• Can cross sectional imaging contribute to the investigation of unexplained child deaths? A literature review.

      Beck, Jamie J.W. (2014)
      Background This review examines the factors that can influence an investigation into the unexpected death of a child before considering if using imaging techniques could be of benefit. Method A systematic search strategy was adopted to search databases using keywords, these results were then subjected to inclusion and exclusion criteria to filter and refine the evidence base further. Discussion More research is published on the use of MRI in comparison with other modalities. There is evidence in the case of MRI in particular that its use could be of benefit in identifying and ruling out potential causes of death in children. Conclusion More research is needed on the use of CT but the routine use of MRI in child death investigation could now be considered. Ethical considerations appear to be a barrier to research in this area and discussions as to how such considerations can be overcome is necessary.
    • Trauma imaging in and out of conflict: A review of the evidence.

      Beck, Jamie J.W. (2012)
      Aim To review the recent evidence that has resulted from experiences in and out of conflict in relation to improving imaging in cases of major trauma. Method A search of electronic databases, the internet and Cochrane library was undertaken to identify relevant publications which were analysed in terms of quality. Evidence that has emerged from civilian and military practice that could influence the practice of major trauma imaging in future was discussed. Results The importance of speed in assessing patients suffering major trauma is becoming more recognised. There is growing evidence that the use of portable ultrasound at the site of major trauma as first line investigation has potential. In more stable patients, the evidence for whole body CT at the expense of radiography is also growing. The concern regarding availability and radiation dose related to CT scanning remain significant but with the outcome of the recent Major Trauma Review and improvements in CT scanning techniques, such concerns are being addressed. There is limited research in the use of MRI in relation to major trauma. Conclusion Ultrasound at the sight of major trauma has potential but further research will be needed. Factors such as operator training in particular need to be considered. CT scanning remains an important diagnostic tool for patients suffering major trauma and this is borne out by the Major Trauma Review and NICE guidelines. The availability of CT scanning in relation to accident and emergency scanning is a factor the Major Trauma Review has highlighted and the close proximity of new CT scanners to accident and emergency is a factor that will need to be taken into account in strategic planning. Given the growing evidence of CT involvement, the continued practice of cervical spine and pelvic radiography in cases of major trauma should be questioned.
    • What is the future of imaging in forensic practice?

      Beck, Jamie J.W. (2011)
      The last two decades has seen increased use of imaging in forensic practice. Although radiography has been used historically, the evidence base for the use of computed tomography and magnetic resonance imaging in forensic practice appears to be growing. This article reviews the evidence base for the use of radiography, CT and MRI in an attempt to ascertain the future use of these imaging techniques in forensic medicine.