Highlights from our Post-Mortem Imaging Course: by Dr Sarah Fleming
1–2 May 2025, Nottingham
On a warm evening on the last day of April, with the horses put to bed, dogs fed and dozing in their beds, with the family left watching TV, my colleague and I are found driving to Nottingham. A girls’ trip you may be thinking, but no, we are chatting about post-mortem imaging and the course we are about to deliver over the next two days. It is 20 years since I was last in Nottingham as a medical student. Upon arriving in the city centre, Nottingham is completely unrecognisable; trams are now here, new restaurants and shops, and also the new road layout which requires a degree in navigation to understand. Times have moved on, but there are still some things that remain steadfast and remind you of old times. The same can be said of post-mortems. The times we knew 20 years ago have radically changed with the onset of new technology combined with traditional techniques. The expectations of the public have increased, with demand for the truth in both life and death.
It is our third post-mortem imaging course, and we have learnt and grown from the success of the previous courses held in Cambridge. This year I was joined by fantastic colleagues from a variety of backgrounds to give insight into the world of post-mortem imaging and how this can be used to support the deceased to give answers to their story. The course highlighted the need for a multidisciplinary approach, with the pathologist as the keystone to this service working alongside the coroner. Laura Howlett started the first day off, describing how to deliver a coronial and forensic imaging service, and the importance of understanding the legalities and documentation which underpin forensic cases. Paul Hunter then followed, teaching about the use of angiography in post-mortem studies. He also shared experience of disaster victim identification (DVI) processes and how radiology plays a vital role in such processes. Just before lunch, I shared the reporting of post-mortem cases and some of the common pitfalls in reporting such imaging. Prof Jason Payne-James got the afternoon off to a great start, sharing experience as a lead medical examiner and how this role is changing the way the coroners work. The day finished by showing some interesting cases and examples from my experience in reporting post-mortem imaging.
On the second day we started off literally with a bang, Dr Rachel Bolton-King shared her fantastic knowledge and expertise in forensic ballistics. Laura then joined Rachel to share some interesting cases where ballistics had been present, and how best to image these patients to ascertain as much forensic information as possible. To round off the morning I then showed more interesting cases, which created great discussion before lunch. On the final session of the afternoon, Prof Amaka Offiah, who was unable to join face to face, shared her experience and knowledge of paediatric cases both for suspected physical abuse (SPA) and also in the post-mortem setting. Her cases highlighted the importance of imaging to protect the living, but also to tell the story of these children who had no voice to tell it themselves.
The course was enjoyed by radiographers, APT’s, pathologists and radiologists. The attendees were super engaged and asked excellent questions as always. This course is evolving each year bringing new people to teach the sessions each time. I am always learning from the feedback from delegates and look forward to creating next year’s program. This year, for the first time, we are doing a one-day update course in ‘digital autopsy’ this December. It would be fantastic to see new and old faces on this virtual update, to share experiences and knowledge.
— Dr Sarah Fleming
Consultant Radiologist, Queen Elizabeth Hospital, King’s Lynn
