Assessing radiological images of human cadavers: Is there an effect of different embalming solutions?

Objectives

The aim of this study is to investigate the impact of different embalming solutions including formalin, Genelyn, Thiel and Imperial College London- Soft Preserving solutions on the quality of radiological images taken from cadavers embalmed with the above mentioned techniques.

Materials and methods

Two cadavers per embalming technique were imaged pre and post-embalming using three different imaging modalities including ultrasound, plain radiography and computed tomography (CT). Imaging criteria and a qualitative grading system for each imaging modality were adapted from the European Guidelines on Quality Criteria for Computed Tomography, the European Guidelines on Quality Criteria for Diagnostic Radiographic Images, and according to the AIUM Practice Guideline for the performance of ultrasound. Qualitative analysis was performed independently by three readers on a Picture Archiving and Communication System (PACS). The readers were blinded to both the embalmment status and the embalming agent used to preclude bias.

Results

On comparison of images pre and post-embalming, brain CT images showed a significant deterioration in image quality post-embalming, while there was no significant change in chest and abdomen/pelvic images and some improvement was observed in Genelyn embalmed cadavers. No changes were observed when using ultrasound to image the spleen and aorta, while a significant improvement in image quality was observed when examining the kidney in all embalmed cadavers with a small improvement when imaging the liver. No significant difference was observed on plain radiography post-embalming, while a minor deterioration was observed mainly in the chest area.

Conclusion

Different embalming techniques had varying effects on image quality, in human cadavers, with the range of imaging modalities investigated in this study. Thus, no ideal embalming solution was identified, which would improve the quality of images on all imaging modalities. Further research is required to compare the quality of radiological images at different stages of decomposition taking into consideration antemortal pathologies with a larger number of donors.