NCT01888380

Brief Summary

In light of declining autopsy rates around the world, post-mortem MR imaging is a promising alternative to conventional autopsy in the investigation of infant death. A major drawback of this non-invasive autopsy approach is the fact that histopathological and microbiological examination of the tissue is not possible. The objective of this prospective study is to compare the performance of minimally invasive, virtual autopsy, including CT-guided biopsy, with conventional autopsy procedures in a paediatric population. Foetuses, newborns, infants and children that are referred for autopsy at three different institutions associated with the University of Zurich will be eligible for recruitment. All bodies will be examined with a commercial CT and a 3 Tesla MRI scanner, and investigators will be blinded to the results of conventional autopsy. After cross-sectional imaging, CT-guided tissue sampling will be performed by a multifunctional robotic system (Virtobot) allowing for automated post-mortem biopsies. Virtual autopsy results will be classified with regards to the likely final diagnosis and major pathological findings and compared to the results of conventional autopsy, which remains the diagnostic gold standard. This interdisciplinary study will determine whether virtual autopsy will narrow the gap in information between non-invasive and traditional autopsy procedures.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
105

participants targeted

Target at P50-P75 for not_applicable

Timeline
Completed

Started Jan 2014

Longer than P75 for not_applicable

Geographic Reach
1 country

4 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

June 17, 2013

Completed
10 days until next milestone

First Posted

Study publicly available on registry

June 27, 2013

Completed
6 months until next milestone

Study Start

First participant enrolled

January 1, 2014

Completed
4.6 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

July 31, 2018

Completed
1 month until next milestone

Study Completion

Last participant's last visit for all outcomes

August 31, 2018

Completed
Last Updated

January 11, 2021

Status Verified

March 1, 2020

Enrollment Period

4.6 years

First QC Date

June 17, 2013

Last Update Submit

January 7, 2021

Conditions

Keywords

AutopsyMinimally invasiveFoetusesNewbornsChildrenAdolescents

Outcome Measures

Primary Outcomes (1)

  • Percentage of cases for which virtual autopsy correctly identifies the cause of death and/or major pathological lesions

    The diagnoses established in both ways by the two independent teams will be compared, the autopsy results being the gold standard. The primary outcome will be the percentage of cases for which virtual autopsy correctly identifies the diagnostic category.

    8 weeks

Secondary Outcomes (3)

  • Clinical indication

    8 weeks

  • MR Protocol

    8 weeks

  • Change in the ante-mortem diagnosis

    8 weeks

Study Arms (3)

Foetuses

EXPERIMENTAL

* still birth and termination of pregnancies * intervention: minimally invasive, virtual autopsy

Procedure: Minimally invasive, virtual autopsyProcedure: Conventional autopsy

Newborns

EXPERIMENTAL

* who died of natural- and non-natural cause * intervention: minimally invasive, virtual autopsy

Procedure: Minimally invasive, virtual autopsyProcedure: Conventional autopsy

Children and adolescents

EXPERIMENTAL

* who died of natural- and non-natural cause * intervention: minimally invasive, virtual autopsy

Procedure: Minimally invasive, virtual autopsyProcedure: Conventional autopsy

Interventions

Post-mortem cross-sectional imaging with CT-guided biopsy

Also known as: Virtopsy
Children and adolescentsFoetusesNewborns
Also known as: Postmortem
Children and adolescentsFoetusesNewborns

Eligibility Criteria

AgeUp to 16 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17)

You may qualify if:

  • Stillborn infants ≥ 16 0/7 weeks of gestational age (GA)
  • Live born infants ≥ 16 0/7 weeks GA until adolescents up to 16 years of age, who died of natural- and non-natural cause (trauma, homicide, suicide and intoxication).

You may not qualify if:

  • Deceased infants who are donors of organs
  • Lack of parental consent

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (4)

University Hospital Zurich, Division of Neonatology

Zurich, Canton of Zurich, 8091, Switzerland

Location

Division of obstetrics, University Hospital Zurich

Zurich, Switzerland

Location

University Children's Hospital Zurich

Zurich, Switzerland

Location

Zurich Institute for Forensic Medicine

Zurich, Switzerland

Location

Related Publications (2)

  • Ruegger CM, Gascho D, Bode PK, Bruder E, Haslinger C, Ross S, Schmid K, Knopfli C, Hofer LJ, Held L, Martinez RM, Bucher HU; Virtopsy Study Group. Post-mortem magnetic resonance imaging with computed tomography-guided biopsy for foetuses and infants: a prospective, multicentre, cross-sectional study. BMC Pediatr. 2022 Aug 3;22(1):464. doi: 10.1186/s12887-022-03519-4.

  • Ruegger CM, Bartsch C, Martinez RM, Ross S, Bolliger SA, Koller B, Held L, Bruder E, Bode PK, Caduff R, Frey B, Schaffer L, Bucher HU. Minimally invasive, imaging guided virtual autopsy compared to conventional autopsy in foetal, newborn and infant cases: study protocol for the paediatric virtual autopsy trial. BMC Pediatr. 2014 Jan 20;14:15. doi: 10.1186/1471-2431-14-15.

MeSH Terms

Conditions

StillbirthPerinatal DeathSudden Infant Death

Interventions

Autopsy

Condition Hierarchy (Ancestors)

Fetal DeathPregnancy ComplicationsFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesDeathPathologic ProcessesPathological Conditions, Signs and SymptomsDeath, SuddenInfant Death

Intervention Hierarchy (Ancestors)

Diagnostic Techniques and ProceduresDiagnosisInvestigative Techniques

Study Officials

  • Hans Ulrich Bucher, MD, Prof

    University Hospital Zurich, Division of Neonatology

    STUDY DIRECTOR
  • Christoph Rüegger, MD

    University Hospital Zurich, Division of Neonatology

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
NON RANDOMIZED
Masking
NONE
Purpose
DIAGNOSTIC
Intervention Model
CROSSOVER
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

June 17, 2013

First Posted

June 27, 2013

Study Start

January 1, 2014

Primary Completion

July 31, 2018

Study Completion

August 31, 2018

Last Updated

January 11, 2021

Record last verified: 2020-03

Locations