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Development of CT-guided biopsy sampling for time-dependent postmortem redistribution investigations in blood and alternative matrices—proof of concept and application on two cases

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Abstract

The postmortem redistribution (PMR) phenomenon complicates interpretation in forensic toxicology. Human data on time-dependent PMR are rare and only exist for blood so far. A new method for investigation of time-dependent PMR in blood as well as in alternative body fluids and tissues was developed and evaluated using automated biopsy sampling. At admission of the bodies, introducer needles were placed in liver, lung, kidney, muscle, spleen, adipose tissue, heart, femoral vein, and lumbar spine using a robotic arm guided by a computed tomography scanner (CT). Needle placement accuracy was analyzed and found to be acceptable for the study purpose. Tissue biopsies and small volume body fluid samples were collected in triplicate through the introducer needles. At autopsy (around 24 h after admission), samples from the same body regions were collected. After mastering of the technical challenges, two authentic cases were analyzed as a proof of concept. Drug concentrations of venlafaxine, O-desmethylvenlafaxine, bromazepam, flupentixol, paroxetine, and lorazepam were determined by LC-MS/MS, and the percentage concentration changes between the two time points were calculated. Concentration changes were observed with both increases and decreases depending on analyte and matrix. While venlafaxine, flupentixol, paroxetine, and lorazepam generally showed changes above 30 % and more, O-desmethylvenlafaxine and bromazepam did not undergo extensive PMR. The presented study shows that CT-controlled biopsy collection provides a valuable tool for systematic time-dependent PMR investigation, demanding only minimal sample amount and causing minimal damage to the body.

New strategy for time-dependent postmortem redistribution studies by CT guided biopsy sampling prior to autopsy and comparison of drug concentrations at these two time points using validated LC-MS/MS quantitation.

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Acknowledgments

The authors would like to thank PD Dr. Frank T. Peters for the helpful discussion on statistical problems.

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Authors and Affiliations

  1. Department of Forensic Pharmacology & Toxicology, Zurich Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse 190/52, 8057, Zürich, Switzerland

    Sandra N. Staeheli, Thomas Kraemer & Andrea E. Steuer

  2. Department of Forensic Medicine & Imaging, Zurich Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse 190/52, 8057, Zürich, Switzerland

    Dominic Gascho, Juergen Fornaro, Patrick Laberke, Lars C. Ebert, Rosa Maria Martinez & Michael J. Thali

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  1. Sandra N. Staeheli
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  2. Dominic Gascho
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  3. Juergen Fornaro
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  4. Patrick Laberke
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  6. Rosa Maria Martinez
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  7. Michael J. Thali
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  8. Thomas Kraemer
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  9. Andrea E. Steuer
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Correspondence to Andrea E. Steuer.

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Ethical approval was obtained by the cantonal ethics committee of Zurich, Switzerland (approval number 42.2005).

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The authors declare that they have no competing interests.

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Staeheli, S.N., Gascho, D., Fornaro, J. et al. Development of CT-guided biopsy sampling for time-dependent postmortem redistribution investigations in blood and alternative matrices—proof of concept and application on two cases. Anal Bioanal Chem 408, 1249–1258 (2016). https://doi.org/10.1007/s00216-015-9234-9

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  • DOI: https://doi.org/10.1007/s00216-015-9234-9

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