
    • Organizer
      日本診療放射線技師会 2021年度 Ai認定講習会
    • Related Report
      2021 Research-status Report
    • Invited
  • [Presentation] 死亡前投与のヨード造影剤による死後 CT の脳実質増強効果の1例2021

    • Author(s)
      沖元 斉正, 石田 尚利, 阿部 浩幸, 池村 雅子, 藤本 幸太郎, 金丸 訓子, 牛久 哲男, 阿部 修, 五ノ井 渉
    • Organizer
      第19回オートプシー・イメージング(Ai)学会学術総会
    • Related Report
      2021 Research-status Report
  • [Presentation] 死亡時画像診断(Ai)における画像診断①(総論)2021

    • Author(s)
      石田 尚利
    • Organizer
      日本医師会, 日本診療放射線技師会, Ai学会 令和3年度 死亡時画像診断(Ai)研修会
    • Related Report
      2021 Research-status Report
    • Invited
  • [Presentation] 生前と死後の腹水CT値の比較:同一症例における縦断研究2020

    • Author(s)
      石田 尚利, 五ノ井 渉, 沖元 斉正, 藤本 幸多朗, 阿部 浩幸, 牛久 哲男, 阿部 修
    • Organizer
      第18回オートプシー・イメージング学会学術総会
    • Related Report
      2020 Research-status Report
  • [Presentation] 肝臓における早期死後変化の検討:生前と死後の肝臓体積及びCT値の比較2020

    • Author(s)
      藤本 幸多朗, 五ノ井 渉, 石田 尚利, 沖元 斉正, 阿部 浩幸, 牛久 哲男, 阿部 修
    • Organizer
      第56回日本医学放射線学会秋季臨床大会
    • Related Report
      2020 Research-status Report
  • [Presentation] Postmortem lung CT of bacterial pneumonia and pulmonary edema in patients with natural in-hospital death2020

    • Author(s)
      W. Gonoi, Y. Watanabe, G. Shirota, H. Abe, H. Okuma, Y. Shintani-Domoto, M. Fukayama, O. Abe, M. Ishida
    • Organizer
      European Congress of Radiology
    • Related Report
      2020 Research-status Report
    • Int'l Joint Research
  • [Presentation] Longitudinal comparison of attenuation in ascites between antemortem and postmortem computed tomography2020

    • Author(s)
      Masanori Ishida, Wataru Gonoi, Hiroyuki Abe, Yukako Shintani Domoto, Kotaro Fujimoto, Naomasa Okimoto, Masako Ikemura, Tetsuo Ushiku, Osamu Abe
    • Organizer
      The 9th Annual Congress of the International Society of Forensic Radiology and Imaging
    • Related Report
      2019 Research-status Report
    • Int'l Joint Research
  • [Presentation] 短期間に脳出血を複数回起こした原因としてリポヒアリノーシ スが考えられた一剖検例2019

    • Author(s)
      鳥光優, 阿部浩幸, 池村雅子, 五ノ井渉, 石田尚利, 槇野陽介, 千葉文子, 山口るつ子, 恒矢重毅, 岩瀬博太郎
    • Organizer
      第103次日本法医学会学術全国集会
    • Related Report
      2019 Research-status Report
  • [Book] 死後画像読影ガイドライン 2020年版2020

    • Author(s)
      日本医学放射線学会、北海道大学大学院医学研究院死因究明教育研究センター
    • Total Pages
      176
    • Publisher
      金原出版
    • ISBN
      430707114X
    • Related Report
      2019 Research-status Report
  • [Remarks] 東京大学医学部放射線医学教室 死亡時画像診断研究グループ

    • URL

      http://www.ut-radiology.umin.jp/division/autopsy.html

    • Related Report
      2019 Research-status Report

URL: 

Published: 2019-04-18   Modified: 2025-01-30  

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