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Проблемы финансирования и обучения специалистов в области посмертной томографической визуализации в Великобритании
Проблемы финансирования и обучения специалистов в области посмертной томографической визуализации в Великобритании
Фетисов В.А. Проблемы финансирования и обучения специалистов в области посмертной томографической визуализации в Великобритании. Consilium Medicum. 2016; 18 (13): 48–51. DOI: 10.26442/2075-1753_2016.13.48-51
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Аннотация
В статье описаны возможные варианты выполнения аутопсий в Великобритании с использованием различных дополнительных методов исследования, включая посмертную томографическую визуализацию (postmortem cross-sectional imaging – PCSI). Показано, что официально утвержденной программы подготовки специалистов по PCSI не существует и такая совместная работа ведется в некоторых центрах Великобритании в инициативном порядке. Доказывается необходимость разработки собственных национальных стандартов и учебных программ в рамках каждой профессии с созданием соответствующих систем аудита (проверки, инспекции) и внешнего контроля качества PCSI. Отмечено, что выполнение и хранение томографических данных осуществляется главным образом в учреждениях Национальной службы здравоохранения Великобритании с оплатой работы специалистов по второй категории (аналог выполнения судебно-медицинской экспертизы). Во избежание стагнации и торможения развития данной работы крайне важно, чтобы в основе данного нового научного направления лежала сильная академическая исследовательская стратегия, подкрепленная устойчивым финансированием, осуществляемым на национальном уровне. Показана важность полноценного материального обеспечения PCSI и разработки собственных стандартов, доказывающих возможность использования PCSI в качестве альтернативы для классической аутопсии.
Ключевые слова: посмертная томографическая визуализация, аутопсия, национальные стандарты, учебные программы, финансирование научной деятельности.
Key words: postmortem cross-sectional imaging, autopsy, national standards, educational programs, scientific activity financing.
Ключевые слова: посмертная томографическая визуализация, аутопсия, национальные стандарты, учебные программы, финансирование научной деятельности.
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Key words: postmortem cross-sectional imaging, autopsy, national standards, educational programs, scientific activity financing.
Полный текст
Список литературы
1. NCEPOD 2006. The Coroner's Autopsy – Do We Deserve Better?
2. Jeffery AJ. The role of computed tomography in adult post-mortem examinations: an overview. Diagnostic Histopathology 2010; 16 (12): 546–51.
3. Levy AD, Harcke HT. New approaches to radiology in mass casualty situations. Brogdon's Forensic Radiology (2nd edition), 2011.
4. Rutty GN, Robinson CE, BouHaidar R et al. The role of mobile computed tomography in mass fatality incidents. J Forensic Sci 2007; 52: 1343–9.
5. Sidler M, Jackowski C, Dirnhofer R et al. Use of multislice computed tomography in disaster victim identification – advantages and limitations. Forensic Sci Int 2007; 169 (2–3): 118–28.
6. RCR/RCPath statement on standards for medico-legal post-mortem cross-sectional imaging in adults. The Royal College of Radiologists. The Royal College of Radiologists. London. 2012.
7. Rutty G. Can cross-sectional imaging as an adjunct and/or alternative to the invasive autopsy be implemented within the NHS? NHS Implementation Sub-group, Leicester, England; 2012 October.
8. Ebert LC, Ptacek W, Naether S et al. Virtobot- a multi-functional robotic system for 3D surface scanning and automatic post mortem biopsy. Int J Med Robot 2010; 6: 18–27.
9. Saunders SL, Morgan B, Raj V et al. Targeted post-mortem computed tomography cardiac angiography: proof of concept. Int J Legal Med 2011; 125: 609–16.
10. Roberts ISD, Benamore RE, Peebles C et al. Diagnosis of coronary artery disease using a minimally invasive autopsy: evaluation of a novel method of post-mortem coronary CT angiography. Clin Radiol 2011; 66: 645–50.
11. Grabherr S, Doenz F, Steger B et al. Multi-phase post-mortem CT angiography: development of a standardized protocol. Int J Leg Med 2011; 125: 791–802.
12. Bolliger SA, Filograna L, Spendlove D et al. Postmortem Imaging-Guided Biopsy as an Adjuvant to Minimally Invasive Autopsy With CT and Postmortem Angiography: A Feasibility Study. Am J Roentgenol 2010; 195: 1051–6.
13. Rutty GN, Robinson C, Morgan B et al. Fimag: the United Kingdom disaster victim/forensic identification imaging system. J Forensic Sci 2009; 54: 1438–42.
2. Jeffery AJ. The role of computed tomography in adult post-mortem examinations: an overview. Diagnostic Histopathology 2010; 16 (12): 546–51.
3. Levy AD, Harcke HT. New approaches to radiology in mass casualty situations. Brogdon's Forensic Radiology (2nd edition), 2011.
4. Rutty GN, Robinson CE, BouHaidar R et al. The role of mobile computed tomography in mass fatality incidents. J Forensic Sci 2007; 52: 1343–9.
5. Sidler M, Jackowski C, Dirnhofer R et al. Use of multislice computed tomography in disaster victim identification – advantages and limitations. Forensic Sci Int 2007; 169 (2–3): 118–28.
6. RCR/RCPath statement on standards for medico-legal post-mortem cross-sectional imaging in adults. The Royal College of Radiologists. The Royal College of Radiologists. London. 2012.
7. Rutty G. Can cross-sectional imaging as an adjunct and/or alternative to the invasive autopsy be implemented within the NHS? NHS Implementation Sub-group, Leicester, England; 2012 October.
8. Ebert LC, Ptacek W, Naether S et al. Virtobot- a multi-functional robotic system for 3D surface scanning and automatic post mortem biopsy. Int J Med Robot 2010; 6: 18–27.
9. Saunders SL, Morgan B, Raj V et al. Targeted post-mortem computed tomography cardiac angiography: proof of concept. Int J Legal Med 2011; 125: 609–16.
10. Roberts ISD, Benamore RE, Peebles C et al. Diagnosis of coronary artery disease using a minimally invasive autopsy: evaluation of a novel method of post-mortem coronary CT angiography. Clin Radiol 2011; 66: 645–50.
11. Grabherr S, Doenz F, Steger B et al. Multi-phase post-mortem CT angiography: development of a standardized protocol. Int J Leg Med 2011; 125: 791–802.
12. Bolliger SA, Filograna L, Spendlove D et al. Postmortem Imaging-Guided Biopsy as an Adjuvant to Minimally Invasive Autopsy With CT and Postmortem Angiography: A Feasibility Study. Am J Roentgenol 2010; 195: 1051–6.
13. Rutty GN, Robinson C, Morgan B et al. Fimag: the United Kingdom disaster victim/forensic identification imaging system. J Forensic Sci 2009; 54: 1438–42.
2. Jeffery AJ. The role of computed tomography in adult post-mortem examinations: an overview. Diagnostic Histopathology 2010; 16 (12): 546–51.
3. Levy AD, Harcke HT. New approaches to radiology in mass casualty situations. Brogdon's Forensic Radiology (2nd edition), 2011.
4. Rutty GN, Robinson CE, BouHaidar R et al. The role of mobile computed tomography in mass fatality incidents. J Forensic Sci 2007; 52: 1343–9.
5. Sidler M, Jackowski C, Dirnhofer R et al. Use of multislice computed tomography in disaster victim identification – advantages and limitations. Forensic Sci Int 2007; 169 (2–3): 118–28.
6. RCR/RCPath statement on standards for medico-legal post-mortem cross-sectional imaging in adults. The Royal College of Radiologists. The Royal College of Radiologists. London. 2012.
7. Rutty G. Can cross-sectional imaging as an adjunct and/or alternative to the invasive autopsy be implemented within the NHS? NHS Implementation Sub-group, Leicester, England; 2012 October.
8. Ebert LC, Ptacek W, Naether S et al. Virtobot- a multi-functional robotic system for 3D surface scanning and automatic post mortem biopsy. Int J Med Robot 2010; 6: 18–27.
9. Saunders SL, Morgan B, Raj V et al. Targeted post-mortem computed tomography cardiac angiography: proof of concept. Int J Legal Med 2011; 125: 609–16.
10. Roberts ISD, Benamore RE, Peebles C et al. Diagnosis of coronary artery disease using a minimally invasive autopsy: evaluation of a novel method of post-mortem coronary CT angiography. Clin Radiol 2011; 66: 645–50.
11. Grabherr S, Doenz F, Steger B et al. Multi-phase post-mortem CT angiography: development of a standardized protocol. Int J Leg Med 2011; 125: 791–802.
12. Bolliger SA, Filograna L, Spendlove D et al. Postmortem Imaging-Guided Biopsy as an Adjuvant to Minimally Invasive Autopsy With CT and Postmortem Angiography: A Feasibility Study. Am J Roentgenol 2010; 195: 1051–6.
13. Rutty GN, Robinson C, Morgan B et al. Fimag: the United Kingdom disaster victim/forensic identification imaging system. J Forensic Sci 2009; 54: 1438–42.
________________________________________________
2. Jeffery AJ. The role of computed tomography in adult post-mortem examinations: an overview. Diagnostic Histopathology 2010; 16 (12): 546–51.
3. Levy AD, Harcke HT. New approaches to radiology in mass casualty situations. Brogdon's Forensic Radiology (2nd edition), 2011.
4. Rutty GN, Robinson CE, BouHaidar R et al. The role of mobile computed tomography in mass fatality incidents. J Forensic Sci 2007; 52: 1343–9.
5. Sidler M, Jackowski C, Dirnhofer R et al. Use of multislice computed tomography in disaster victim identification – advantages and limitations. Forensic Sci Int 2007; 169 (2–3): 118–28.
6. RCR/RCPath statement on standards for medico-legal post-mortem cross-sectional imaging in adults. The Royal College of Radiologists. The Royal College of Radiologists. London. 2012.
7. Rutty G. Can cross-sectional imaging as an adjunct and/or alternative to the invasive autopsy be implemented within the NHS? NHS Implementation Sub-group, Leicester, England; 2012 October.
8. Ebert LC, Ptacek W, Naether S et al. Virtobot- a multi-functional robotic system for 3D surface scanning and automatic post mortem biopsy. Int J Med Robot 2010; 6: 18–27.
9. Saunders SL, Morgan B, Raj V et al. Targeted post-mortem computed tomography cardiac angiography: proof of concept. Int J Legal Med 2011; 125: 609–16.
10. Roberts ISD, Benamore RE, Peebles C et al. Diagnosis of coronary artery disease using a minimally invasive autopsy: evaluation of a novel method of post-mortem coronary CT angiography. Clin Radiol 2011; 66: 645–50.
11. Grabherr S, Doenz F, Steger B et al. Multi-phase post-mortem CT angiography: development of a standardized protocol. Int J Leg Med 2011; 125: 791–802.
12. Bolliger SA, Filograna L, Spendlove D et al. Postmortem Imaging-Guided Biopsy as an Adjuvant to Minimally Invasive Autopsy With CT and Postmortem Angiography: A Feasibility Study. Am J Roentgenol 2010; 195: 1051–6.
13. Rutty GN, Robinson C, Morgan B et al. Fimag: the United Kingdom disaster victim/forensic identification imaging system. J Forensic Sci 2009; 54: 1438–42.
Авторы
В.А.Фетисов
ФГБУ Российский центр судебно-медицинской экспертизы Минздрава России. 125284, Россия, Москва, ул. Поликарпова, д. 12/13
f_vaddimm64@mail.ru
Federal Center of Forensic Medical Expertise of the Ministry of Health of the Russian Federation. 125284, Russian Federation, Moscow, ul. Polikarpova, d. 12/13
f_vaddimm64@mail.ru
ФГБУ Российский центр судебно-медицинской экспертизы Минздрава России. 125284, Россия, Москва, ул. Поликарпова, д. 12/13
f_vaddimm64@mail.ru
________________________________________________
Federal Center of Forensic Medical Expertise of the Ministry of Health of the Russian Federation. 125284, Russian Federation, Moscow, ul. Polikarpova, d. 12/13
f_vaddimm64@mail.ru
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